Last month, the operators of Rivington House went public with their plan to close the nursing home for AIDS patients after 20 years on the Lower East Side. VillageCare officials said it no longer made sense to keep the facility open because, in an era in which AIDS victims are living longer, the center has been half empty for a few years.
This week representatives from VillageCare went before the human services committee of community Board 3 to explain what will potentially happen to the converted school building at 45 Rivington St. that has served as Rivington House since 1995. Matthew Lesieur, director of public policy, said the organization sought, unsuccessfully, to turn the center into an assisted care facility for AIDS patients.
Legislation making the conversion possible was approved by the State Legislature three years ago but vetoed by Governor Cuomo. The state also blocked a proposal to convert Rivington House to a nursing home for the general population. The governor has pledged to reduce Medicaid-supported nursing home beds by 5,000, creating an inhospitable environment for institutions in need of a lifeline. It’s part of a strategy to support home-based care for more seniors, rather than relying on large nursing home facilities.
As we reported last month, Rivington House was purchased in 1993 for $1,550,000. The agreement stated that the building’s use would be “limited in perpetuity to a not-for-profit ‘residential health care facility.’ ” VillageCare took out a $72 million state loan to pay for the conversion of the building from a school to a medical facility.
At Tuesday’s meeting, CB3 District Manager Susan Stetzer alluded to fears expressed in the local community that 45 Rivington St. could potentially be snapped up by a developer of luxury housing. “At the time of our first call,” she said, “I think you were looking for the highest bidder. I think you weren’t aware of this deed, probably. When I spoke to you, you did not know about the restrictions.”
Lesieur said VillageCare is now focused on changing the terms of the deed, asking the city to drop the not-for-profit requirement. “There are a lot of health care providers,” he explained, “but they are profit driven, throughout the country, who would readily grab and buy the building and maintain it as a nursing home.” Lesieur said the organization needs to figure out how to pay off the Rivington House mortgage and how to deal with “pension obligations.” He indicated that preliminary conversations have taken place with the local City Council representative. “We’ve been working with Margaret Chin’s office and she is very receptive to the idea,” Lesieur said. “If we can get a for-profit provider in there we can maintain the building as a nursing home.”
This afternoon, Chin told us she met with VillageCare officials to learn more about Rivington House’s predicament, but she did not express support for changing the non-profit requirement in the deed. Chin said she wanted the community board to weigh in and wants more facts before moving forward. Her office has reached out to the mayor’s office and city agencies to find out what options might be available. Members of the human services committee expressed reservations about turning the facility into a for-profit venture. They passed a resolution calling for a collaborative effort with local elected officials to find a solution that will keep Rivington House as a community asset.
There were about 100 remaining residents at Rivington House last month. That number has now been reduced to 15, as VillageCare works on moving them to other facilities and, in some cases, to private residences. The closure, at the end of November, will lead to the layoff of about 230 staff members.
Editorial note: This story, including the headline, has been modified to more strongly emphasize that VillageCare hopes to alter the deed for the Rivington House building, paving the way for the sale of the property to a “for-profit” operator. The change was made after VillageCare officials contacted The Lo-Down to reiterate that the organization as a whole would never seek to drop its non-profit status; it is only trying to change the status of the Lower East Side building. The story has also been changed to reflect the fact that city, not state, officials would need to approve a change in the deed. Finally, Rob Goldman, director of corporate communications, stated in an email message, “suffice to say we have always been aware of and sensitive to the restrictions on the deed.” When asked last month whether the sale restrictions on the building were still in place, Goldman told The Lo-Down he did not know the answer to that question.
Isn’t the term “profit driven” enough of a clue that you don’t want them anywhere near this facility that was promised to the community as a health care site for poor and working class neighbors “in perpetuity”?
And we may have slowed down the AIDs epidemic, but the Alzheimer one is around the corner. We can’t afford to lose nursing homes for the poor and working class.
