Lest We Forget…

Loretto, led by president and CEO Kimberly Townsend, implementing new initiatives

By Lou Sorendo

Kimberly Townsend, president and CEO of Loretto in Syracuse, is leading the nonprofit organization that specializes in elder care during a time of intense transition.

A major initiative Loretto plans involves launching a major expansion to meet the increasing demand for memory care services in the area. This project involves renovations at two facilities — Loretto’s skilled nursing facility, known as the Cunningham building, and the Heritage, the area’s first assisted living facility dedicated to memory care.

Its signature will be a new memory care addition at The Nottingham Senior Living community in DeWitt, with state-of-the-art residential space, as well as a dedicated area for advanced training and research needs.

“Not only are we trying to meet the needs of today and plan for the future, but we are also really driving toward finding a cure for Alzheimer’s and related dementias,” Townsend said.

A public announcement concerning the new memory care unit was expected on Oct. 18, followed by a groundbreaking on Oct. 19.

“It’s a broad initiative that also includes a workforce training component,” Townsend said.

“Every individual who will be interacting with someone who is living with Alzheimer’s and their family will have an appropriate level of Alzheimer’s Association-certified training,” she said.

The ability to provide space to support research toward a cure is important to those at Loretto, which has already been involved in some significant projects — one with Clarity Research and another with physician Sharon Brangman, professor of medicine and division chief of geriatric medicine at SUNY Upstate Medical University.

“Part of this work will be continuing those projects as we search for the cure,” Townsend said. Townsend said causes of dementia are traced to plaques, tangles and tau proteins. Studies have shown vascular health is tied intricately to brain health.

“If you have high blood pressure or heart disease, that’s going to impact your brain health and contribute to that,” Townsend said.

“There are some diagnostic studies that we participate in that will be able to identify those markers 10 to 15 years before the onset of symptoms,” she said.

Townsend added there are also drugs being studied designed to stop the progression of the disease.

“We are involved in both those clinical research projects. We are trying to continue our commitment to being a national leader in delivering high-quality memory care services,” he said.

Over the next 10 to 15 years, Townsend said to expect about a 20 percent increase in demand for Alzheimer’s and related dementia care services.

That will be caused by a number of different factors, including the aging of the demographic and the fact that people are living longer.

“In my view, there is an inability to meet demand today for all the people who could be receiving services,” she said. “This is why we are undertaking this initiative. But I am really anticipating in the future that we are going to need to continue to expand that portfolio to keep up with increased demand.

“We have to continue to invest in training, research and facilities in order to meet the needs of the future.”

Major player on eldercare scene

Loretto employs 2,500 workers and is the sixth-largest employer in Onondaga County. It has 19 sites in Onondaga and Cayuga counties.

It is the fourth-largest health system in Onondaga County as well.

It generates about $190 million in revenues annually.

“It is a very busy and dynamic system. We are a growing system. In the nearly five years that I have been here, we’ve grown dramatically. It’s fun, interesting and exciting to see the growth of the system in terms of meeting community needs,” she noted.

Not only does Loretto employ many people, it recruits and hires in economically depressed regions of the area.

“Syracuse is a sanctuary city, and it also has pockets of poverty. Part of our philosophy through our partnership with Work Train, an initiative of CenterState CEO, is to go out in the community and actively recruit and hire individuals who might have systemic barriers to employment,” she said.

Townsend said Loretto has been highly successful in doing that. Of the 400 employees it has hired over the last four years of the program, the retention rate has been 80 percent.

“It’s really improving the economic development within the area,” she said. “People with good jobs and benefits go out and spend money in the community. We support our local vendors and try to buy local whenever we can. Of course, we’ve had quite a bit of expansion, and we’ve done a great job in supporting our local building trades through all the projects we’ve done in the past five years.”

While no hard numbers are attached to the economic impact that Loretto has on the region, it is obvious that it makes a significant difference.

“We offer very competitive wages and benefits to 2,500 employees who reside in this area and care for close to 10,000 people annually,” Townsend said. “We also make investments and partner with other organizations on projects that will increase their viability and impact on the community,” she said.

When Loretto was founded in 1926, it was built on three foundational principles.

It was founded on meeting a social need, partnerships and innovation. One of those partnerships was the Sisters of St. Francis in the Syracuse diocese, and it was the first diocesan home for the aged in North America.

At that time the social need was prevalent. People who were aging in the community and didn’t have families wound up in the county poor farm at the end of their lives.

“If you fast-forward to today, those are still our three core foundational principles,” Townsend said.

“We develop high-value partnerships with hospitals, payers and organizations in the the community to deliver care,” Townsend said. “We also recently opened a restorative care unit in partnership with our hospitals to significantly lower readmission rates and remain innovative. We are always trying to meet community needs, which are always evolving.”

Rapid growth trend

During her tenure, Townsend has overseen several key capital projects as the system continues to evolve.

Since she began in 2014, Loretto has completed construction of The Cottages at Garden Grove in Cicero, now managed by Crouse Health and St. Joseph’s Health in Syracuse.

Loretto renovated and built an expansion on the former Mercy Health and Rehabilitation skilled nursing facility in Auburn, which is now The Commons on St. Anthony.

Loretto has also built a new PACE CNY site on Creek Circle Drive in East Syracuse for a program that is approaching 600 participants.

This program of all-inclusive care for the elderly provides comprehensive health services for individuals aged 55 and over who are nursing home eligible by the state’s Medicaid program.

