This history of benefiting the community is fundamental to the Jewish Home’s initiatives and philosophy, and informs its membership in “Building a Healthier San Francisco” – a collaboration of San Francisco hospitals, Department of Public Health, United Way, human services’ providers, philanthropic foundations, and numerous community-based organizations.
The following gives an overview of these community services from July 2011 to June 2012. For a complete account, download our comprehensive Community Benefit Report that covers this time period.
In 2009, the Jewish Home initiated its site master plan, with the goal of bringing it into alignment with health care reform and the way in which care will be delivered in the future. To accommodate seniors’ diverse and changing wishes, needs and interests, the Home aims to develop a full continuum of care that will be sustainable and viable for generations to come; serve a broader range of individuals than it does currently; and also revitalize the surrounding community, benefiting San Francisco as a whole. With this integrated model of housing and services – encompassing residential care and skilled nursing, independent and assisted living memory care, short-term rehabilitation, acute geriatric psychiatry, and community-based healthcare services – individuals will be able to age in place or be served through home- and community-based clinics and programs, technological advances, and innovation.
While the Jewish Home may be changing the mix of services it provides, its mission to enhance and enrich the quality of life for the Bay Area’s older adults remains steadfast, as does its efforts to continue to provide the best care and services possible to its key population of frail, vulnerable elders, including charitable support. In general, the Jewish Home serves the most medically/cognitively frail, as well as financially indigent elders (82 percent of Jewish Home residents are indigent and/or Medi-Cal recipients who do not pay the full cost of care), with an average age of 87.
Innovations on the Jewish Home’s Alzheimer’s Garden Unit include an enclosed garden accessible only to this living environment and the creation of a more homelike setting in order to better serve these individuals. Furthermore, the careful, selective use of the WanderGuard (a signaling device that alerts when a person wearing one is about to exit the facility) enables the Home to care for many more residents with Alzheimer’s, as they may then safely reside on other living environments located on the campus. This also affords these individuals greater freedom to enjoy a variety of secure areas and outdoor spaces.
STARS, the Jewish Home’s short-term and rehabilitation services program, is designed for those age 65 or older who require temporary skilled oversight – including medical rehabilitation and management by on-site physicians, nursing care, and physical, occupational and speech therapies – usually following discharge from an acute hospital or an acute illness, with the goal of returning to the community. In response to the greater need for short-term and rehabilitation services, the Home has significantly expanded the number of beds initially allotted to this type of care.
The Jewish Home is one of the only enterprises in 14 Bay Area counties that ensures the emotional and mental health of seniors through its on-site acute geriatric psychiatry hospital. In fact, it is an imperative service to the greater Bay Area community, as many other similar services have closed. Licensed by the Department of Public Health, acute short-term stays are available to both voluntary and involuntary patients, thus serving a greater number of elders in their time of psychiatric crisis.
Mental health problems in the elderly are often combined with multiple, chronic illnesses that can frequently be disabling. The Jewish Home’s multidisciplinary expertise is applied to diagnose and treat the acute psychiatric issue, while also working with the patient and their family/caregiver to address other aspects of their health. Individualized treatment plans include therapy, specially focused activities, and expert, dedicated care – delivered by geriatric-care professionals who recognize older adults’ complex medical needs and their differing reactions to medications, in addition to acute psychiatric illnesses. Additional modalities, such as acupuncture, has helped many of these patients deal with panic attacks, chronic pain and anxiety issues, and the inclusion of live classical music offerings support a more soothing, healing environment.
The fact that the hospital regularly has a near-full census further solidifies that there is a need for this unique program that addresses older adults’ combined emotional, physical, medical, and medicinal requirements. It is a need that the Jewish Home is successfully meeting.
The Jewish Home aims to promote and protect the community’s health by advancing and sharing knowledge and understanding of the factors that affect health. The following are some of the numerous endeavors undertaken during fiscal year ending June 30, 2011.
