By JULIE MINDA

Founding congregations of large Catholic hospital systems in the U.S. began methodically grappling decades ago with how best to preserve their ministries and charisms as their congregational ranks decreased.

Many congregations chose to create a new sponsorship structure — a ministerial juridic person — to allow for continuity of their ministries and charisms under the sponsorship of lay leaders. They created formation programs to instill in lay sponsors and management the essence, purpose and priorities of running a complex business as a ministry.

Allison Q. Salopeck, president and chief executive of the Jennings eldercare organization, visits with Sr. Margaret Mary Grochowski at her jubilee. The last surviving member of the Sisters of the Holy Spirit congregation, Sr. Grochowski died Nov. 7, 2021. The congregation moved to a lay sponsorship model for Jennings in 2020.

More recently, founding congregations of eldercare ministries have been working through these succession issues and discerning how best to maintain fidelity to the mission when congregation members no longer work at or even sponsor their facilities. Some are doing so with the overhang of pressing concerns over keeping their ministries financially viable in what can be a scorching economic landscape for nursing home operators.

Ownership of Catholic continuing care facilities is more decentralized than it is on the acute care side of the ministry. Many Catholic nursing homes operate as stand-alone facilities without the financial shield that can come from being part of a large and sophisticated organization.

McDonough

Susan McDonough, a Catholic eldercare and post-acute care specialist with Ziegler Investment Bank, said while the ministerial juridic person model has proven an ideal structure for sponsorship of many ministry systems, it is not a viable choice when congregations have just one or a few facilities. And the structure of sponsorship is related to the Catholicity of an institution; it does not solve financial challenges.

She said many congregations have sought to enter into mergers, affiliations or other types of partnerships with other Catholic systems or to sell their facilities to them, to ensure the continuation of their ministries. Some have not been able to make such a match but have had success with merging with another nonprofit that is faith-based or that is not faith-based but is willing to agree to provide a space for religious worship and to hire chaplains to see to residents' spiritual needs.

McDonough said there is a great value in preserving Catholic eldercare facilities for the high-touch, compassionate and high-quality care they provide. She has advised many congregations on how best to plan for their facilities' ongoing operations as the congregations' membership declines. She says her main concern is that sponsors be proactive and "think early about their options, before there are very few options left."

Letting go
As CHA's senior director of theology and sponsorship, Fr. Charles Bouchard, OP, advises sponsors of stand-alone nursing homes and small eldercare systems and other eldercare services in the Catholic health ministry on succession planning to ensure their ministries endure without the active involvement of congregation members.

Sr. Rose Anthony Mathews, center, joins other residents of Benedictine Living Community — At The Shrine for a chair yoga session. Sr. Mathews is one of 37 Adorers of the Blood of Christ who moved to the eldercare community in Belleville, Illinois, earlier this year as their convent was closing.

Fr. Bouchard said congregation members may delay the information-gathering and decision-making process as they struggle with accepting a diminished presence and influence over a ministry they built and nurtured. They must discern whether they want to, or can, maintain some active involvement or whether it's time to let go of any control or connection.

He said there are a small number of dwindling congregations that sponsor one or a few facilities that may be waiting too long to make decisions. "This means they have limited time to look for partners, and less opportunity for the sisters to have a personal influence on their successors while the sisters are actively involved," he said.

McDonough said religious sponsors shoulder a "huge responsibility" and decisions about the viability of their congregations' ministries and the services they provide to communities can weigh heavily. She wants to impress upon sisters and brothers that the best chance to get as close as possible to their vision of how the ministries will continue will come from being proactive in planning.

McDonough said if decisions lead to the divestiture of motherhouses, convents and other facilities that once housed aged and infirm members, congregations also must plan to ensure their members are well taken care of until their deaths. The Adorers of the Blood of Christ did this earlier this year, arranging for the last 37 sisters who lived at a motherhouse in Southern Illinois to move to a Benedictine continuum of care complex.

Matchmaking
McDonough has served as matchmaker for small congregations that have agreed to reside together in a facility for the aged. Sometimes congregations have instead chosen to move into their own wing of an eldercare facility.

McDonough explains that this can happen in several ways. When the sisters own an eldercare facility and transfer it to another party, they may agree with the acquirer in advance of the transfer which wing will be for the sisters' use. As vacancies occur, other sisters could move into that section. Once the sisters' numbers dwindle, then laypeople would be admitted to that area. These arrangements would be contingent upon the sisters having a payer for their care.

In some instances, sisters move from a place they own, into a new building that they do not own. If a unit in the new place is empty, the sisters may contract to all move into that same unit, with the proviso that as rooms become vacant on that wing, they would be offered to members of that congregation. This arrangement could come into play when the congregation is relinquishing their property and making a related agreement that will ensure they have a place to live and receive the care they need.

Some congregations decide they don't need to have all members living in one unit of a facility.

Arrangements will vary based on the desires of the congregation and its members and the availability of living space in the place where they are moving, says McDonough.

The aim usually is to keep as many of the congregation members together under one roof, though that becomes more difficult as numbers decline and congregation members need differing levels of care, some of which may not be available in a single location.

» Read about how two Catholic eldercare systems are taking different tacks to preserve their founders’ legacy