Loretto has also constructed the O’Brien Road Apartments in Radisson for low-income seniors, a U.S. Housing and Urban Development 202 project. HUD provides capital advances to private, nonprofit sponsors to finance the development of housing for elderly residents.

Loretto has also done extensive renovations across its system, including its Cunningham building.

As baby boomers age, they are going to be looking for services, Townsend explained.

“That’s one thing we know about baby boomers, and I’m on the tail end of that line, is they want options.” Townsend, 55, said Loretto is the only system in the region that provides a comprehensive continuum of care in a post-acute setting.

It features short-term rehabilitation, skilled nursing, and housing of every variety, including assisted, independent and affordable. It also offers the PACE program and has adult medical day programs.

“We really try to provide a person with what they really want based on where they are as they age. We feel that is going to be helpful to us in the future,” she said.

About 70 percent of the people served by the Loretto system are Medicaid eligible.

“We are a safety net provider for the community,” she noted.

However, Medicaid reimbursement on the skilled nursing side hasn’t seen a trend factor increase — or cost of living increase — in eight years, Townsend noted.

“It’s challenging, but we are a very efficient system and effective in how we help people stay in their homes and maintain their health,” she said. “We are able to continue to provide that as part of our mission.”

“We’re dealing with Medicare and Medicaid primarily, and any downward pressure on reimbursements associated with the entitlement programs is going to be extremely challenging,” she said.

Townsend said Loretto has people it cares for, particularly in its skilled nursing facility and short-term rehabilitation that have complex medical needs.

“We have several people across our system who are over 100,” Townsend said. “These are people who require a lot of care. It’s going to be really important that the government keeps its social contract with these people in providing adequate resources for people to provide care for them.”

Townsend said now that tax reform has occurred, “some people are saying we really need to look at entitlement programs, and what can be done to cut payments associated with entitlements.”

“I’m not anticipating positive movement in entitlement programs. I’m anticipating increased scrutiny. Reimbursements have been declining through the years,” she said.

“What we’ve done that is going to be extremely helpful is creating a niche in caring for very medically complex people,” she said. “That’s going to help us because Medicare has now shifted money particularly from hips and knees — which is was what they paid for 10 years ago — to now providing better reimbursement for people with very complex medical needs, and that’s something we do well.”

Confronting the shortage

Townsend said one of her greatest challenges at Loretto, and one that “keeps her up a night,” is the clinical workforce shortage being felt by all health care providers, particularly for certain types of nursing staff.

“Kimberly’s passion for making Central New York a compelling place to live and work is exceeded only by her compassion for those who have already given a lifetime of service to this community and are now in need of our returned service to them. She has put her substantial intellect and expertise in the health care field toward making Loretto a premier provider of elder care in Central New York. Furthermore, she’s also been an important partner and an innovator helping to develop and deliver leading-edge for workforce solutions for the health care industry.” 

– Robert Simpson, president of CenterState CEO.

“The shortages are really across the board,” she said. “We know that the nursing workforce — whether that’s certified nursing assistants, home health aides, LPNs, RNs or nurse practitioners — is aging and exiting.”

Townsend said there are not a sufficient number of people coming in to fill the void, and that is not considering growing demand for services.

“We’ve tried to do some unique things here at Loretto in terms of growing our own,” she said.

When Townsend meets with employees at new employee training sessions, she makes it clear to them that while they may be going into such services as dining or housekeeping, their dream of perhaps becoming an RN can become a reality.

“At Loretto, we will help them get there. We have a very robust LPN pipeline program to support people who are CNAs, HHAs or other staff to become LPNs,” she said. “There are really not enough people out in the marketplace to care for the people who are aging and in general for everyone.”

Several things need to happen in order for that trend to reverse, Townsend said.

“We need to provide some sort of incentive for schools to offer more programs or to open up more seats for programs,” said Townsend, noting there is only one LPN program in the area, and that is BOCES.

The City of Syracuse School District did feature a program, but closed it and the void has yet to be filled.

“Something we’ve had great success with is we really reach into the community and make people aware of what a great opportunity health care is,” she said.

This past summer, Loretto hosted a MASH camp for 9th and 10th graders in Syracuse. Students were brought in for a two-day camp to view various jobs in health care.

“It’s not just about becoming a nurse; there are other career paths such as recreational and physical therapy,” she said.

“We’re finding good success in starting with students who are in high school and just encouraging them to consider health care professions. A lot of times, those might require two-year degrees and not four-year degrees. For those students who would be willing to consider earning a two-year degree, we would really help them understand all the opportunities within health care,” she said.

“If you are a nurse, an RN or LPN in Syracuse, you have more opportunities than you can possibly consider,” she said. “Anytime you have a lack of supply and great demand, it creates a positive impact on wages. These are great-paying jobs with great benefits.”

“It’s a great retention strategy. In my experience, people want to grow; they want to grow in their jobs; they want to grow in their ability to provide for their families,” Townsend said. “By underwriting and assisting that, it really builds strong loyalty.”

Townsend said a shortage of primary care providers in the region is also a challenge for every community.

“If you look at the people who go into primary care versus demand for those services, there is a real shortfall. I think the government is trying to make efforts to improve the number of primary care slots that are open in residency programs,” she noted.

“I think they are also trying to help reimbursement to primary care physicians, so there are some ongoing efforts, but it’s going to take a while to catch up,” she said.

This is crucial, she said, particularly with the aging demographic and a shift away from delivering care in hospitals and delivering care in lower-acuity settings while keeping people healthy and in their homes, she added.