The Jewish Home’s president and CEO was in attendance at Aging Services of California’s annual conference in Palm Springs, Calif., in May 2012. (Aging Services is the leading advocate for quality nonprofit senior living and care, representing over 400 nonprofit providers of aging services that collectively serve more than 100,000 seniors.) In addition to being present while the immediate past chair of the Jewish Home’s board of trustees received Aging Services’ Trustee of the Year award, the Home’s CEO was honored to be asked to give the reflection at the conference’s Opening General Session, consistent with this year’s theme, “Inspire, Serve and Advocate.”
The Jewish Home’s president and CEO and chief financial officer attended the 2011 Ziegler Senior Living Finance + Strategy Conference held in Colorado Springs, Colo., in September 2011. This invitation-only event is the industry’s leading conference, focusing on cutting-edge finance and strategic positioning trends affecting today’s senior living providers.
The Jewish Home’s chief administrative officer serves on LeadingAge’s 2012 Not-For-Profit Leadership Cabinet. LeadingAge is made up of 5,400 nonprofit organizations in the United States, 38 state partners, businesses, research partners, consumer organizations, foundations and a broad global network of aging services organizations that reach over 30 countries. The leadership cabinet is charged with, amongst other things, reinforcing the responsibilities that nonprofits have as stewards of philanthropic support and public interest; demonstrating that nonprofits are serving the public good; preparing a report that reflects on the challenges to tax-exemption and recommend actions that nonprofits can take; and communicating nonprofits’ purpose, strength and impact to entities upon which nonprofits rely, such as policy makers, funders, donors, and the public at large.
Director of the Jewish Home’s Center for Research on Aging was selected as the recipient of the 2012 American Society for Clinical Pharmacology and Therapeutics (ASCPT) William B. Abrams Award in Geriatric Clinical Pharmacology. The award honors an investigator in geriatric clinical pharmacology for outstanding contributions to the field. ASCPT consists of over 2,100 professionals committed to promoting and advancing the science and practice of human pharmacology and therapeutics. The Society focuses on improving the understanding and use of existing drug therapies, and developing safer and more effective treatments for the future.
The Jewish Home’s chief nursing officer was able to bring back a complement of best practices ideas and innovative programs from other healthcare communities and organizations as a result of his attendance at the March 2012 American Society on Aging Conference in Washington, D.C. As the conference included an advocacy day at Capitol Hill, there was an opportunity to meet with the lobbyists for a variety of programs and bills advocating for older adults. Discussions covered the Affordable Care Act, reauthorization of the Older American’s Act, entitlement programs, and enhanced quality of life for those we serve. Conference workshops dealt with geriatric care management, care transitions, and quality assurance programs.
The Jewish Home recognizes that providing and collaborating in educational opportunities for adults foster personal and professional development, enhance a sense of community, and promote cross-cultural understanding, cooperation, and support. Below are a few examples of the learning programs and information-sharing made available over the fiscal year ending June 30, 2012.
Over the past 39 years, the Jewish Home has partnered with San Francisco City College in offering several adult education classes to the general community. Approximately 20 to 25 students enroll each semester in the Creative Arts class at the Jewish Home, a weekly all-day endeavor of nine months’ duration. As this class includes resident artists, a spirit of collaboration and participation between the Home and the community is fostered and strengthened. Tai-chi Chia® Mind/Body/Spirit/Health is another course provided through City College that meets weekly at the Home each semester. It is also open to the general community and has an enrollment of 20 to 25 students. Two separate classes were held this past fiscal year, so as to accommodate English-speaking residents as well as those for whom Russian is their primary language.
The Jewish Home’s rabbi and director of Jewish Life regularly teaches in the Jewish community and participates in both educational and leadership development programs with other agencies. Organizations include: Jewish Family and Children’s Services; Union for Reform Judaism; Bay Area Jewish Healing Center (this involves joint training and supervision of spiritual care partners for the collaborative end-of-life program, Kol Haneshama); Northern California Presbyterian Homes & Services, covering an annual event entitled “The Day of the Spirit”; and Bay Area congregations. He is often invited to make presentations to chaplains, Jewish professionals, and lay people on the use of poetry and sacred texts in pastoral care, and on spiritual issues related to aging, illness, dementia and death.
