December 17, 2005
Dow Jones WebReprint Service®
Sister Rosemarie Wants You
Little Sisters of the Poor have an odd business plan
for nursing homes: Beg for help, lavish it on residents.
By CLARE ANSBERRY
Staff Reporter of THE WALL STREET JOURNAL
PITTSBURGHWith the cost and quality of care for the elderly looming as increasingly urgent problems, the Little Sisters of the Poor have an unusual solution: They beg.
One recent day, two nuns in white habits stood quietly in a dimly lit produce warehouse. Around them, workers wheeled carts stacked high with sacks of potatoes. Outside, trucks rumbled up to the concrete loading docks with their 8 a.m. deliveries.
When the owner of the warehouse hung up the phone, Sister Rosemarie stepped forward with a request vital to the dwindling order's mission: Did he have any vegetables to spare? The owner nodded to one of his workers to get a 50-pound bag of carrots and two boxes of eggplants. The second nun, Sister Marcella, her back and shoulders curved from arthritis and degenerating disks, lifted her head and thanked the man.
The two nuns wound their way around boxes of sweet-smelling Georgia peaches, reviewing in low whispers what they would ask of the next distributor on their weekly rounds at the Strip, this city's open-air produce market. A thin man with a cigarette gave them a case of broccoli and chopped romaine. A coffee roaster provided five pounds of dark roast and a pound of chocolate-raspberry blend.
At the huge Consumers Produce warehouse, Joe McCain scoffed at Sister Marcella's request for a watermelon. "One watermelon?" he asked skeptically. Without waiting for her response, he said he was giving her four.
The nuns brought a vanload of donated food back to their block-long brick home. There, they and eight other Little Sisters of the Poor care for 60 elderly residents, age 70 to 100. Begging to provide for the impoverished elderly defines their order and has sustained it for more than a century.
Sister Rosemarie and Sister Marcella at a Pittsburgh produce market.
"We beg so the elderly poor don't have to," says Sister Mary Vincent, the administrator of the home.
As the baby boom ages and anxiety grows about elder care, the Little Sisters and their begging tradition are an anomaly. They provide poor residents with high-quality careindividual rooms and lots of individual attentionon a tight budget. Almost 90% of the residents here have assets of less than $10,000. More than half have none at all. Residents pay if and what they can. Typically, the sisters accept only a third of a person's income from pension or Social Security.
While nursing homeseven those catering to the poorgenerally rely on government programs, private insurance and fees paid by residents for most of their income, the Little Sisters follow a more difficult path. They receive no continuing help from the Vatican or the local diocese. If offered an endowment, they would refuse. Instead, the nuns beg for food, for clothes, for money and for special wheelchairs. Donations account for about 60% of their annual $5 million budget. The rest comes from Medicaid, Medicare, Social Security and other sources.
Their model isn't easily replicated, nor is it necessarily desirable. They face a declining population of nuns. Begging for contributions to renovate or expand can take a long timeor not work at all. Homes in Detroit and New Orleans closed, as did a second home in Pittsburgh. Begging gets harder when the economy tanks or when disasters, like Katrina, divert donations elsewhere. Costs of food, medicine and energy are rising.
Yet the sisters here have plans to expand, converting an old wing into apartments for dozens more elderly poor. Instead of looking for a long-term source of funds, such as an endowment, they rely on Divine Providence and the attentive ear of their patron, St. Joseph. "It's not the way of the world," says Sister Mary Vincent. "People think it's stupid. I talk to them, and I know they're thinking, 'My God, these people are in outer space.' "
An advisory board staffed by local CEOs and bankers gives the nuns financial advice such as how to save money on nutritional supplements and cleaning materials, as well as contracts with elevator maintenance companies. But the nuns refuse to budge when it comes to suggestions they cut corners on construction or offer fewer amenities.
