Posted March 05, 2020 in Articles
Author: Bob Jacob
Menorah Park and Montefiore will become one organization under the Menorah Park name, while the Montefiore name will remain on its facility, in an affiliation that hopes to become a national model for how a community takes care of its seniors.
After about two-and-a-half years of discussions, the boards of directors of both senior health care and residential facilities approved the affiliation March 3. It will become effective June 30.
Menorah Park CEO James Newbrough will continue as CEO of the new Menorah Park. Seth Vilensky, president and CEO of Montefiore, will become vice president of business development and community services.
“I think this is really great for this community,” Newbrough told the Cleveland Jewish News. “There’s a lot of excitement because of us coming together and doing this, and really creating something that’s really going to solidify the future for these types of services.”
The two nonprofits occupying the same campus off Cedar Road near Interstate 271 in Beachwood where they have been competitors since the early 1990s and now will become partners – creating a $120 million organization.
The expected benefits will be capitalizing on best practices, expanding programs, enhancing the range of services offered and finding efficiencies.
“The Jewish community and the general community will be very excited about it – us coming together – forming a larger organization and the commitment that we have to the quality of services and the breadth of services that we are going to have to offer as one organization, to be kind of a one-stop shop for everything, and have everything in one organization,” Vilensky said. “It’s going to be a great asset to people in the community.”
Newbrough and Vilensky discussed the affiliation in an exclusive interview with the CJN, including how the process began, why it happened, how it will impact residents and staff, and what the future holds.
Model of the future
During its strategic planning process which began in March 2017, Menorah Park examined growth strategies used by other organizations, including health care organizations like University Hospitals and Cleveland Clinic. It became apparent becoming bigger made the most logical sense, Newbrough said.
There wasn’t space for expansion on its current campus, though.
“The affiliation of working with Montefiore on this has created a very nice model and very nice pathways, or tools, for us to look at other organizations in the future that we could potentially bring into our network, and take what is Menorah Park and Montefiore – these two organizations which I consider the gold standard in senior living – and create a larger organization that becomes regional or much larger in scope,” Newbrough said.
Newbrough and Vilensky both cited the changing environment in the health care industry, which has led to nursing home closings and consolidations as well as staffing shortages. Single-site nursing homes have been especially at risk.
“It makes sense in health care, you have to grow, and you have to scale up in order to be sustainable and be an innovator, so we think (this) is going to be a great platform for us to grow,” Vilensky said. “And you look around the country, single-site operators … are struggling, and in some cases, going out of business. We look at this as a platform to be much more sustainable with a model that other people can emulate and join.”
While it’s early in the process, the hope is Menorah Park may find opportunities to partner with other organizations in Northeast Ohio. Newbrough said there are no specifics yet, but they are having conversations and looking into other organizations as potential partners.
“We see this as a model going forward,” he said. “What’s interesting to me is it’s been done in health care and in a lot of other businesses, but in our sector at this point and time, (it’s) very limited that that’s occurred.”
In the beginning
Vilensky joined Montefiore on April 13, 2015, and Newbrough came to Menorah Park on Oct. 5, 2016.
Newbrough said he was surprised to learn Menorah Park and Montefiore were competitors, but possible affiliation wasn’t on his mind.
“When I took this job, it was interesting because I came from Columbus up here and when I came onto the campus, my initial question was trying to figure out, you had two organizations sitting basically on the same campus that were doing the same thing,” Newbrough said.
“As I found out more about the organization, that they were a competitor of ours, but sitting right across the parking lot from us, I didn’t really envision that (affiliation). What I envisioned, or what my initial thought was, there have to be ways we can collaborate and work together and partner on things.”
Both organizations participated in legislative-action activities in Washington, D.C., where Newbrough and Vilensky started to get to know each other.
“We started to talk about ways we can work together, and the medical transportation service came up, hospice service, things like that,” Newbrough recalled. “As we started talking more and shared things more, it started to become more clear that it made a lot of sense to look at really doing this.
“We both have very similar missions, similar organizations. We’re in the same services line of business in many cases, so we started to talk about ways we can collaborate and work together.”