The rabbi’s community teachings, his studies, and his work at the Jewish Home enhance and complement one another. Doorways of Hope: Adapting to Alzheimer’s, a chapter he penned, was included in the book Broken Fragments: Jewish Experiences of Alzheimer’s Disease through Diagnosis, Adaptation, and Moving On (ed. Douglas J. Kohn, 2012). Doorways of Hope combines the rabbi’s experience at the Home with scholarship on Jewish tradition, dementia, and the literature of pastoral care. The entire volume can be useful across the board – from Jewish Home staff and volunteers, to residents and family members.
Director of the Jewish Home’s Center for Research on Aging moderated a panel titled Healthy Brain Aging: What People of all Ages Need to Know in February 2012. Sponsored by the Business Leadership Council of the San Francisco-based Jewish Community Federation, the panel addressed genetics, dementia, and Alzheimer’s disease. Attendees learned about the latest research on recognizing the problems associated with one’s aging brain, as well as remedies to treat the symptoms.
The influx of elderly Russian émigrés to the Bay Area had a significant impact upon San Francisco’s Jewish community. The Jewish Home continues to address this population’s need for residential care, programs, and services. With the assistance of full-time Russian-speaking staff in a range of disciplines and departments, over 140 Russian-speaking residents benefit from the robust Russian services program offered by the Home.
Older adults, particularly low-income seniors, frequently tend to self-isolate. Furthermore, the challenges of shopping for and preparing a healthful meal can be quite overwhelming. In response to this identified need, the Jewish Home – equipped with one of the only kosher kitchens in the Bay Area capable of preparing meals for upwards of several hundred people in any given week – has collaborated for more than 10 years with the San Francisco Jewish Community Center (JCC) to provide hot, nutritious meals to community-dwelling seniors, regardless of their religious or cultural affiliation.
The Home prepares approximately 15,000 meals per year (about 1,250 a month) for the JCC. Additionally, the Home prepares frozen meals that are delivered to seniors who are unable to go to the center, due to illness or injury.
The Jewish Home also ensures that our community seniors are not forgotten or alone during special times. That means preparing tasty, traditional food for 11 important holidays throughout the year.
Seniors in our community need a place to feel at home and interact with friends. Without these meals, many of them would be at risk for poor nutrition and social isolation. Providing fare for the JCC’s older adults is consistent with the Jewish Home’s philosophy of partnership with the nonprofit community in service to our elders.
The Jewish Home’s medical director for short-term and rehabilitation services (STARS), the Home’s community liaison, associated team members and colleagues continue to inform, provide community outreach, and establish strategic partnerships with Bay Area professionals and entities with respect to the Home’s on-site short-stay programs, namely STARS and its acute geriatric psychiatry hospital. The following reflect the range of this past year’s undertakings:
The Jewish Home’s partnership with teams from the University of California, San Francisco (UCSF) results in referrals in various areas: UCSF’s congestive heart failure team works with STARS to diminish the need for post-operative re-admission by following patients during their STARS stay and thereafter at home. This program is being replicated in association with St. Mary’s Medical Center, San Francisco. UCSF’s orthopedic surgery team begins the STARS admission process on the day of surgery in preparation for admission to STARS on day four. UCSF’s stroke recovery bridge program admits patients to STARS for lower impact rehabilitation. The goal is to increase patient strength to allow for more intensive (acute) rehabilitation. This program is being replicated with St. Mary’s, Saint Francis Memorial Hospital, and California Pacific Medical Center (CPMC), Davis Campus. UCSF’s palliative care team prepares patients to be admitted for end-of-life palliative care.
All case managers have been informed that the Jewish Home has become a member of the Health Net alliance. It is notable that Health Net’s medical management director has established STARS as their preferred provider (“first choice”) for seniors requiring such services. This preferred provider status is directly related to the Jewish Home’s five-star rating from the U.S. Centers for Medicare & Medicaid Services.
As part of a new bridge program, Stanford Medical Center refers patients to the Home’s STARS program; STARS rehabilitates patients until they are able to transfer to another facility for acute rehabilitation.
The Jewish Home partners with local high schools that aim to involve youth in their community by encouraging them to fulfill needs in their respective milieus. Mutual goals include the promotion of civic responsibility and the development of leadership skills. During this past fiscal year, students from Archbishop Riordan High School, Galileo High School, and Saint Ignatius completed their community service requirements at the Home.
