Convalescent hospitals feel pinch of sick economy.

Quality of care remains stable as budgets hit the skids 

Patient shortages, budget cuts and layoffs are hitting several Southland convalescent hospitals. Administrators blame the recession, a surge in home health care and the proliferation of nursing facilities at acute-care hospitals for their woes.

Twenty of the 150 beds at Grand Park Convalescent Hospital are currently empty, and as a result the hospital is losing $1,350 a day, said a spokesman at the Los Angeles-based convalescent hospital.

"For the first time in 10 years, we have had to lay off help and cut hours," added the spokesman, who wished to remain anonymous. The hospital laid off a total of five nurses during April, and also plans to cut back its housekeeping and maintenance staff by 10 percent.

Meanwhile, the budget at the Jewish Home for the Aging of Greater L.A. underwent a 5 percent cut last year, according to Sheldon Blumenthal, chief executive officer of the Reseda-based facility.

The recession is hitting convalescent hospitals in a variety of ways. For one, some patients that would otherwise be admitted to the hospitals are being cared by family members at home instead.

That way, family members taking care of the older person can keep his or her Social Security check instead of turning most of it over to the state government. This is a tempting proposition during tough economic times, said Barbara Mascari, administrator of Astoria Convalescent Hospital in Sylmar.

The recession is hurting the Jewish Home for the Aging in a different manner.

The home depends upon both state funding and charitable contributions for its budget. Those funds are still coming at unchanged levels, but they aren't keeping pace with the inflation rate, Blumenthal said.

Since its budget was cut last year, the home has laid off 12 staff members and reduced 30 other positions through attrition, CEO Blumenthal said.

Aside from the recession, nursing homes' business is being hurt by the rise in the number of hospitals that offer skilled-nursing facilities, or care similar to that received in convalescent homes, in recent years.

"We've had to adapt to the changing times," said Steve Galper, administrator of Berkeley East Convalescent Hospital in Santa Monica. "A lot of acute-care hospitals are opening up skilled-nursing facilities."

Both Santa Monica Hospital Medical Center and Saint John's Hospital & Health Center in Santa Monica have recently opened skilled-nursing facilities. Nearby Berkeley East used to get many of its patients from these hospitals, but now it gets only half the number it used to, said Steve Galper, administrator of Berkeley East Convalescent Hospital.

Another reason for a decline in business at some convalescent homes is the surge in availability of home health care. Entrepreneurs have opened up businesses that specialize in home health care, and are providing services that have never been offered before, Galper said.

"These patients can now have any type of treatment administered in the home," he added.

Seeking to reverse its business decline, Berkeley East has implemented a marketing program to attract patients. The hospital advertises in several publications for seniors as well as local news publications, Galper said.

Also, the convalescent home is accepting some new types of patients, he said. These include patients that need heavy care, respiratory care and/or intravenous care and patients registered with health maintenance organizations, such as Kaiser Permanente Medical Care Program.

Budget and staff cuts haven't harmed nursing homes' quality of care, administrators maintained.

"So far we've been able to maintain high-quality care," Blumenthal said, adding that the Jewish Home for the Aging is "trying to work smarter."

Likewise, care quality hasn't yet been affected by layoffs at Grand Park, its spokesman said. The facility is successfully adjusting to the changing ratio of staff members to patients, she said.

One convalescent home said the recession was actually helping to improve the quality of its care. There is less turnover at the Los Angeles area Beverly Manor convalescent hospitals. Thus, the existing staff has more of a chance to learn the unique needs of each individual patient, said Bill Ihle, spokesman for Fort Smith, Ark.-based Beverly Enterprises, which owns the nursing homes.