Those conversations eventually led to more conversations, which involved a small circle of people, including a few lay leaders and the organizations’ board chairs. As time went on, additional people were brought in. All were seeking to find what would be in the best interest of both organizations and the community. Confidentiality was key.
Over time, other board members were brought in and a due diligence committee was formed. The committee consisted of about three or four board members from each organization that met on a regular basis, to see if they were heading down the right path.
“Then as we got deeper into this, we started to bring in other people to help us with these conversations, whether it would be on the professional leadership side or the lay leadership side,” Newbrough said.
Vilensky praised the collaboration as “incredible.”
“Jim and I have had a great relationship throughout this whole process,” Vilensky said. “I think Jim has been a great partner and his strategic vision, and his ideas and his intuitiveness to really stick with this, I think has really helped us. And then we formed a great partnership to see us to where we are today.”
Along the way, Menorah Park and Montefiore signed non-disclosure agreements to “take those conversations to a different level and see how we can share information,” Newbrough said.
The organizations looked inward at the care and services they were providing, and to see if there could be new efficiencies.
“With the great community support that we’ve enjoyed as two separate organizations, to be able to have one organization with that level of support – and then be able to gain the efficiencies we need going forward – we felt like that made our future look a lot better for the organization,” Newbrough said.
The two organizations already collaborated on some small initiatives over the years. For example, Menorah Park ambulances have provided the majority of ambulance service to Montefiore residents since spring 2017, with some conversations occurring before.
“We’ve gained a really good understanding of our mission, the caring that we provide, the services that we provide,” Newbrough said. “That became clear to me, and I think Seth will echo this, is that we’re a lot more similar than we are different, and that really has come about because of these meetings, and because of the time frame. And the Jewish community has been very supportive of both organizations.”
As discussions continued month after month, year after year, potential roadblocks were overcome. Eventually, there was no turning back.
“I can truthfully say in working with Seth, we never got to that point where we said, ‘Let’s call it a day,’” Newbrough said. “… I think we complemented each other very well sometimes, and then having the board members and others involved including professional staff to help us figure out ways around things, or how potentially we can get past obstacles or hurdles to do this was key.
“That’s been the biggest thing. Everybody kept their eye on the prize, which was if we can, if we can come together as one organization where it’s really going to be good for the Jewish community as a whole.”
Vilensky echoed those sentiments.
“With any relationship, it goes in different phases, but I think the overarching thing was everybody felt in their mind this was the right thing to do for the community and both organizations, so we just kept marching down that path,” he said. “That gave us the perseverance to go forward and nobody wavered on that.”
While talk of affiliation loomed on the horizon, Menorah Park hired a professional to examine its contracts for service providers, vendors and more. She found there were multiple landscapers and snow removal companies providing service on the Cedar Road campus for its various buildings.
“She was able to start to really look at that and leverage the economy of scale we had,” Newbrough said. “In the first four months she was here, she had achieved hundreds of thousands of dollars of savings by renegotiating contracts. So, I see that as a real opportunity where we get her focused – you’re talking about a $120 million organization. Can we leverage that with some of our vendors to get better rates? So, I see that’s an opportunity for us there.”
Menorah Park has an operating budget of about $82 million. Montefiore and The Weils, a senior living community in Bainbridge Township owned and operated by Montefiore, have an operating budget of about $40 million.
Impact on residents, employees
The nearly 1,400 Menorah Park employees and the 600 Montefiore employees were informed of the affiliation from senior management throughout the day on March 4.
Newbrough and Vilensky both assured staffing for patient care services would not be compromised.
“I wouldn’t say we’re looking at eliminating or reducing services,” Newbrough said. “We’re looking at enhancing services. So if we have two of a particular program, hospice service, for example – we have a hospice program here and they have a hospice program there – we’re looking at how can we enhance those services so you have an opportunity to put those programs together and come up with a much stronger program.”
“… We feel we have a good, strong base and we want to grow that. Through the due diligence process, we’ve identified areas where we can be efficient, where we have duplication or overlap. But as far as the how-to or when you start getting into that, that’s going to be this process where we now will be involving departmental leadership at that level to develop action plans, so we can move forward in the smartest way possible and come out with the strongest programs that we can.”