The Home also partners with local colleges to host service-learning programs, which combine experiential learning with community service. This past year, students from City College of San Francisco and San Francisco State University were placed at the Home.
Regarded as one of the premier training sites for rabbinic interns specializing in geriatric work, the Home continues to provide training and supervision to rabbinic students from Hebrew Union College – Jewish Institute of Religion in Los Angeles, Calif. (in cooperation with the Kalsman Institute on Judaism and Health), and Hebrew Union College – Jewish Institute of Religion (HUC-JIR) in New York. The students gain knowledge about aging and the illnesses associated with old age from residents, staff members across all departments, volunteers, and family members. Through this essential on-the-job training, the students learn about collaboration, discover how a large institution works, and how a rabbi functions within this kind of setting. These internship opportunities also enable Jewish Home residents to experience the gratification of being mentors to young rabbinic students.
Second-year medical students from University of California, San Francisco (UCSF) are hosted by the Jewish Home’s rabbi every fall/winter as part of the students’ essential core curriculum. In fiscal year 2012, 30 medical students chose to attend five sessions at the Jewish Home. The program helps the medical students appreciate the challenges and rewards of working with patients and families during serious and terminal illness. The students observe the rabbi’s style of visitation with Jewish Home residents, study texts and poems with him, and reflect on ways in which pastoral care may be integrated into a physician’s practice.
In partnership with UCSF, a graduate student pursuing a master’s in nursing completed her internship at the Jewish Home by piloting a new training that focuses on developing nursing unit-specific quality improvement (QI) programs. Taking QI measures and practices from the overarching facility-wide level to individual units has resulted in enhanced team work, a greater sense of community among staff, increased self-worth, creative problem-solving, and the opportunity to share in successes. The UCSF student has reported the program’s positive outcomes to UCSF and other comparable facilities.
With the Jewish Home’s chief nursing officer acting as preceptor, the Home is offered as an internship site for San Francisco State University (SFSU) students in the administrator-in-training program. This forms part of SFSU’s master’s in gerontology curriculum.
Achieve, a year-round, four-year high school scholarship and enrichment program for underserved, low-income minority students, opens a world of possibilities by providing students with access to quality education – including cultural, career, and community service experiences. A total of 32 achieve students from Archbishop Riordan High School and Mercy High School participated in an academic-year program at the Jewish Home, where they assisted residents of the Home with a variety of activities, ranging from Oneg Shabbat (post-Sabbath) services to acting as companions. Partnerships and interactions such as these result in a deeper understanding and appreciation of both generations’ perspectives, life experiences, and challenges.
The Home frequently participates in joint educational programs with religious and non-religious youth groups, ranging from kindergarteners to those attending middle school. Teachers from synagogues often request visits to the Home when they wish to introduce their students to the wider Jewish community, educate them about the cycle of life, and respect for elders. Their visits are also intended to promote the concept of community service. The Home collaborates with, among others, Bay Area Mitzvah Corps, Brandeis Hillel Day School, Congregation Beth Am, Congregation Beth El, Congregation Beth Sholom, Congregation Emanu-El, Congregation Kol Shofar, Congregation Sha’ar Zahav, Congregation Sherith Israel, Mercy High School, Peninsula Beth El, Peninsula Jewish Community Center, and Peninsula Temple Sholom.
The Young Adults Division (YAD) of the Jewish Community Federation provided community service at the Jewish Home by assisting with activity programming and celebrating the Jewish holidays with the Home’s residents and patients. These kinds of undertakings make for rewarding and enjoyable interactions across generations.
Employment Plus, a nonprofit agency, seeks both paid and voluntary employment for adults with developmental disabilities and provides on-the-job support through job coaching. The long-term goal of the program is to have individuals become fully integrated, participatory, and contributing members of the community in which they work and live. The short-term goal is to maximize each individual’s self-reliance, independence, and productivity. The Home serves as a work site for four adult participants in this program who perform duties in the Home’s Environmental Services department one and a half hours per day, four days a week, accompanied by a job coach.