James Will, chairman of the advisory board and former CEO of Armco Steel, recalls a nun asking him: "Would you like to go to heaven and stand before St. Peter and say I lived in a wonderful and beautiful home but when it came to putting together a home for the poor, I gave them a cheaper version?"
"They're unshakeable in their belief that they're doing God's will and because they're willing to do it, they will never be let down," says Mr. Will. "It's hard for us in the everyday world, fighting financial battles, to understand."
Unlike at many nursing homes, every resident at the Little Sisters home has a private room. Those who can't dress themselves are dressed each day in their favorite outfits, including jewelry. Men are clean shaven. The sisters throw festive Mardi Gras parties with shrimp etouffé. White wine is offered with Sunday dinners.
The nuns work hard to make sure no one dies alone. One nun sits by the bedside of the gravely ill throughout the day. When she feels death is near, she alerts the others by beeper, summoning them from meetings, mass and errands to the room, where they pray and sing.
There is little staff turnover among the lay workers here. The average length of service is 12½ years. By contrast, between a third and a fourth of the nation's long-term-care workers have less than a year's experience. Residents here live an average six to seven years, compared with the nationwide average for nursing homes of two to three years.
Sister Mary Vincent stops in to check up on resident Isabelle DeFazio in her room at the Little Sisters of the Poor home in Pittsburgh.
"If I had my own home, I wouldn't be any happier," says Cecilia Hugo, who has lived with the sisters for 17 years.
The order was founded in 1839 by Jeanne Jugan, who came across a destitute elderly blind woman in the streets of a small town in France. She carried the woman back to her apartment and placed the woman in her own bed. To feed the woman and others who followed, Jeanne Jugan went house to house, begging for food.
The order maintains a global reach, with 206 nursing homes scattered from Bangalore to Paris, serving about 15,000 people. But as fewer women chose to join religious orders, their mission is becoming harder. A century ago, there were 5,400 Little Sisters world-wide. Now there are 3,000. No one has joined the Little Sisters in Pittsburgh for about eight years.
Sister Rosemarie, a short, energetic woman with a deep laugh, is the designated begging nun. In her early 50s, she is one of the younger nuns here. She was born in the Philippines, immigrated to Montreal, obtained a fine-arts degree in interior design and worked in a department store. Though she was baptized Catholic, her family wasn't particularly religious. After college, she began going to church, met the Little Sisters and joined the convent.
New in her begging position, she admits mixed feelings. She misses being with the residents. "I'm out of the house so much I feel out of the loop," she says. Demands are relentless, with food obtained one week needing to be replenished the next.
Sister Rosemarie goes about it methodically. Monday is reserved for getting produce and 20 loaves of fresh bread from a bakery. Tuesday she visits local grocery stores, hunting for donations of meat that is still good enough to eat but has passed its sell-by date. Another day is devoted to Costco for leftover pastries and muffins. Thursday she heads to the Pittsburgh food bank.
Between visits to two wholesalers on a recent day, she dialed a third on her cellphone to see if it will give her popcorn for an upcoming carnival. That call complete, she made another to a paint store seeing if it will donate a few gallons to paint the basement.
Wherever Sister Rosemarie goes, she takes her place in line. Someone once told her she shouldn't have to. "Yes, I do. That's what the poor have to do. You wait in line," she says.
Sister Mary Vincent must keep her focus on longer-term concerns. Earlier this year, the Little Sisters completed a $16 million addition and chapel renovation, raising the entire amount over five years through donations from individuals and foundations. Now, the sisters are embarking on a second, $8 million phase to convert an old wing into independent-living apartments to house an additional 49 residents. Though the construction project would likely qualify for federal low-income housing grants, the sisters won't use them because they don't want the government dictating whether they can add a sitting room or more closet space. That leaves asking people for money, a long and tedious process and one that she doesn't especially like.