As the baby boomers age, Alzheimer’s and dementia will escalate. By 2050 it’s predicted that people afflicted age 65 and older may triple from 5 million to 16 million. For women age 65 and older the risk factor is 1 in 6, men 1 in 11. Women are most likely to be the unpaid caregivers to the elderly – 3 in 5.
– Alzheimer’s Association
This governor is reducing Medicaid –supported nursing home beds by 5,000 “…creating an inhospitable environment for institutions in need of a lifeline. It’s part of a strategy to support home-based care for more seniors, rather than relying on large nursing home facilities.”
But for many low-income urban seniors ‘home -based care’ is not a long-term option. Walkup apartments, rooms too small to hold hospital beds, constant care to decrease bedsores – it doesn’t work. “Nearly 19 % of women Alzheimer’s caregivers had to quit work either to become a caregiver or because their caregiving duties became too burdensome. In 2013 15.5 million family and friends provided 17.7 billion hours of unpaid care to those with Alzheimer’ s and other dementias – care valued at $220 billion.” – Alzheimer’s Association.
We need nursing care facilities, well-paid, trained staff, and decent buildings to house them. We need places where elders who are vulnerable aren’t hidden away -inviting overwork from caregivers and abuse out of the eye of caregivers.
This Medicaid redesign was crafted by “a paid consultant to some of the biggest players in the New York health care industry, including Mount Sinai Medical Center, NYU Langone Medical Center and the state’s largest association of nursing homes” all of which had financial interests at stake in the Medicaid changes that were adopted by NYState.” – NYTimes.
From In The Public Interest: “… New York will begin moving 1.5 million patients into managed care in October. And with the Affordable Care Act expected to raise Medicaid enrollment by 16 million by 2019, the Commonwealth Fund concluded that “given recent patterns in state contract awards to managed care plans, it is reasonable to anticipate that plans operated by publicly traded companies will enroll the majority of the expanded Medicaid population.” As a result, the Washington Post reports that insurers expect $60 billion in new annual revenue from this market after 2014.
As with Medicare, the privatization of Medicaid through managed care is likely to result in a significant reduction in public moneys spent on health care….Already, evidence is emerging that managed care providers may practice some of the same abuses as the private sector programs run by those companies…”
This is about squeezing the last bit of profit from every corner, even those corners with so very little to give.
We lost two nursing homes recently – their residents scattered to the wind, uprooted from nearby friends and relatives – and now this facility. The Rivington House staff have to find 230 new jobs and 127 residents have been evicted or ‘transitioned’ depending on your viewpoint. It reminds me of the closing of Bialystoker, the photos of an elderly woman in a wheelchair on the street protesting the closing of her home. At that age, shouldn’t have had to beg for her home.
We can do better than this.
Time for electeds to engage in a solution-finding mission on the treatment of the elderly, the frail, the vulnerable? “We have these frail older people moving about in the medical-industrial complex that we’ve constructed…It’s all about profit margins. It’s not about caring for people.”
-NYT report on the Institute of Medicine’s “Dying in America” -National Academy of Sciences.
Harms in nursing homes are “… strongly linked to inadequate staffing. …but states’ enforcement of 1987 laws has been weak in the face of a hugely profitable, politically powerful nursing home industry…”
“Many geriatric experts say that if the wasteful medical spending on this stage of life could be redirected, it could pay for all the social supports and services actually needed by today’s fragile elders and their families. Instead, public money has been … benefiting health care businesses but not necessarily patients.
“Home care agencies abruptly drop… or refuse… high-needs cases …as unprofitable under changes in the state’s Medicaid program. Hospitals, eager to clear beds, increasingly sent patients to nursing homes. The nursing homes were often too short-staffed … but still [draw] premium Medicare rates…
“The way the reimbursement system works, these decisions are not made on the basis of what the individuals need. They’re based on what the institutions need.”
“…Now mostly for-profit, hospice companies … provide supervision and visits at home a few times a week through Medicare … The catch:… [you] lose all Medicaid home care, the daily help he needed to be home at all.