Medical social workers, hospital discharge planners, and other geriatric specialists gathered at the Jewish Home in October 2011 for the Home’s 11th annual hosting of the Bay Area Social Workers In Health Care event. This much-anticipated occasion once again featured a reception, a dinner, and an enlightening hour of continuing education. From Isolation to Inclusion: Reaching and Serving LGBT Older Adults was the title of the evening’s special programming component, presented by the director of Education and Outreach at Openhouse. With Openhouse’s focus on developing critically needed housing, services and community programs to support the health and well-being of lesbian, gay, bisexual and transgender older adults, the evening’s guests learned how to create welcoming, safe, and secure environments for LGBT clients.
The Jewish Home is a mid-size employer in the city of San Francisco and provides employment to more than 700 employees each year, ranging from skilled labor to executive-level positions.
Staff of the Jewish Home supported the efforts of Jewish Family and Children’s Services (JFCS) by donating a significant number of new and gently used coats for JFCS’s clients of all ages. The Jewish Home shares JFCS’s commitment to helping those who need it most, fostering strong individuals, strong families, and a strong community.
Staff of the Jewish Home had the benefit of participating in HealthWorks in October 2011. This wellness program, run in collaboration with Kaiser Permanente, provided a comprehensive health screening covering blood pressure readings, body fat percentage, BMI, total cholesterol and glucose.
The Jewish Home embarked upon a new process in 2011 to hear directly from residents and staff about their levels of satisfaction in various areas. In partnership with a research company, anonymous and thus confidential surveys were conducted to help identify community and organizational strengths, provide standardized data that is comparable across communities, and impart information to direct quality improvement efforts. An interdepartmental task force has been charged with developing and implementing detailed action plans to improve life and work experiences at the Home. These surveys are ongoing, with the next survey process scheduled for completion in March 2013.
The Home’s Emergency Management Committee is responsible for ensuring that both residents and staff are primed, equipped, and safe during any expected (and unexpected) crisis, and that all are educated, as well. This committee also partners with community agencies, attending external meetings with other hospitals to share policies and ideas, and participating in citywide table-top drills. This enables hospitals, skilled nursing homes, and San Francisco’s first responders to practice emergency preparedness in a larger, citywide response mode.
The Jewish Home’s security personnel conduct patrols of the facility’s perimeter and abutting neighborhood area as a regular part of their 24-hours, seven-days-a-week security measures and safety protocols. By working in concert with the local police department, being vigilant about tracking unusual occurrences, and maintaining open lines of communication with the SFPD, the Home’s security team plays a significant role in preventing some neighborhood crime, while continuing to ensure the safety of its residents, patients, staff, visitors, and nearby dwellers.
The Jewish Home successfully partners with local organizations, fostering dialogue, collaborations, and ongoing communications with its neighbors.
Since the inception of the Excelsior Street Festival 10 years ago, the Home has served as a major sponsor of this annual event.
A strong Jewish Home contingent, including family members and good friends, raised funds for and took part in the Walk to End Alzheimer’s in September 2011. This nationwide event raises awareness and funds for Alzheimer’s care, support and research to treat and prevent the disease, and to provide programs to improve the lives of millions of those affected.
Enriching the quality of life of older adults is the Jewish Home’s mission – and also an accelerated scientific imperative. The need for research to develop new therapies for disorders of aging, diseases of the elderly, and prevention of age-associated diseases is even more essential and relevant today. Statistics show that people are living longer and geriatric care has changed; it now focuses on quality of life – helping individuals retain their physical and mental capacities for as long as possible.
The March 2012 appointment of the first occupant of the Jewish Home-based Harris Fishbon Distinguished Professorship in Clinical Translational Research in Aging will advance this urgent need for more geriatric research and further the Jewish Home’s mission of ensuring that people enjoy quality of life. This new, prestigious position is key to the success of the Jewish Home’s goal of being the leading center for geriatric clinical research in the San Francisco Bay Area.
With one in four older adults living with four or more co-occurring chronic conditions – many of them serious and thus contributing to high illness burden – the Fishbon appointee will lead the development of a research program to improve the care and health of older adults, including very old persons, by translating research findings into clinical benefits and therapies.
