By Joel Magalnick, Editor, The Jewish Sound
The day I walked into the Summit at First Hill to chat with Jeff Cohen, CEO of the Kline Galland and Affiliates Jewish senior service organization, the atmosphere was nothing like the image of the dank, infirm life I had of the Kline Galland’s first days in an old farmhouse in Seward Park. The lobby bustled with residents, their visitors, and the occasional caregiver. As I sat with Cohen in the conference room, we could hear in the background two special guests: Members of the Seattle Opera who had come in that afternoon to give a performance.
If that’s the reality of the few hundred who live in the Summit’s 12-story tower, or a few miles south at the Kline Galland nursing facility in Seward Park, the real expansion over the past decade for the Jewish seniors’ organization has been not in physical structures, but in services ranging from home care to pain management to dying with dignity.
It’s what Cohen and outgoing board president Mark Kane call the “continuum of care,” and it’s what will keep Kline Galland relevant in the coming decades.
“Being in a position to provide the level of care to the elderly at all stages, from independent living to hospice, or full-scaled nursing, is wonderful that all of that can happen in a Jewish environment,” Kane said.
As the Kline Galland celebrates its 100th anniversary, Cohen sees his organization as one that’s on the vanguard of helping seniors as they age, whether it’s on his turf or theirs.
“We’re trying to meet the community’s needs in a different way — not so much with bricks and mortar, but with programs that people want and need, and also that the government is guiding providers to provide,” Cohen told The Jewish Sound. “To survive in this very dynamic healthcare environment, you need to change, and luckily we’ve had a board that’s very supportive and open and amenable to providing change that the community wants and needs.”
This care for seniors across the spectrum has resulted in an increase of services on multiple fronts in the past eight years:
• A doubling of the number of beds in the transitional care unit, which provides short-term rehabilitation for post-operative seniors, making it the largest in the state.
• Establishment of a palliative care unit, a home-based service that provides pain management care for the chronically ill.
• Creation of the only Jewish hospice service in the Northwest, offered in either of the Kline Galland’s facilities or off-site.
• A home-health agency that provides nursing care “to make sure the quality follows the patient home,” Cohen said, which applies to about 95 percent of the patients discharged.
• Expansion of the home-care program, where nurse’s aides help patients at home with bathing, dressing, medication reminders and more.
All of these programs, Cohen said, grew from the operating budget and are now self-sustaining.
With the arrival of the Affordable Care Act, known more familiarly as Obamacare, Cohen said Kline Galland had already been working to build up what the act embraces: “Giving appropriate care at the appropriate level for the appropriate cost,” he said.
In particular, Cohen referred to hospital readmissions, even if the readmission has nothing to do with the original ailment.
“The hospital’s going to be penalized,” Cohen said. “So the hospitals are really focused on partnering with places that could help prevent those readmissions and give really good care after they discharge the patient.”
These programs save hospitals and the state or federal government money, which keeps Kline Galland in the loop to continue to provide its services. But with the creation of these services came a change in mission: Kline Galland no longer serves just the Jewish community.
For one thing, “it’s the law,” according to Cohen. “If you take Medicaid and Medicare dollars, you have to serve everybody.” For another, to be able to scale these services, the Jewish community here is just not big enough to justify the cost structure.
“[It] is wonderful for us to be in the position to provide those services with a Jewish touch to the greater community,” Kane said.
The irony, however, is that with people coming in for weeks instead of years, “we’re serving significantly more of the Jewish community than we ever have before,” Cohen said.
One person who has helped to provide that Jewish touch for over two decades is Jeanie Alhadeff. She is a board member and former president, as well as the chair of the Kline Galland’s centennial celebration that takes place Oct. 22.
“When I first started on the board, we were just talking about a nursing home,” Alhadeff said. Today, “we are an organization that takes care of every single need or want as somebody ages.”
Alhadeff experienced the agency’s new services first-hand, when her mother, one of the first residents of the Summit at First Hill, entered hospice.
“From the social worker to the nurse to the chaplain, each one of them honored my mother with respect and dignity and love,” Alhadeff said. “They were an enormous support system for me, because caring for a parent who is failing can be a lonely experience.”
Alhadeff’s mother’s condition actually improved, so she no longer needs that care, but Alhadeff said it was important to have that service available.
Though the agency is for the most part doing well, with its budget having doubled to nearly $40 million since Cohen took over in 2006, the road ahead does look bumpy. The state has not adjusted its Medicaid payments for patients who cannot afford to pay for their care since 2008.
“Our costs continue to rise 3 percent every year. Our staff costs go up, our utility costs go up, Seattle is not exactly a low-cost place to do business,” Cohen said. “It has been extremely challenging to maintain the level of quality while at the same time balancing our budget every year.”
The coming legislative session will likely be a moment of truth for funding on all fronts, not just with how we care for seniors. Kline Galland is hoping at best to even the playing field. Cohen and the board have, by themselves and with other similar agencies, lobbied in Olympia to increase payments.
“It’s been more about avoiding diminishing reimbursements than getting significant increases,” Kane said.
As the state struggles to pay for seniors who can’t afford their own care, and with the huge wave of Baby Boomers about to come crashing down on the system, it will be up to Cohen to make sure his agency stays abreast of constant change in the healthcare system and stay above water.
“We’re watching the health care system change frequently, and he has the pulse on that and is trying to stay ahead of it,” Alhadeff said.
Cohen believes he and his staff are up for the challenge.
“One thing about Kline Galland,” he said. “It’s never been static.”