"Fund raising is a pain," she says. Filled with uncertainty, the process leaves the sisters' projects beholden to the fortunes of others, as well as the local economy. She concedes it would be easier to look for long-term funding, but the tradition passed down by their founder requires that they live hand to mouth. They only seek enough money to address their current needs, whether that means lunch tomorrow or a new wing.
"I pray to God asking why it has to be this way, but I know why he's doing it this way," Sister Mary Vincent says. "He wants more people involved in the work of helping the poor."
Lately, she has been sending the nuns out more often into the community to raise both money and public awareness of their mission. Traveling in pairs, they knocked on doors of new homes in high-income developments, looking for contributions. They went to the Pittsburgh International Airport, setting up metal folding chairs and a table near the entrance, across the hall from the Salvation Army representatives and their red kettle. Rushed travelers stared straight ahead, avoiding eye contact with the nuns. Others stopped, often asking the sisters to pray for a family member or friend.
Begging makes Sister Mary Vincent, who tends to hang back behind the other sisters, uncomfortable. "All these people coming at you, wondering who you are and what you're doing. People challenge you. 'How come you're out here begging? You get Medicaid.' Or 'I heard you got $5,000 in the last collection. Why are you back out here?' " she says. Trying to ignore their comments, she tells herself that she isn't begging for herself but for the poor. "That doesn't take the sting out of begging if you have any pride," she says. "People think you're doing it for yourself."
Teams of sisters are dispatched on weekends to area churches. On a recent Sunday morning, near the end of the 7:30 mass at Church of the Resurrection, Sister Marcella and Sister Katherine Ann received Holy Communion and then walked briskly toward the back of the church. Each picked up a green-felt-lined wicker basket, which held a single piece of paper with the words "Little Sisters of the Poor." They stationed themselves on either side of the back doors.
As mass ended, the church emptied. The sisters stood quietly. People filed by, dipping their hand in a font of holy water, making the sign of the cross and dropping dollar bills into the basket. Many have already contributed during the regular church collection and simply nod at the sisters.
The sisters used to bring in a fair share of donations by stationing themselves outside factory gates. But in a less industrial, more secular age, they rely more on special fund-raisers.
On a recent afternoon, the nuns and some residents gathered at a parking lot filled with 250 motorcycles. Sister Mary Vincent was pleased. The weather was good, the crowd big and festive. Beefy motorcyclists wearing bandanas and tattoos, their shoulder-length hair in ponytails, bought raffle tickets for a 165-piece tool kit and a hypnotherapy session. Eighty-nine-year-old Anna DiRenna, who has lived with the Little Sisters for 17 years, buzzed in her electric wheelchair between the rows of motorcycles with license plates like VROOM and BECHA.
Sister Mary Vincent thanked John Cigna, a big man with an unlit cigar in his mouth. A local newscaster and biker, Mr. Cigna organized the event. He lined up members of HOG, which stands for Harley Owners Group, and the American Legion Riders. Each biker paid $25 to ride the 60-mile course and return for a cookout and music by Jimmy Sapienza's Five Guys Named Moe. Mr. Cigna remembered the Little Sisters visiting his mother when he was a young boy.
Father Jerome Dixon, former chaplain for the house and now a resident, stood up on a chair. The crowd hushed. Heads bowed. "We ask your blessings on these vehicles, which carry out friends on the journey this day. Keep them from all harm," he said.
After, the riders roared out of the parking lot. A dozen residents, mostly women wearing plastic visors and dark sunglasses, lined the curb, waving with one hand, purse in the other. The event raised $5,000.
The following day, two nuns sat outside a Giant Eagle supermarket in metal folding chairs. They sold raffle tickets for a grandfather clock and cookbooks filled with recipes from the nuns and their residents, raising a few hundred dollars.
Sister Mary Vincent recalls a banker-adviser telling her that he sometimes couldn't sleep at night worrying about how the Little Sisters would finance needed renovations with such piecemeal donations. She told him to have faith. "I really can say I've never lost a night's sleep," she says.