Serving as a nursing home administrator is a challenging career choice, but Linda Miele-Cavallaro embraces both its challenges and rewards. “In a way, it’s the business of people’s lives,” says Miele-Cavallaro, who heads the Thompson House Residential and Rehabilitative Care facility on the campus of Northern Dutchess Hospital in Rhinebeck. “You find yourself making decisions on a regular basis that affect people’s quality of life.”
The Thompson House is a 100-bed, licensed, skilled-nursing home that provides both short-term rehabilitation and long-term residential care.
Miele-Cavallaro grew up in Brooklyn, lived in Staten Island, and eventually moved to the Valley with her husband, who at the time was proprietor of a nursing home in Dutchess County. “That planted the idea in my mind,” she says. “I decided to explore the possibility of working in nursing home administration despite the fact that my husband didn’t have a hands-on position, and that I had never set foot in a nursing home at that point. So I didn’t really know all that was involved.”
With a business background in administration, she got her first hands-on nursing home experience during an internship at a facility in Catskill (“that’s how I got my feet wet; there was so much to learn”); she eventually became a licensed nursing home administrator. Then she earned her master’s degree in health care administration, and for six years headed the facility her husband was affiliated with; it was eventually sold.
In 1997, Miele-Cavallaro, who lives in Poughkeepsie, took over the reins at the Thompson House and has headed the facility ever since.
She oversees all aspects of day-to-day operations involving residents and staff. “The only constant is change,” she says, noting that nursing homes are among the most highly regulated industries in the nation. “I learn something new every day.”
The facility’s residents range from bedridden to mobile, “and since we’re on the Northern Dutchess Hospital campus, there’s quick access if medical emergencies arise.
“We emphasize quality of life,” she adds. “Some residents enjoy activities like going out in a wheelchair-accessible van to restaurants and shopping malls. Our activities staff also arranges trips to seasonal events like picnics and to the Dutchess County Fair.”
While residents are primarily seniors, Thompson House also contains a 20-bed, short-term rehab unit. “One of the most gratifying aspects of the job is that we are able to discharge more than 300 people a year back to their homes after they complete short-term rehab,” Miele-Cavallaro says.
Being female hasn’t been a challenge in her health care career, she says. “Nursing home administrators come from all backgrounds. They’re both men and women — some have business training, some come from nursing, others from social work. You do need to be compassionate and adaptable to do this job.”
She’s been hailed for her quality of care: Twice, she received the Health Quest Facility Leadership Award for Thompson House. And she was this year’s recipient of the Eli Pick Facility Leadership Award from the American College of Health Care Administration.
Overall, “health care is becoming more integrated,” she says. “As a person ages, the goal is starting to focus more on helping them move seamlessly from one setting to another as their needs change — such as from senior living, to assisted living, to nursing care if it’s needed and back to the community with supports in place.”
Miele-Cavallaro points out that, by next year, New York State will require all Medicaid nursing home residents to be enrolled in a managed care plan. “Some areas of the state are already making the transition. We expect that this will help save the state dollars while continuing to provide many services that the aging boomers will require,” she says.
Technology continues to be an enormous force virtually everywhere, and the nursing home field is no exception, she says. “Here at Thompson House, we’re moving now into a big project of transferring our data to electronic medical records. Things are always evolving.”