Long-Timers; Edward Brody: Building on a solid foundation.

Editor's Note: From time to time, our new "Long-Timers" Department will feature a long-term care professional who has had a long and distinguished career in the field.

Octogenarian Edward Brody, former owner/administrator of Park Pleasant Nursing Home in Philadelphia and past-president of the American College of Health Care Administrators (ACHCA), has enjoyed a lengthy and distinguished career in the nursing home industry. In 1945, America was brimming with hope and promise. "I graduated from the University of Pennsylvania in Philadelphia in 1940," Brody says. "After one year of graduate school, I was drafted into the Army, where I served for three and one half years until I was discharged with the rank of lieutenant in 1946. I married a Penn classmate from Philadelphia, where we settled down."

"Like other young men at the time," he reminisces, "I was searching for a career. I had heard that nursing homes were a good business venture. So, along with three partners, we studied the existing nursing homes in the area before we began to search for a property on which to establish our own facility."

Originally, Brody and his partners looked at many estates in Philadelphia's Main Line area. "We saw some terrific buildings but just couldn't get the zoning changed." Finally, just off the campus of the University of Pennsylvania, they located a former school for boys that had ceased operations. The school still owned the small mansion and sold it to Brody's group. It was completely renovated and became Park Pleasant Nursing Home, with a 48-bed capacity.

The Park Pleasant founders designed their facility to provide very forward-thinking services for that time. "We employed registered nurse on each shift, seven days a week, in addition to a nursing director. At that time no one had round-the-clock RNs on staff; they used what were then called 'practical nurses' to provide care," Brody recalls. A friend asked him where he planned to get that many RNs. "Mind you," Brody says, "this was in 1947, and I asked, 'Why, are they hard to get?' I found out that I'd have to pay private-duty wages, which at that time were $1 per hour. So that's what we paid, and the nurses were very happy to get it." Park Pleasant's staff also included a paid medical director and a staff physical therapist who, incidentally, was one of the partners.

Brody discovered that in most of the existing homes at that time, the least mobile people were usually housed on the uppermost floors of a facility, which meant that they never left the floor until they went home, were hospitalized or died. To avoid that isolation, a six-passenger elevator was installed so all residents could have access to the lounges and dining room. "From the beginning, our dining room served residents restaurant style, course by course. Because I was involved with a fledgling business and a fledging family, my wife and daughters would often walk to Park Pleasant to join me for dinner." The residents enjoyed a homelike--not hospital-like--atmosphere.

As progressive as Park Pleasant was, Brody struggled mightily to survive because he couldn't get private-pay patients, and the public assistance rate did not support his operation. "We hung on this way until about 1969 or 1970," remembers Brody, "until I discovered something that proved to be our financial salvation. It was not unlawful to get more money for a bed occupied by a medical assistance resident, as long as the payment did not relate to a specific person. So, in essence, if I could find a nonprofit organization that would lease beds at Park Pleasant, for a reservation fee those beds would be available to them." The Catholic Archdiocese of Philadelphia did not have nursing homes of its own and became Park Pleasant's first client.

From this beginning, Brody gained many hospital contracts, and with growth came expansion. The land on which the facility sits could accommodate a new structure; it was built and 123 beds were added. Meanwhile, the original building was refurbished with the intention of providing private and semiprivate rooms with baths, along with housekeeping service and three meals a day. In essence, it was a forerunner of the assisted living concept of today. "We would not provide nursing service, but staff would be present in case of emergency," Brody explains. "Loads of people wanted to come here," he remembers, "but all those who expressed an interest at the time received $400 a month from Social Security, and we needed $1,000 per month to make it work. We couldn't do it and abandoned that idea." The building was then converted to administrative offices and storage.

To keep abreast of industry concerns and government regulations, Brody became a member of the then American Nursing Home Association (ANHA) and its Pennsylvania state affiliate. He was elected president of the state association and, in 1969, served on the executive committee of ANHA as national secretary. Brody also occupied the presidential chair of ACHCA after serving on its board of governors for five years, representing Region II and then, after regions were redefined, Region III. In his opinion, membership recruitment and retention was and continues to be the major challenge ACHCA faces. During his term, the ACHCA membership roll showed some modest growth.

When his term was up, Brody attended the installation dinner for the president-elect and remarked, "I just fell off the dais." The new ACHCA president said, "Not necessarily. Your people would elect you in a minute if you wanted to be governor again." Brody asked his region if they would like him to return. Consequently, although he thought his years of association service were over, Brody became regional governor for another two years.

Today, Park Pleasant has entered a new era of demand. The facility admits only those individuals with very high MDS requirements in order for it to receive adequate reimbursement. "When we began, life expectancy was around 66 or 67 years of age. Today, it's about age 73 or 74 for men and nearly 80 for women. We only care for very sick people, and it is commonplace to have oxygen and IVs in use," says Brody. In fact, because of Park Pleasant's enormous use of disposables, two floors of the original structure are dedicated to storage of these supplies.

As to improving the state of the industry, Brody recognizes the imperative need to satisfy an array of very difficult, inflexible regulations in order to be licensed for state and federal reimbursement. He feels it's past time for the government and the industry to get together to discuss how to reduce the severe problems regulations pose without compromising the quality of care delivered. "Another continuing problem is how to increase the supply of RNs, LPNs and CNAs. These problems that plague us now will only compound in the future as the population ages," he predicts, suggesting that "it's time that the government includes nursing home practitioners in its considerations for planning and regulation." Meanwhile, the federal government and nursing home representatives should look at successful incentive plans from other fields, such as the National Guard, as a possible way to attract sizable numbers of people to the nursing home field, Brody says.

To address the problem of recruitment and retention own facility, Brody has instituted programs at Park Pleasant to encourage and financially support career education for its staff. Currently, a CNA there is studying to become an RN. "We need to help our staff grow," Brody says. Citing an example, Brody tells the story of how the facility recognized the potential of one telephone operator who was encouraged to continue her education while working and eventually become a department head. Brody feels Park Pleasant provides its employees with the tools to succeed and recognizes staff achievements.

On a lobby wall, there is a glass display case "Wall of Fame" that displays 8" x 10" photographs of all employees with two years or more of service. "We have 157 people for our 123 licensed beds. Photographs of more than half our staff are in the case."

Today, Brody's daughters run Park Pleasant but Brody, at age 83, still maintains a presence there Monday through Friday, serving as director of community affairs and keeping a general eye on things. "Sometimes things can escape notice because they are not a priority at that moment. I try to lend help where I can and bring my observations to meetings or discuss concerns with my daughters privately. So far, it seems to be working."

For more information, contact Edward Brody, Park Pleasant Nursing Home, 4712 Chester Ave., Philadelphia, PA. 19143, or call [phone] or fax [phone].