by Robert Wiener
NJJN Staff Writer

July 23, 2009

The Daughters of Israel Nursing Home in West Orange will close its senior day care center — a victim, its directors said, of shrinking enrollment and declining state Medicaid reimbursements.

The Herr Adult Medical Day Center, which provides recreational and medical services to senior citizens, is targeted to close by Aug. 31, said Susan Grosser, executive director of Daughters of Israel.

It will be replaced by a subacute rehabilitation facility for post-surgical patients. Such patients will spend up to four weeks at the nursing home before returning to their regular residences.

While the day care center has always operated at a deficit, “the rehab facility can add significant dollars to our budget,” said Grosser, although, she added, “we don’t yet have any projection of how much it will earn.”

The Herr Center opened in 1975. “For the 11 years I’ve been here, the program has not really been a revenue generator, but when the economics were better that did not matter,” said Grosser. “It was a service that we provided to the community.”

At its peak, the center served 50 to 60 people a day. “Even at a deficit it was sustainable,” she said.

Currently, however, just 20 to 25 clients visit the center on any given day, most of them on Medicaid. “Our program was an adult medical day center, and about half of the people did not need a medical day center,” Grosser explained.

Because of state cutbacks, she said, “we were set to lose about $10 a day per Medicaid client.”

Grosser emphasized that “the day center is not the core of what we do at Daughters. We felt that was a change we needed to make to help maintain our core mission.”

The nonprofit Daughters of Israel provides comprehensive services for some 300 residents, including long-term care and senior housing. It is a partner agency of United Jewish Communities of MetroWest New Jersey.

After the closing was announced, the professional executive committee of MetroWest Cares, made up of senior staff from the federated agencies serving older adults, met on July 21 to discuss the move’s implications.

“There was an immediate conversation about what we in the community can do to recover part of this,” said Karen Alexander, director of eldercare services at UJC MetroWest.

In attendance at the meeting were representatives of Daughters of Israel, JCC MetroWest, Jewish Vocational Service, Jewish Family Service, Jewish Community Housing Corporation, and the Jewish Service for the Developmentally Disabled.

“There was a consensus that this is a hole in the fabric of the services the community has been able to provide. I hate to say it, but it is the kind of thing we anticipated in this economy,” said Alexander.

‘Heavy hearts’

The rehab center that will open will be run in partnership with Select Medical Services, the parent corporation of Daughters’ next-door neighbor, the Kessler Institute for Rehabilitation.

Its patients will be housed in a 27-bed unit that is part of the nursing home’s ambitious renovation project, which is targeted for completion in mid-October.

Grosser said there are no current plans to curtail other programs or decrease the budget by staff cutbacks.

Daughters’ employees are working to find alternative programs for Herr Center clients, working with their families and taking clients on field trips to other centers in the area to help ease transitions.

“We have definitely been talking with clients’ families and helping them through the process,” Grosser said. “Change is never easy.

“We don’t have any confirmed placements yet, and of course, our doors will not close until everybody is appropriately placed.”

She said the decision to close the center was not an easy one.

“We sit with heavy hearts,” she said. “This is a program that has been part of our community for many years. It served a wonderful purpose. But we needed to take a serious look at our programs here.”

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