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Not an Easy Fix

With a privatization proposal on the table, Albany County Nursing Home’s residents and employees face an uncertain future

by Erin Pihlaja on February 6, 2013

Happy at home: Barchitta and her mom Hannah at the ACNH. Photo by Erin Pihlaja.

“Shake it, don’t break it,” says Hannah to the people she passes as she is wheeled through the hallways of the Albany County Nursing Home. As she, wheelchair-bound, travels across the threshold of the common room, a staff member calls to her, “Hey, Hannah, look! I’m shakin’ it.”

In the large room, two other staff members dance and smile at residents; some sit and watch TV, others carry on conversations with one another. Hannah shakes her gloved hands along with the music that plays overhead. Back in her room, a picture on her bedside table shows Hannah some 50 years before, a striking young woman wearing lipstick, a sassy dress, and a stylishly coifed hairdo. In the framed black-and-white photograph, young Hannah leans into her handsome husband—they both wear bright smiles.

Hannah has lived at the nursing home for five years, and she was a resident of the now-closed Ann Lee Home prior to that. Her hair is now white, but it is still carefully maintained, thanks to a stylist who frequents the facility. She seems genuinely happy in this place—she has friends and the staff know her by name.

“I don’t think a privately owned nursing home would take my mother,” says Hannah’s daughter, Renee Barchitta. “She has a mental health diagnosis.” Prior to moving Hannah into Ann Lee, Barchitta spent six months trying to find a home for her after it was clear that she was unable to live on her own.

“My husband and I went every weekend,” she recalls. “At 99 percent of the places, as soon as they heard ‘mental health diagnosis,’ they said, ‘No,’ right away. Once place even asked me if she could manage her own incontinence. And I’m still on the waiting list for another place but I haven’t heard anything from them.” Barchitta put her name on that list seven years ago.

“They told me they needed a guarantee of $120,000 in cash a year for two years before they would accept her,” says June Maniscalco, of the private nursing home where her mother spent the last years of her life. “My mother had the money, and we spent every nickel of it on her care after the $240,000 just to get her in. What if you don’t have that?”

Maniscalco’s grandmother also lived in a private nursing home. “They told us up front that when her money ran out, we had to move her. She died before that happened,” she recalls. Her mother-in-law is Hannah’s roommate, and Maniscalco and Barchitta are two of the five core members of the ACNH Family Council.

“[The council] is really here to make sure this place is open, operational, and run properly,” says Barchitta. “We don’t need a fancy building or new furniture. The care here is good and that’s all that matters.” Both women worry about the fate of ACNH, and they aren’t the only ones.

The battle began years ago when former Albany County Executive Mike Breslin waffled between closing the facility and building a new one. Today, faced with budget concerns, County Executive Dan McCoy has been pushing the county legislature to approve a lease agreement that would allow USG, a private entity, to lease the ACNH and manage its operations.

Worried: An employee for 37 years, Webb no longer feels secure at ACNH. Photo by Erin Pihlaja.

“We just got a lease last month,” says Gary Domalewicz, the chair for the Albany County Legislature’s Elder Care Committee. “I have yet to see a lease that’s finished. Even in our committee meeting last week we didn’t have a complete lease.”

“This is a hard topic to explain to somebody,” he says. “I can make the ACNH profitable in one month, but that’s not our challenge. We need to take care of most needy of Albany county residents in their elder years. All publicly owned nursing homes are a challenge, and yes we’ve got to be the most cost-effective as possible, but does county government have to make a profit? Is the Albany jail profitable? Why have a jail, a nursing home, or Meals on Wheels? Because you take care of the most needy.”

Domalewicz, who at one point had family members in ACNH, has been a part of this process for years, but says that it’s going to, and should, take more time. “I am not going to vote on any lease when questions aren’t answered,” he says. “I want to make sure the loan gets repaid. This is the first time in 20 years as a county legislator that I know of, that we loaned money out to a private entity. This deserves due diligence.”

“This has been years now,” says Robina Webb, a Senior CNA at ACNH. “Maybe four, five years ago, I started wondering every day, ‘Do I have a job, or do I not have a job?’ How do we feel? Awful.”

