The CPA who helped turn a hospital around
Jay Nadel of Englewood Hospital and Medical Center claims that its emergency room has become the best in the country.
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Photo by Jerry Szubin
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On the website of a hospital outside of this area appear various recent remarks posted via the Internet. The very first:
“Do not go to their E.R. The nurses are horrendous, they are always short [staffed], and most are careless, do not want to be bothered. If you go past midnight expect to see a few nurses sleeping at he desk. I’ve heard numerous inappropriate conversations….”
Directly under that is: “I would stay away from the E.R. Staff always looks like they hate everyone. I’ve heard bad stories about this place. Nurses sleep, make fun of patients.”
Complaints about emergency rooms seem endemic, including this memorable post, about a famous hospital in California: “The only way I will ever go back to UCLA ER is if I’m carried in on a stretcher unconscious.”
That hospitals don’t do more to reduce the volume of such complaints is puzzling. After all, far more people visit a hospital’s ER than are admitted as patients. So a hospital’s reputation tends to hinge upon what happens to visitors in its emergency room. Do they wait seven or eight hours before seeing a doctor or nurse – who pooh-poohs their illnesses or injuries? Or are they treated promptly and sympathetically – even if they confess that they have no money and no health insurance?
The second scenario certainly seems true of Englewood Hospital and Medical Center.
“We have the best emergency department in the entire country,” boasts Jay C. Nadel, chairman of the hospital’s board of trustees, and he believes it. He proudly escorts visitors to the E.R., which – unlike so many other E.R.s – is well-lighted, clean, sparklingly new, and welcoming; it resembles a cocktail lounge rather than something tacked on to a decaying 19th-century building.
Nadel, a CPA, points to the comfortable chairs where patients are supposed to wait: empty. He’s pleased as punch. All the patients are being seen and helped.
Nadel became chairman of the board five years ago, and in that time he has helped turn the hospital’s reputation around – from an institution faced with tough issues to a cheerful, proud, and prosperous place with good staff morale. In fact, he’s being honored tomorrow, April 30, for his “exceptional dedication to the community in ensuring the present and future of quality healthcare at the Medical Center.” A gala in his honor will be held at Pier Sixty in New York City, where he will receive the Touchstone Award, EHMC’s highest tribute given to someone “for distinguished service to the Medical Center and the community it serves.” (But he quickly adds, to this writer, that he has had many skilled people assisting him.)
Impressively, Nadel was able to help the faltering hospital even though he doesn’t have a whisper of a medical background. For 25 years he worked on Wall Street, for such illustrious companies as KPMG, Bank of New York, and Weiss, Peck & Greer. But unlike the magazine publisher who fell on her face recently when she became New York City’s schools chief, Nadel made a big switch and wound up receiving top grades.
He’s 52, lives with his wife, Beth, and their three children in Demarest, and is a graduate of the University of Maryland. He spent his early years in Jersey City but moved to Fair Lawn, where he attended high school.
Besides his work at the hospital, he is a trustee of the Jewish Home at Rockleigh as well as a member of the New Jersey Meadowlands Commission.
In person Nadel is cheerful, courteous, upbeat, funny, quick-witted, shrewd – and handy with compliments. (“Great question!” he responds to a few of this reporter’s humdrum inquiries.)
In a 45-minute interview last week, Nadel talked about the first thing he did after becoming chairman; how much he is paid; how someone living in (say) Omaha can find a good hospital; how Englewood caters to its large Jewish community; and what his next career might be, assuming he ever leaves EHMC.
Jewish Standard: How did you deal with the hospital’s problems when you first became chairman?
Nadel: The first thing I did was: completely nothing. For six months. Except listen. And people came up to me and asked, what are you going to do about this or that? I said I was very proud to say: nothing. Except listen.
My parents had told me that God gave me two ears and just one mouth – for a reason. My background was not in health care, so I wanted to learn and to understand. I went on a listening tour – for six months. I sat with management, major physicians, and leaders of institutions, fellow trustees, community members, nursing staff, other staff, technical staff.
And in a collaborative way we put together our game plan for the future. And you know, it wasn’t easy, but when it was done, it was pretty comprehensive. And it was something we could all agree on, and we all signed up for it. And from that point on, the institution just took off.
This was always a well-respected organization, and the question was: How do we get to the next level?
J.S. Improving the emergency department was one of your goals?
Nadel: In the last few years, Englewood Hospital has been transformed – it’s been put on the map. Look at the ratings of Englewood doctors in the CastleConnelly guide, where only physicians can rate other physicians [http://www.castleconnolly.com/index.cfm].
The emergency department had been built in the 1970s, and it was crowded. Although the doctors and the nurses were fantastic, the facilities were not very good. Today it’s the best in the country.
J.S. It’s easy to reach, right off Engle Street. And I see that there’s even free valet partking for the E.R. now.
Nadel: We put it right on the street. When people drive by, they can’t help but see the entrance.
I had been told that when you build a spanking new emergency department, you bump up 3 percent or 4 percent in patients. That’s considered enormous. In our first year, it was 7 percent. The real surprise was the second year: another 7 percent. It’s a tremendous feeder of patients to our hospital.
J.S. If you don’t mind a personal question, did you take a big cut in income to take this job?
Nadel: The chairman of the trustees is a voluntary position. A lot of people don’t understand that you do it without being paid. I was coaching my son’s baseball team, and one of the kids’ fathers came up to me and said, “Jay, somebody told me you don’t get paid for being chairman of Englewood Hospital.” I decided to really give this guy a good time, so I said, “Bob, not only do I not get paid, but I have to pay for the privilege.” He almost fainted.
