More than 30 years ago , when Kelley Rice-Schild first began working at the nursing home that had been run by three generations of her family, she decided to organize a big communal outing for the residents. She spent weeks planning a field trip to Parrot Jungle, scoring both a driver and a bus that would accommodate walkers and canes.
But when the day arrived and the big yellow bus pulled up in front of the building, none of the residents — not even those Rice-Schild had lobbied and cajoled earlier — wanted to leave the nursing home. Venturing outside felt too scary for most.
“I watched the bus leave completely empty,” she recalled with a wry laugh. “Then I sat on the steps and cried.”
That was in 1982, when she was fresh out of high school. Today, Rice-Schild has become the fourth generation of her family to run the Floridean Nursing and Rehabilitation Center, which opened 70 years ago and bills itself as Miami’s oldest continuously-running nursing home.
The Floridean has survived as a family operation in an industry that has seen consolidation and a growing number of both state and federal regulations.
“My grandfather was an entrepreneur, but I don’t think he saw this as going on forever,” Rice-Schild said. “It wasn’t his intention at all.”
Family ownership over the decades helps make the institution feel more like a home, Rice-Schild added. She knows most of the patients by their first names. Enlarged photos of her family line the hall. Many of her employees have worked there for years.
“The Floridean is one of the last, if not the last of the family owned nursing home,” said LuMarie Polivka-West, senior director of policy and program development at the Florida Health Care Association, the Tallahassee-based advocacy organization for long term care providers. She added that she couldn’t think of any others that have been continuously owned by the same family for seven decades.
Roots run deep at the Floridean, even for the employees. Activities director Maryann Chapman remembered volunteering at the home as a teenager, and her grandmother worked at there as a certified nursing assistant for 38 years.
“I used to come as a kid and give the residents mani-pedis and then I volunteered in the office,” Chapman, now 25, recalled. “I’ve always liked coming here, working with the older people, giving them a lot of affection.”
Relatives of the nursing home residents say it’s the home-like atmosphere that separates the Floridean from other settings. Lilia Fernandez, 97, was first admitted as a rehab patient, but stayed on when her daughter, Zenaida, who has a disability from childhood polio, couldn’t care for her. She has now lived there for five years, and Zenaida credits the staff for making a difficult decision less so. “My mother loves it,” she said. “They take her out shopping and to restaurants. She likes the people, and I can visit whenever I want to. They’re very family-oriented.”
She feels free to drop in at any time — which she does, visiting her mother almost every day.
In 1944, when the Floridean Rest Home. as it was called them, opened on Northwest 32nd Place, the surrounding area was mainly rural, with large tracts of undeveloped land. World War II was raging and room rates at the home clocked in at $3.33 a day, paid privately by elderly Northerners who “came here to die,” said Gina Guilford, Rice-Schild’s sister. “And once they were here, they never moved out.”
Back then, the mission-style building had 50 beds and no elevator or air conditioning, except in one room.
Founded by businessman Jack R. Rice Sr. and wife Julia, the home was a business venture for his mother Florence “Flori” Dean — hence the name — a licensed practical nurse who lived at the home as its first director.
“Miami was pitching itself as a place for people with respiratory problems, so the Floridean filled a need,” said Miami Dade College historian Paul George, whose aunt lived in the facility during the 1990s. “They came south and stayed.”
After World War II, as housing developments pushed west, the neighborhood around the Floridean populated quickly with duplexes and single-family homes. Today, as a nursing and rehabilitation center, it can accommodate 90 patients. What was once a three-person operation now employs 180 people in nine departments. The current daily room rate runs $245.
The average length of stay is 27 days, in part because 50 percent of patients are there for rehabilitation after a hospital stay.
But the changes at the Floridean go beyond the growth of its facilities. Its population now reflects the demographics of the neighborhood. Almost 90 percent of the patients are Spanish-speaking, and as a result, the staff is overwhelmingly Hispanic, as are the meals and many of the holiday celebrations. Weekly outings — the very activity that frustrated Rice-Schild as a new employee — are an ordinary part of the social calendar. Residents tend to be more active than past generations and expect both more entertainment and involvement. There’s a resident’s council; a gardening club tends a patch of green peppers, pumpkin and lavender.
But the most complicated changes may be stricter government guidelines, the result of Medicare and Medicaid — programs that didn’t exist when the nursing home opened its doors.
The Floridean is rated five stars, or “much above average,” on the Nursing Home Compare website for Medicare. In a similar state website, FloridaHealthFinder.gov, run by the Agency for Health Care Administration, the Floridean rates four stars in overall inspection, meaning the facility ranked better than 61 percent to 80 percent of similar facilities in its region.
It also earned five stars in various inspection components, such as dignity and restraint and abuse. Its only lower rating, two stars, falls under “quality of life,” which means “it was an isolated deficiency” according to Shelisha Coleman, press secretary for AHCA.
Though the regional star comparisons are useful for consumers, Coleman notes that the performance measures represent only how a nursing home ranks within its geographical region. “A low rank does not necessarily indicate a ‘low quality’ facility. Similarly, a high rank does not necessarily indicate a ‘high quality’ facility,” she said.
The Floridean has had some deficiencies cited by state inspectors and reported on the Agency for Health Care Administration website, but Coleman said these had been resolved.
Many of the Floridean residents are referred to the home by local social workers or nurses. Humberto Castello, a former El Nuevo Herald executive editor, found the Floridean after visiting several centers on a list given to him by a hospital social worker. His mother, Carmen Alfonso, was admitted for rehab and at first she was a reluctant patient. Then…
“After the first week, she was smiling, playing the piano, asking for books, putting on make-up — being her regular self,” he said.
After rehab, she returned to her Coral Gables home, but was so lonely that she asked to return to the Floridean. The 84-year-old has now been there for about four years. “The atmosphere is very welcoming,” Castello said.
Rice-Schild, who worked her way up to the home’s top spot, said she likes to hear these stories because her job, although rewarding, is often exhausting. None of her three children have expressed interest in taking over the family business, although all went into healthcare professions. And of her three siblings, only older sister, Gina Guilford, is involved, writing and producing the center’s newsletter.
Will there be a fifth generation Rice running The Floridean years from now? Maybe. Guilford’s 25-year-old son, Christopher, helps in the kitchen and with the weekly outings.
“Time will tell,” Guilford said, “but he says he’s interested in working with the elderly.”