February 26 marks Webb’s 37th year at ACNH. When she applied she says it was difficult to get a job there. And she remembers there being a waiting list for patients as well. Somewhere along the line, things changed. “When I first started at most I had five to six beds a day, but over time it grew anywhere from 10 to 12,” she says. Staff levels have decreased, in part Webb believes, because of the uncertainty of job security. “I worry for my coworkers,” she adds. “I’ve got the age to retire, but I haven’t had a raise in four years. Every time we asked—nothing.” Currently there are over 300 employees at ACNH.

“Our workers have sacrificed unbelievably,” says Mindy Berman, communications director for 1199SEIU, the union that represents workers at ACNH. “For four years, we’ve taken zeros. Ten years ago we had over 300 members there, now we have around 230. So many have left over the last two months. We care about the lives of our workers who now have another piece of uncertainty.”

“They’ve had that uncertainty since 2007,” says Phoebe Mackey, an 1199 union organizer. “It’s been one thing after another.”

Berman can trace troubles at ACNH to 2003, but both she and Mackey agree that it was the introduction of the Berger Commission that brought the biggest stages of change. The commission was charged with assessing the physical and financial state of New York’s health-care facilities. Their report recommended the reduction of approximately 4,200 beds in hospitals and 3,000 in nursing homes. Some facilities were slated to close; others were supposed to be restructured. ACNH merged with the Ann Lee Home, and plans were made for a new facility to be built. Later, Breslin began to discuss closing the facility. Those involved, namely the residents and the employees, have been waiting for answers ever since.

Expecting the worst: McBean anticipates losing benefits and staff coverage after privatization. Photo by Erin Pihlaja.

Donna McBean has been a registered nurse at ACNH for more than 25 years and is the nurse manager of her floor. “There is uncertainty from the top all the way down,” she says. “After 25 years it’s like you’re starting over. All the staff is in limbo, they don’t know what is happening. Should they leave? Retire? Stay?” McBean worries about what will happen to her benefits. She is a county employee, but won’t be if USG takes over and she is certain that things will change. And that is if she gets to keep her job.

“We are overstaffed by [USG’s] standards,” she says. “It’s worse—if coverage is cut our residents do not get the care that they need.”

“The staffing patterns are different,” says Berman. “People are going to lose their jobs. When you start putting the bottom line in there it becomes something different.” According to Berman, the idea of profitability has been a vicious circle. Families don’t know if the ACNH is closing, so they are afraid to put their loved ones there. Beds remain empty and profit margin goes down. As revenue decreases, more severe cutbacks are taken. “With no residents how can we be viable?” she asks. “How can we compete to get residents?”

The employees of ACNH are still trying. “There was a survey at ACNH,” says Mackey. “The Department of Health does a review of everything they do there. The survey was excellent with everything. With everything that is going on with their lives, the employees are still giving excellent care.”

“I try and shield the residents so they don’t know what’s going on,” says Webb. As a senior CNA, Webb’s responsibilities are vast. “Every day, I bathe them, get them dressed, groom them, clean their glasses, make sure their teeth are clean,” she explains. “If their shoes need wiping, I wipe ‘em off. I ambulate them, help feed them, and I encourage them. For some of them there we are the only family they have.”

Webb has many stories about her patients. “These people had lives,” she says. Sometimes she puts makeup on the women, and spends extra time sprucing up the men. “One day it’s gonna be my turn,” she says. “I want someone to treat me great and remember I was once a functioning person in my community.”

She worries what will happen if the ACNH closes, or if USG decides it can’t make it profitable. “These patients lived here, in Albany,” she says. “They served our country, paid Albany taxes. They were veterans, mothers, and someone’s child. We’ve got young people in here, some in their 50s. Now you’re gonna turn your back and send them away. All I can say is, ‘Wow. How dare you?’”

At a wooden table in the common room of ACNH, Hannah seems unaware of the stress carried by her caretakers, or that there is turmoil in the place she calls home. With her hands in the air, she tosses her head about and sings to anyone within earshot. “One-sie, two-sie, I love you-sie! She pauses and, as if she has just awoken from a daydream, looks clear-headed and focused. “I gotta make you smile and love. That’s what it’s all about.”