Daily Hampshire Gazette - Established 1786
P/cloudy
48°
P/cloudy
Hi 55° | Lo 39°

Fisher Home’s new director confronts financial challenges

  • Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office. CAROL LOLLIS

    Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office. CAROL LOLLIS Purchase photo reprints »

  • Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office. <br/><br/>CAROL LOLLIS

    Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office.

    CAROL LOLLIS Purchase photo reprints »

  • <br/>Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office Tuesday afternoon. <br/><br/>CAROL LOLLIS


    Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office Tuesday afternoon.

    CAROL LOLLIS Purchase photo reprints »

  • <br/>Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office Tuesday afternoon. <br/><br/>CAROL LOLLIS


    Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office Tuesday afternoon.

    CAROL LOLLIS Purchase photo reprints »

  • <br/>Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office Tuesday afternoon. <br/><br/>CAROL LOLLIS


    Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office Tuesday afternoon.

    CAROL LOLLIS Purchase photo reprints »

  • Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office. CAROL LOLLIS
  • Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office. <br/><br/>CAROL LOLLIS
  • <br/>Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office Tuesday afternoon. <br/><br/>CAROL LOLLIS
  • <br/>Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office Tuesday afternoon. <br/><br/>CAROL LOLLIS
  • <br/>Maxine J Stein the Executive Director at the Fisher Home in Amherst in her office Tuesday afternoon. <br/><br/>CAROL LOLLIS

“She had that passion, she understood our vision, and she knew how much the people who work here care about this place,” said Palazzo, a longtime employee at the Hospice of the Fisher Home in Amherst.

“She” is Maxine Stein, and the job was executive director of the nine-bed residential hospice.

The position had been vacant for a year, following the departure of Gregory Keochakian, the previous director. None of the candidates they’d interviewed, Palazzo said, had seemed just right.

“We were really stubborn,” recalled Palazzo, the home’s spiritual and bereavement coordinator

She wanted someone with “a hospice heart,” plus solid administrative skills, she said — and no one, in her eyes, fit the bill.

Until Stein. A social worker by training, Stein had worked as coordinator of the hospice program at the Lutheran Medical Center in St. Louis, back in the 1980s. Her later career track had taken her into administration as chief executive officer at the National Ovarian Cancer Coalition in Florida, and, most recently, as director of development for five years at the Yiddish Book Center in Amherst.

Palazzo liked Stein’s manner — direct, dynamic, confident and unpretentious. Still, she wondered what lay ahead.

“It was a little bit scary,” Palazzo said.

Settling in

Seven months into what she calls the job of her lifetime, Stein talks about the Fisher Home as “a gem, a treasure,” the only residential hospice in this area, and one of the few in the state. She speaks with pride of the home’s staff of 33 full- and part-time employees trained in hospice care, plus a large corps of volunteers. But she also is candid about the stiff financial challenges that she must address, namely, she said, the “paramount” need to raise money to support the home’s mission.

As an independent hospice that’s not attached to an outside institution, the Fisher Home is “an expensive operation,” she said. And providing residential, around-the-clock services, she adds, is costlier than keeping patients at home. The Fisher Home exists, she said, for the patient who, for any number of reasons, can’t be cared for at home.

“This is a harder model of care,” Stein said. “And financially and business-wise, it’s a bear.”

Employees say that Stein has gained the trust of the staff, while tackling issues that had been put on the back burner.

Stein’s confidence, Palazzo said, “made us feel at ease. We could go back to only thinking about doing our jobs.”

Dignity, compassion, comfort

The one-story home, at 1165 North Pleasant St., is set back from the road, with flower gardens and a gazebo out front. Inside, the patients’ rooms are furnished with home-like touches — watercolors on the walls, quilts on the beds, bird feeders at the windows. There’s a living area, dining room, and kitchen.

Stein’s office is neat and tastefully furnished — bookshelves, Picasso prints, a wall hanging from Africa, photos of her three grown children, Sarah, 30, Rebecca, 27, and Ben, 23. Stein, 60, lives in Northampton with her second husband, Henry Simkin, a family physician at Valley Medical Group in Florence; the couple married in 2007.

Stein grew up in Pittsfield, where, she says, her parents, Arthur and Sylvia Stein, instilled in her the importance of community service. Her father, an attorney, did a lot of pro bono work, she said, and her mother, at 85, is still going full tilt as a member of her local zoning board.

After graduating from Bennington College in Vermont, Stein earned her master’s degree in social work at Washington University in St. Louis, where she first learned about hospice care, with its message of helping people die with dignity, surrounded by compassion and comfort.

“I fell in love with it,” she said.

Figuring it out

The Fisher Home serves patients who have been diagnosed as likely having less than six months to live; the average stay, Stein said, is around two weeks. During that time, the staff, including a medical director, nurses, aides, social workers and counselors, manage the patient’s physical symptoms while also helping both patient and family with whatever personal issues come up.

“The people who come here are letting us enter their lives at an intimate, vulnerable time,” Stein said. “I think all of us feel the honor and privilege of doing this work.”

