Margaret Tietz - doing more with less

The Margaret Tietz nursing and rehabilitation center in Jamaica has gone through a lot of changes since its founding in 1971 as a residence for aging Holocaust survivors, according to Gerald Hart, in his second year as executive director.
The original population of about 200 residents was a hearty lot - strong enough, or lucky enough to escape death at the hands of the Nazis. “It was a much healthier population back then,” Hart said. “We were more like an assisted living facility,” he continued.
With the passage of time, their numbers have dwindled - barely 15 of the elderly currently at the center are survivors of the camps.
Now, the Tietz Center has diversified its operations to include roughly 40 beds devoted to short-term rehabilitation and a small, 14-bed inpatient hospice unit.
The people within are also diversified, with Christians, Muslims and Buddhists exercising their religious and dietary preferences alongside Jewish residents.
“The interesting thing is that by consensus, everybody worships on Friday,” Hart remarked. “The way Queens has become the most diverse borough, we’ve become the most diverse in our patient population and staff,” he said.
Some of the diversification was also prompted by economic necessity. With more affluent elders seeking accommodations in warmer climes, facilities like the Tietz Center have come to rely more on sources like Medicaid reimbursements for revenue.
And therein lays a problem Hart contends.
“The reimbursement rates, which never fully covered the cost of the quality care we provide are being cut even more drastically in the state budget,” Hart laments. “Governor Spitzer has not been very friendly to long-term nursing care,” he said.
The method for funding the care of patients is a mind-boggling compilation of “trend factors” “case mixes” “base years” and “acuity levels,” among other factors.
Even before the latest proposed reductions, “For every $300 we spent providing care, we were only getting $220,” Hart explained.
For example, patients with dementia (typical in Alzheimer’s disease) usually require the highest levels of care, but aren’t acutely ill - thus a low “acuity level.”
“It costs a lot to properly care for (them) but the State says ‘they aren’t sick’ so they don’t reimburse nearly enough” he said.
They struggle to make up the shortfall and the anticipated cuts to come.
“We were lucky to get the kitchen endowed by the Beth Abraham Family of Health Services in the Bronx,” Hart recounted. “Their (Bronx) religious population was dwindling, and ours is increasing so we got it,” he said.
It hasn’t helped that in a recent issue of The Queens Courier, grants of nearly $3 million made to the Kupferberg Holocaust Center were mistakenly attributed to Hart’s facility. “You know how much I’d like to get that much money?” he asked.
With so many worthy causes seeking help, Hart is always on the lookout, and not just for money.
“Do you know a good kosher chef?” he asked, “preferably Bukharian.”