Positions will be evaluated at the departmental level.
“Whenever you look at consolidating programs and putting things together, sometimes that changes positions for people, and so maybe there's positions that are no longer there going forward,” Newbrough said.
“But again, take the combined organization with our growth opportunity, also with the job market we’re in right now, we’re really looking at how we can best utilize the staff that we have and how we can do that going forward, and how we can position ourselves for growth. That will become clearer to us over the next few months.”
Vilensky said potential new efficiencies are “in the back office and administrative functions” and “we will be very thoughtful about how we bring these plans together and who we involve in putting these plans together.”
He said an immediate benefit is the sharing of best practices across the two organizations. They have started to do that with some of the professional staff.
“One of the great things I’m excited about for this affiliation is we can have one really strong recruiting HR team that is working on helping us find the greatest talent in Northeast Ohio,” Vilensky said. “We all know there’s this shortage of nurses and caregivers in this area, and right now, we’re competing to find those caregivers. We want to join forces to have one really strong arm to find that really great talent in the area.”
Menorah Park provides health care and residential choices for adults as they age from apartments for independent living and assisted living, to skilled nursing care, memory care, rehabilitation services, adult day care, home health care and hospice services.
Montefiore provides skilled nursing care, rehabilitation therapy, home health care, memory care, assisted living and hospice. Its hospice house is the only nursing home-based hospice house in the area. The Weils features a rehabilitation pavilion and assisted living and memory care residences.
“We’re going to provide the same care to the same number of residents, so we really need – especially at the direct caregiver level – all the great nurses and (state tested nursing assistants), and therapists and direct caregivers we have today, and more in the future as we grow,” Vilensky said. “That’s kind of a key point.
Menorah Park’s occupancy rate is about 98% to 99%, and it has waiting lists for its assisted living, independent living and memory care facilities. It touches an average of 1,100 people per day, which includes those using its Peter B. Lewis Aquatic & Therapy Center, Adult Day Center and Center 4 Brain Health. It also provides home care services from its Beachwood location and an Akron-Canton location.
“The demand for our service is very strong and continues to be very strong and we are certainly looking at that, and with this affiliation, ways we can strengthen and build upon what we have,” Newbrough said. “Memory care is an area where there is a lot of need and continues to grow, so we’re excited about opportunities to do things, working together in those areas.”
Montefiore’s and The Weils’ reach is between 400 and 450 people each day and it has an occupancy rate of 99.3%. The occupancy rate at Montefiore is the highest it’s been since Vilensky arrived.
“There’s a lot of demand for the high-quality of services that we’re providing, and that’s one of the things we’re going to look at into the future is, how do we grow those programs, and where’s the need in the community and where do we begin to fill some of those gaps?” Vilensky said.
According to Vilensky, Montefiore’s hospice has seen 25 years of growth and has more than 70 patients in its Vinney Hospice and Palliative Care of Montefiore and Maltz Hospice and Palliative Care Pavilion.
“We’re going to have the opportunity to promote our programs that we do excellently to a broader audience,” Vilensky said. “For example, Montefiore residents discharging from our rehab could now be referred to Menorah Park’s Adult Day Center and Center 4 Brain Health activities. It just opens up the campus for referrals and collaboration across the different programs in a much broader way.”
Setting the foundations
For now, the Menorah Park Foundation and The Montefiore Foundation will remain two separate foundations under one operating structure. No details will be finalized until July 1.
“Our goal is to maintain the engagement of our dedicated members and supporters as we move into this new structure,” Newbrough said.
The mission of the Menorah Park Foundation is to provide financial resources to enable the organization to care for the physical, emotional, intellectual and spiritual needs of its residents and clients. It reported net assets of $24,368,000 as of 2018.
“Our goal over the next couple weeks is to really make sure we don’t disenfranchise donors or other people that have been supportive of these organizations,” Newbrough said.
