'I'm not sure if what future generations are going to need in terms of senior care is the same as what my grandparents needed.'
If you ask Adrienne Green, MD, it's natural that she's found herself at an organization like the San Francisco Campus for Jewish Living.
Prior to joining the organization, the recently appointed CEO served as the chief medical officer for the University of California San Francsico Medical Center. Early in her career, she worked in skilled nursing, and later as a hospitalist, working often with elderly patients.
HealthLeaders spoke to Green about her journey with organization, her goals as CEO, and what the future holds for post-acute services like skilled nursing facilities.
The following transcript has been edited for clarity and brevity.
HealthLeaders: Prior to becoming CEO, you served as a trustee for the Campus for Jewish Living. How did you initially get involved with the organization?
Adrienne Green: I've always held this organization in high regard. For many years it was referred to as the Jewish Home and, while I was working with the hospital, we sent many patients here and I had the opportunity to work with them often.
I'd been out to the campus on a couple of visits and worked with some of the team on some collaborative programs, and it was through those collaborations that people got to know me and invited me to join the board in 2019.
My time on the board was clouded by COVID, so I had a slightly different board experience than others. What I brought to the board, though, was a clinical perspective, the ability to think about new clinical programs and partnerships, and a framework for how the organization could think about quality and ensure they were providing high-quality care.
Those are things that I get to continue doing as CEO.
HL: What are other goals you hope to accomplish as CEO?
Green: In my mind, the first order of business is to provide stability for the organization. We need a stable staff to ensure that we live up to our reputation of providing the highest quality care for seniors.
After this stabilization phase, we get to do the fun work of doing some strategic planning and thinking about our community needs and wants for the future. We've got a 152-year-old organization with an amazing reputation in the community. I want to sustain that and innovate to make sure that the organization continues that reputation and thrives.
I'm not sure if what future generations are going to need in terms of senior care is the same as what my grandparents needed. For example, more people are going to be cared for in their homes, and there may be less demand for the typical long-term care nursing home. We will still need it, but maybe we need less of that and more that happens in the home.
There are patients coming out of our hospitals that are far more complex than they were 25 years ago, so making sure that our short-term skilled nursing services can provide care for those patients, and that we have the skill sets we need to care for these very complicated patients is another important challenge for us.
Technology will also come into play somewhere in terms of eldercare. I'm not quite sure how it fits yet, but I want to make sure that we're thinking about that as we're thinking about what our organization looks like for the future.
HL: How important is it for post-acute services like skilled nursing to be elevated or emphasized for the public?
Green: Most people wait until it's too late to start thinking about it. With the baby boomer generation coming of age, we are going need to be able to, first, accommodate the volume of elders who need a wide array of care.
Some of that care lies in our traditional models of long-term care in the skilled nursing setting, the short-term care with the increased complexity that I mentioned. We also need to think about the different models we might need.
I know people are already electing to age at home and engage either family or caregivers to allow them to be at home at the end of their life. We need to think about what that looks like and how some of our traditional skilled nursing facilities might interface with that.
The other piece is senior living communities—whether they have independent care, assisted living, more advanced memory care, or hospice services—and how it will accommodate the growing number of elders.
HL: Post-acute providers are struggling to recruit young healthcare professionals due to lack of interest or bias with working with the elderly. What would you say to change their minds or offer a different perspective?
Green: This isn't the most glamorous area of healthcare, but it's necessary. It's incredibly rewarding hearing patients’ and residents’ stories. Providing the respectful, dignified care that they deserve at this critical time in their lives is really a privilege.
While full-time work in this area isn't for everyone, I highly encourage health professionals across all disciplines to, at a minimum, get some experience and spend some time in nursing homes or observing home visits with a home health nurse, so that they can at least understand the environment and what their elderly patients might need, as well as advocating for what they need.
There will be a handful of people who make this their everyday life, but I hope that from an educational perspective, we can encourage students and training programs to make sure that there are training opportunities in this environment.
Jasmyne Ray is the contributing editor for revenue cycle at HealthLeaders.