Nursing the Bottom Line to Take Care of Seniors

By Dan Rosenblum In 1971, James Davis, then about to graduate from City College of New York, was headed to a job on Wall Street when it fell through. When he went to the chair of his economics department, the idea came to study hospital administration, instead. Through the 1970s, Davis worked at Roosevelt Island's Coler-Goldwater Hospital and the Westchester Medical Center. Now, more 40 years later, Davis, 62, is president and CEO of Amsterdam Continuing Care Health System, which manages Amsterdam Nursing Home and two Long Island spin-offs. "To be honest, I kind of fell into it, and I'm very grateful that I did," he said. Most of the nursing home's 409 residents come from the Upper West Side, Morningside Heights and Harlem. The nursing home also offers an adult day health-care center for seniors to get meals, medical checkups and other services. The nursing home, which faces the Cathedral of St. John the Divine, has a long history. The 140-year-old organization, originally the Home for Old Men and Aged Couples, moved uptown in 1896 and was rechristened Amsterdam Nursing Home in the 1970s alongside a major expansion. One of Davis' first tasks in 1988 was to expand the original building and convert it into a health-care center to meet the needs of more frail or sick seniors. "They come here because they need us," he said. But all is not quiet for Davis, because the nursing home is being hit with cuts to Medicare and Medicaid reimbursements, which he said make up more than 90 percent of Amsterdam's revenue. He calls dealing with this part of his job "daunting." "It is becoming increasingly difficult to maintain the quality that we want to provide as a mission-driven not-for-profit in this environment," he said. "It really is becoming a challenge." To meet some of that challenge, Davis is looking into cutting costs and sharing services with other nonprofits. But the main driver of Amsterdam House's bottom line is a move to diversify into private-market retirement homes. Davis said their original plan to build the second retirement community in Upper Manhattan was ended by the reality of skyrocketing real estate prices and luxury developers making it too expensive to expand. Instead, he looked to Long Island. The retirement community Amsterdam at Harborside opened in 2010 in Nassau County, and they're building a second facility in Suffolk with help from a state grant. Profits go back into the Manhattan facility. "There's no question business as usual isn't going to work anymore," he said. State Sen. Tom Duane, who represents much of Manhattan's West Side, met Davis in the late 1990s. He said he has friends and relatives at Amsterdam Nursing Home. "If I won the lottery, I would buy some place in Manhattan where he could open up a continuing care retirement community in New York, because I have the same peace of mind that I have about his facilities- that's the same trust I have in his ability to make things happen," said Duane. In 2008, Davis and his wife moved to the Upper West Side from Westchester. He said he enjoys the neighborhood's diversity and community, especially walking to work. He's also an avid golfer, when he doesn't work. Still, much of his time is divided between Amsterdam Home, checking up on the progress of the new communities in Long Island and going to Albany to "hammer away on reimbursement." "The bottom line is, it's an enormous responsibility to take care of a lot of people and to take care of the employees who take care of them-and that challenge is what keeps me going," he said.