“We want to be sure that they understand this is really a very positive thing and the strength of both organizations, and keep that support for them,” Newbrough said. “So, it’s certainly honoring the legacy of all the donors, the volunteers, the community support. We want to continue to recognize that, try to build on that.”
The Montefiore Foundation supports the programs of Montefiore and The Weils through entertainment and outings, Judaic activities and religious services, music and art therapy, volunteer appreciation and community events, medical equipment and nurse education, computer access and library resources and more, according to its website. Its net assets were $12,841,000 as of 2018.
The organization also focuses on empowering people to engage in activities of wellness as illustrated by the Montefiore Foundation Home Run – a 5K Walk/Run. Additionally, Shining Star CLE, a solo-singing competition, connects the generations by showcasing high school students competing for college scholarships, while raising funds for memory care. The CJN is a media sponsor of both events.
“There’s a lot of respect given to the names and the important donors that named these programs,” Vilensky said. “That was definitely considered highly in terms of the affiliation.”
Business of boards
Newbrough and Vilensky both said board involvement has been crucial and praised their boards. On July 1, there will be one operating board of at least 36 members under the Menorah Park name.
Currently, Menorah Park has a 36-member active board of trustees, with about seven or eight vacancies. Including life trustees and emeritus trustees, the board numbers more than 100.
Montefiore has a 55-member board of directors, including active, life and honorary trustees. Montefiore will have representation on the new board after July 1 and all of its life and honorary directors will become part of the new board.
“We want to keep them engaged and honor their contributions and their legacy as part of this process,” Vilensky said of the Montefiore board members.
He said there will be new opportunities for people to get involved.
“People that have supported both organizations, there’s going to be so much work to do and so much exciting work to do, whether it’s as part of the foundation work and the development work we do with our Shining Star fundraiser and our other development work, serving on various committees or being part of the planning as we go forward,” Vilensky said.
The heads of both boards praised the decision for affiliation.
“This is great news for both organizations, and most importantly, for the community at large,” said Beth Rosenberg, president of Menorah Park’s board, in a news release. “It brings together two organizations built around Jewish values, with a common mission: to provide high-quality health care to adults as they age by offering a range of services in a variety of settings.”
Ira Goffman, chair of Montefiore’s board, said in a news release, “Our facilities are not only physically close to each other, we couldn’t be more closely aligned in how we approach the challenges of a changing health care system along with a growing population that expects more at every stage of life.”
Newbrough also lauded support from those in the community who supported the affiliation, such as key leaders of the Jewish Federation of Cleveland.
Stephen H. Hoffman, the longtime president of the Federation who retired at the end of 2018, and his successor, Erika B. Rudin-Luria, and other key Federation employees were brought in shortly after the non-disclosure agreements were signed.
“We had several meetings with them,” Vilensky said. “They’ve been nothing but supportive and have been encouraging to us, really pushing us to come up with the right relationship and ask some of the important questions about how this is going to impact the community, and it’s stronger because of their input.”
The Federation’s “Nakum: Alzheimer’s/Dementia Task Force Report,” which was released in 2017 was referred to during the process. The task force conducted interviews with more than 90 family members, clergy, physicians and others connected to dementia. The report lists dozens of recommendations, organized across areas where dementia care improvement is necessary.
“Their role is helping us identify community support (and) identify key community-wide issues,” Newbrough said. “We know the issues we face as individual providers or organizations, but if you step up to that sort of community lens or focus, that’s where the Federation sits. They’re looking at the greater good of the entire Jewish community, and so (we are) making sure we keep in lock step with them, and their strategic vision and plans for the Jewish community.
“We also used some of the resources they’ve had, such as a population study which helped us look at needs into the future and where we will be at,” Newbrough added, referring to the 2011 Greater Cleveland Jewish Population Study.
The Federation provides financial support to both of the partner agencies. Its 2019-20 allocation to Menorah Park was $441,665 and to Montefiore was $364,797.
“Menorah Park and Montefiore have been longtime partners of the Jewish Federation and key contributors to the Cleveland Jewish community for more than 100 years,” Rudin-Luria told the CJN. “We worked closely together and just as a matter of course, anytime we’re doing planning for older adults in our community, then Menorah Park and Montefiore are around the table as experts. JFSA (Jewish Family Service Association) is also around the table.”