The Fishbon professorship is the product of a research partnership established in 2010 between the University of California, San Francisco, and the Jewish Home. The Jewish Home’s elderly population provides UCSF with the ideal setting for this research, while UCSF, one of the nation’s most significant academic medical centers, is an excellent partner in this work.
Director of the Jewish Home’s Center for Research on Aging and her co-investigator from UCSF’s Division of Geriatrics continue to study how multiple medications affect elderly Americans who suffer from multiple diseases, and how to improve their treatments. This ongoing study is made possible through funding by a National Institutes of Health challenge grant, an award garnered by the Jewish Home’s research director through the American Recovery and Reinvestment Act.
The Jewish Home’s chief nursing officer teaches two core classes, Aging Processes and Aging and Diversity, to students seeking a master’s degree in gerontology from San Francisco State University. His curriculum includes a day-long intern program at the Jewish Home. Designed to introduce the students to the unique aspects of working in a skilled nursing facility and encourage them to make it their career choice, the program covers every facet of the Home – from patient care, to meeting spiritual needs, to fundraising, and everything in-between. This experience brings the students’ course work to life and broadens their understanding of serving the elderly – a population that is growing faster than any other. In addition to expanding their knowledge base, students have an opportunity to view the Jewish Home’s high standards and philosophy of care. Outcomes are proving to be most positive: To date, a number of students have chosen to take up available positions at the Home.
In collaboration with the San Francisco-based American College of Traditional Chinese Medicine, the Home serves as a weekly on-site acupuncture clinic, helping acupuncture students gain experience in treating elders and providing residents who choose to manage their treatment through this modality with the opportunity to do so in a suitable setting and convenient manner.
As a complement to traditional medical care, Healing Touch – a therapeutic approach that uses gentle, non-invasive hands-on touch and energy techniques – has proven to be a particularly good tool for decreasing agitation in residents with dementia or Alzheimer’s disease. This award-winning program has been enthusiastically embraced by the Home’s culture, by the medical community, and beyond.
At the initiative of the Jewish Home’s rabbi and director of Jewish Life, the Home implemented Kol Haneshama: Jewish End-of-Life/Hospice Volunteer Program – a program of volunteer and staff training that the Jewish Home co-sponsors with the Bay Area Jewish Healing Center. The Home and the Healing Center have worked in close partnership with the Zen Hospice Project, a nationally recognized innovator in the training of volunteers for end-of-life care. In addition to the interagency cooperation that exists between the Jewish Home, the Bay Area Jewish Healing Center, and the Zen Hospice Project as a result of this program, numerous families have benefited from knowing their loved one formed a close relationship as they approached the end of their life.
The needs that this award-winning, nationally recognized program addresses is enhanced by the work of the Home’s Palliative Care Committee, an interdisciplinary group that looks beyond symptom management to the psychosocial and spiritual aspects of the end of life, of dying residents, and their families.
Congruent with the Jewish Home’s philosophy that no one who is actively dying should be going through this process alone, the Home collaborates with two Bay Area home care agencies, scheduling sitters (caregivers) for the times that staff may not be available, when family members live at a distance, or in those cases where the resident/patient does not have loved ones. These caregivers receive personal training by the Home’s chief nursing officer, thereby gaining valuable skills in the care of the elderly.
The Jewish Home has a 140-plus-year history of community benefit to the elderly population of the Bay Area. Objectives to continue this history of service are a principal part of the Home’s organizational philosophy and strategic planning initiatives. Specific activities to address community benefits include transforming the Jewish Home’s campus into a model of care that will benefit more older adults in the Bay Area (including the frail and vulnerable), address urgent societal challenges (such as the huge wave of baby boomers reaching retirement age), and help sustain the Jewish Home’s charitable mission by being financially viable; along with Jewish Home & Senior Living Foundation, establishing Jewish Senior Living Group to develop a broad and integrated network of senior living communities, programs, and services in the Bay Area; exploring collaborations with organizations whose missions are similar to that of the Jewish Home’s, with the intent of extending the breadth of care, programs, and services so as to better serve constituent members.
The board of trustees of the Jewish Home is committed to its long tradition of service to the entire community and, in particular, the underserved. It will continue to identify and plan for needs as the ages and demographics of both members of the community and the Home’s residents undergo change.