As director, Stein said, she’s someone who likes delving into the ins and outs of management. “I’m a very logical person, and I like figuring out how to make things work,” she said. “It’s something I’m comfortable with and that I think I’m good at. My style is collaborative and democratic — but I will make decisions.”

Knowing her position had been vacant for months, Stein said she knew “I had to come in and be a leader. But I also had to establish trust and learn everything about the organization.”

Before starting in January, she immersed herself in the nitty-gritty of the $1.65 million annual budget and personnel policies. After she started, she began meeting, individually and in small groups, with staff and volunteers to learn about their jobs and roles. She listened and observed, Palazzo recalled, wanting to know what worked, what didn’t.

“She didn’t come in like a steamroller,” said Katherine Curtis, the clinical director. Curtis, who had served as interim director during the search, said Stein established herself in a way that made people feel secure, not threatened.

“It was a relief to have a leader,” she said.

As she settled in, Stein reconfigured some of the office space to make it more efficient, and to give employees more room. She supported bringing in several new programs, such as one to ensure that veterans at the hospice receive care that’s tailored to their needs. She started making the rounds to introduce herself to other area hospice organizations and support services, such as Cancer Connection in Florence.

She also began contacting doctors’ practices and health providers, asking to meet with them to answer questions and concerns they might have about the home, about how patients are admitted, or about the care provided.

In general, she said, the admission process starts after a doctor or medical team has concluded that nothing curative can be done, life expectancy is six months or less, and the patient and/or family member or health care proxy have indicated they want hospice care.

The process isn’t complicated, Stein said, and usually involves a few phone calls at most between a patient’s caregivers and the hospice, plus a forwarding of paperwork about the patient’s medical condition. Sometimes there’s a waiting list for a bed at the Fisher Home, and sometimes a bed is available right away; the census varies, Stein said.

Pain management should be a top priority at any hospice, and is at the Fisher Home, Stein said. “When you get pain under control, you can focus on who that patient is as a person — and you can also focus on the family, because sometimes they’re the ones who are reeling. We’re treating the whole person and the whole family.”

Financial picture

The Fisher Home is supported, in part, by reimbursements from Medicare, Medicaid, health maintenance organizations and other private insurance plans that include a hospice benefit. But those programs don’t cover the cost of room and board at a residential hospice — that fee is the responsibility of the patient.

The Fisher Home’s fee is $350 per day — and while some long-term health insurance plans help cover it, Stein said, many don’t. To help those who can’t pay, and to avoid becoming what Stein calls “an elitist” program, the Fisher Home has long tried to subsidize the costs for some patients. So far this year, she said, the home has provided $60,000 in what is essentially free care.

Those costs, coupled with uncertainties about what lies ahead at the national level for the economics of health care, will make fundraising a mandatory part of her mission, she said. She has also applied to a private trust for a grant to help cover costs, she said.

Stein said she plans to step up the home’s fundraising efforts, including solicitation letters, and one-on-one meetings with individuals, philanthropists and businesses. Her goal is to raise an additional $100,000 this year — and to triple that annual amount in the future.

“Until now, we have not turned to the community for support, but that will be part of my work,” she said. “Not every community can boast an in-patient residential hospice, and we’re hoping the community will value it as much as we do and will help us preserve it and take care of it.”

Financial support for the home also comes from sales at the Hospice Shop of the Fisher Home, at 55 University Drive in Amherst, which raised about $200,000 last year, Stein said. The home also receives memorial donations, Stein said, “and we’re always so touched and grateful for those.”

Down the road, Stein said she wants to expand the Fisher Home’s staff services to patients in Amherst and a few surrounding towns in their own homes. At present, she said, the staff does that for about three or four patients at a time, but could add more as long as they are in or close to Amherst.

She also hopes to see the Fisher Home become a resource for the broader community, offering educational programs, workshops and lectures on issues related to end-of-life care.

The right touch

When she is asked about her own life, Stein, who recently turned 60, answers with the perspective of one who knows that many people’s lives are cut short. “I feel so lucky,” she said. “Lucky that I can get out of bed every day, get dressed, put my shoes on, and have a cup of coffee.”

When the time comes to face the end of her own life, Stein said, she hopes she’ll receive “the kind of love and care that I know we are providing here. I don’t fear death, but I don’t look forward to it. I love life so much.”

Though her days are filled with administrative responsibilities, Stein has the right touch in dealing with patients and families, said Norma Palazzo. “If she’s walking by, she’ll always introduce herself, and ask, is there anything you need? With Maxine, there’s no pretense. She speaks from the heart.”

So far, she appears to have the backing of those who hired her.

“Maxine’s not fearful of anything,” said Shauneen Kocot, of Northampton, head of the board of directors. She’s the one you want, she said, “at the helm of this ship.”

Board member Bill Dwight, of Northampton, says he backed Stein because she had “the whole package, and then some,” of hospice experience, plus management, communication and organizational skills.

“Apparently,” he said, “we prayed to the right god.”

Suzanne Wilson can be reached at swilson@gazettenet.com.

Legacy Comments0
There are no comments yet. Be the first!
Post a Comment

You must be registered to comment on stories. Click here to register.