Menorah Park and Montefiore were involved in the Nakun work, but the affiliation is not a result of that study.
“It is a result of Menorah and Montefiore looking ahead at the needs of older adults and looking at their organizations and saying, ‘How is it that we can continue to provide excellent, high-quality care to older adults in our community?”
Rudin-Luria lauded the professional and volunteer leadership at Menorah Park and Montefiore.
“I think the synergies they bring to this affiliation are very exciting and really demonstrates their commitment to putting the individual and the family first,” she said. “The emphasis on doing what’s best for the community, I applaud that. This positions Menorah and Montefiore, frankly this positions the Jewish community as well, for the future to meet the demands of the aging baby boomer population and future populations of older adults.”
History and tradition
Menorah Park and Montefiore each has a storied history in Greater Cleveland, and Newbrough and Vilensky want to ensure those legacies continue into the future. And while talks between the two organizations about a partnership occurred prior to their arrivals, it never advanced past the talking stage.
Menorah Park was founded in 1906 as the Jewish Orthodox Old Home, opening its doors on Orange Avenue in Cleveland. It quickly outgrew its space and moved twice before arriving at its current location in 1968, becoming known as Menorah Park Jewish Home for the Aged.
In 2017, Menorah Park’s rebranding included changing its name from Menorah Park Center for Senior Living to simply Menorah Park, as well as combining its websites and changing its logo.
Newbrough was hired after a 12-month search to succeed Steven R. Raichilson when he retired after nearly 30 years. Newbrough served as president of the Home Care Division of Ohio Health, a multi-hospital integrated delivery system in Columbus. He has more than 35 years of experience in the health care field and began his career as a registered nurse in the critical care unit at the then-Akron City Hospital.
Newbrough became the first non-Jewish CEO of Menorah Park.
“I worked for different faith-based organizations for years,” he said. “What I have found is there are a lot of similarities.”
He recalled something a rabbi said at Menorah Park.
“He comes to the realization – even if someone were non-Jewish, but were strong in their faith – whatever their faith was, that was just as important,” Newbrough said. “I’ve tried to really make sure that when we make decisions here, that we honor the Jewish values, we honor the legacies of the organizations, but really make sure we’re doing things the way they should be done in a Jewish organization. And possibly sometimes that might give me the viewpoint of being maybe a little more observant than others may be because I’m a little more vigilant of that because I don’t want to misstep. I work very closely with our rabbinical staff and with our general staff to make sure we’re doing that.”
Montefiore was founded in 1882 as the Kesher Home for Aged and Infirm Israelites in the Woodland Avenue area of Cleveland. Two years later, British philanthropist Sir Moses Montefiore made a contribution and his name was added to the institution.
In 1918, it moved to Mayfield Road in Cleveland Heights and in 1923, the agency name was shortened to The Montefiore Home. In 1991, it relocated to Beachwood. In 2002, The Weils opened.
Vilensky, who replaced Lauren Rock, was previously administrative director of the Cleveland Clinic’s Center for Connected Care. Rock was president and CEO from 2007 until she retired in 2015.
Looking to the future
What will the community see come July 1?
“I don’t think they’ll see anything (different),” Newbrough said. “They’re going to continue to get the same great care.”
He added, “There’s a lot of people in the community that thought we were together anyway, as one organization, because we’re on the same piece of property. But I think that for those that didn’t, the reaction is going to be very favorable … the time is right and both organizations are very good, and they provide great, great care. And if this makes both organizations stronger and gives us more depth of resources, gives us greater ability to provide that excellence in caring to a broader group and to strengthen our programs, I think it’s going to be very positively received by the community.”
Vilensky said, “It’s just great to see it all come together when both of these institutions are so important to Cleveland and the Cleveland Jewish community. The fact that we’re just going to be strengthening them for the next generation and our parents and grandparents, I think it’s just so wonderful to see it come together. And we have great people involved on all different sides, and when they start working together even more closely, we’re going to create something just really special.”