J.S. Exactly what is your job here? What does the chairman of the board do?
Nadel: Basically the board is to provide oversight and leadership – whether it’s a hospital, a nursing home, a for-profit institution or a not-for-profit institution. It’s always the same.
And at the end of the day, everybody has a boss. My boss is the board. And my job is to help bring Englewood Hospital up to the next level.
The truth of the matter is, like a lot of things in life, it’s really what you make it. A chairman is supposed to gain consensus, to provide leadership through consensus. But a lot of it is what you make of it, based on the individual characteristics of the institution
It’s a lot about knowing when you should be using your head and when you should be using your heart.
J.S. What did you learn about the hospital’s mission?
Nadel: Its mission is to be the regional leader in providing humanistic medicine. Other hospitals in the area are great, but our mission is to be their leader.
We have 2,800 employees, the largest in Northern Valley, and another 800 doctors on top of that, and almost another 1,000 volunteers. So it’s a relatively big enterprise, with revenues of $360 million to $370 million a year. The question is, how do you bring humanism into this?
J.S. By “humanism,” you mean, among other things, accepting all patients?
Nadel: Yes, but there’s a way to “accept” and a way to “accept” – if you know what I mean. We treat someone with no insurance – an illegal immigrant who broke his hand – the exact same way we treat a VIP. We’re very proud of that.
I like to believe that what drives me is the Judeo-Christian ethic – which our country was founded on. I’m a member of Temple Emanu-El in Closter – it’s Conservative and it’s our family synagogue.
We have lots of different ethnic groups in Bergen County; we’re a welcoming place. And our hospital doesn’t turn away one single person. If someone comes in with no money and no insurance, and says, “I need help,” we treat him. We treat everybody. Everybody.
To me, “humanistic” also means treating the entire person and not just the illness.
J.S. The hospital is mindful of the large Jewish population in this area?
Nadel: We have a liaison to the Jewish community [Rachel Dube], a Shabbos elevator, kosher food, a place for the family to stay on Shabbos when their loved ones are being treated. These amenities are used very robustly, and we’re looking to expand them because of the demand. And Englewood Hospital has a good relationship with Jewish Family Services. We host the cocktail reception for their annual Night of 100 Dinners event.
Whether it is the Jewish community or the Korean or the African-American or the Hispanic, we are very, very sensitive to these communities and the special needs they may have.
The Jewish community has been very special to Englewood Hospital throughout the years, and we have been helped by generous philanthropists like Bill and Maggie Kaplen, Henry and Mickey Taub, Angelica and Russell Berrie.
J.S. There were financial problems when you became chairman?
Nadel: In the old days, hospitals in New Jersey got reimbursed dollar for dollar for charitable work. Then, 20 years ago, with economic troubles, we received 90 percent. Then 75 percent, 50 percent, and 25 percent. When I became chairman they gave us about 20 percent. Today, our cost of charity is about $15 million and the state gives us a check for only $800,000.
So our mission has been to make up the difference. And we had to start running a hospital more like a business. Asking ourselves: Where can we make money? How do we advertise? How do we attract more patients?
Now, the hospital had never raised its fundraising to a higher level. Here we live in a relatively prosperous area of the United States, and we had to make sure we had the right people with the right attitude to foster a real culture of philanthropy. We needed to get more money from the outside.
Not long ago we did a survey and asked doctors what they wanted most. One was: a great emergency department. Another: the latest technology.
Besides upgrading our emergency department, we implemented a new computer system – second to none in the area. We now have state-of-the-art equipment in just about all the areas.
But we take our time in deciding what we need. So you’re not going to see a lot of equipment lying around unused.
J.S. Let’s say that someone is living in, maybe, Omaha. How does he or she find a good hospital – like Englewood?
Nadel: It’s funny how the best doctors normally work at the best hospitals. For good doctors, you can check CastleConnelly.
J.S. Why do the giant New York City hospitals have such splendid reputations?
Nadel: They’re great institutions. But we have an affiliation with Mount Sinai. There’s lots of crossover – in resources, money, and people. We’re able to benefit from their really significant scientific research in various areas.
We also have a medical school residency program with Mount Sinai, and we have our own residency program. We recruit from around the world some of the best and brightest to assist our doctors. And on top of that, we have a nursing school in conjunction with Ramapo College.
So there’s a certain robustness in our environment here. We have a certain vibrancy that you don’t get at other hospitals in the region. I don’t mean to belittle our competition, but this vibrancy is something that’s unique to Englewood Hospital.
J.S. To change the subject: What are the marks of a successful business leader?
Nadel: Different circumstances call for different individuals with different skill sets. What I tell my kids is that one of the most valuable skills is the ability to listen. And that this is a wonderful country, and what this country has done for the Jewish people is unprecedented in world history. There are so many opportunities here – there are low-hanging fruit all over the place. And today all the information you need is right at your fingertips.
The single most valuable opportunity is getting involved in your community -because it pays dividends every single day.
J.S. You’re fairly young. Might you ever have another career?
Nadel: At least one!
J.S. What might it be?
Nadel: It might be the public sector or the private sector. I’ve been approached at times to consider public office. But I’m focused on the hospital right now, and what the future might bring, I don’t know. But there are a lot of exciting possibilities.
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