SCHENECTADY — Cold and frustrated union members picketed a Schenectady on Thursday as part of a larger protest over staffing in the for-profit nursing home industry in New York.
The small cluster of employees were outside the Schenectady Center for Rehabilitation and Nursing because it’s one of many nursing homes run by Centers Health Care, a large for-profit company.
But the rally wasn’t specifically about the Altamont Avenue facility or its Bronx-based owner, said 1199SEIU Healthcare Workers East. The industry is the problem, and the COVID-19 pandemic has highlighted the issue of inadequate staffing, the union said. It staged similar pickets outside other nursing homes statewide Thursday and is pushing for legislative change.
Others have raised the issue as well: A late-January report by the state Attorney General’s Office got a lot of attention for faulting certain aspects of Gov. Andrew Cuomo’s handling of the nursing home COVID crisis, and for concealing its tragically high death toll.
But the report’s criticism was mainly directed at the for-profit nursing home industry, and repeatedly mentioned high staff-to-resident ratios in some of the hardest-hit New York nursing homes.
The Attorney General’s report noted that current state law does not require a large nursing staff in nursing homes — one RN for one shift of at least eight hours each day, plus one RN or LPN serving as charge nurse around the clock for each unit or cluster of units in a facility.
Eloise Downs of Schenectady, a certified nursing assistant who has worked for Schenectady Center and its predecessor entities for 33 years, said the nursing home is particularly short-staffed on weekends.
“Some days there’s not enough help,” she said. “You want to spend time with the residents but you can’t.
“The staffing is good during the week but then the weekend, we have like two aides.”
Downs said she thinks using temporary and agency staff is not a good solution.
“I would like to see more permanent people.”
The facility, she added, does have adequate supplies of protective equipment and a management that is generally supportive of its employees, though it tends to look for ways around problems rather than solutions.
Schenectady Center previously has been the subject of staffing complaints by employees and by families of residents, but the issue is hardly unique to it, or to the other facilities run by its parent corporation.
An August 2020 report by the state Department of Health cautioned about the high cost of mandated minimum staffing levels in hospitals and nursing homes, and it concluded that flexible staffing solutions are needed.
But the issue is not dead — nurses unions are still pushing for mandated minimum staffing, and COVID pandemic has raised the profile of the issue.
The goal of 1199SEIU, and the point of the series of rallies it held statewide Thursday, is to change the state regulatory structure governing nursing homes.
Executive Vice President Milly Silva, leader of the union’s nursing home division, said the sacrifices of so many employees and deaths of so many residents through the pandemic is driving the effort.
“Our goal is that the experience of the last year is honored,” she said.
The union is pressing an initiative its calls Invest in Quality Care, which seeks legislation and regulatory changes to mandate that nursing home operators:
- Invest at least 70 percent of revenue in direct care;
- Be transparent about their financial relationships, as the current regulatory environment incentivizes moving money out of the facility;
- Be held accountable for self-dealing arrangements such as when a spinoff or a company owned by a relative is hired to provide linens or food service.
This last situation is something state Attorney General Letitia James flagged in her report as problematic.
Significant amounts of revenue can disappear into a complex and layered structure of contractors and subcontractors without comparable degrees of benefit for residents, Silva said. Administrative fees are a particularly common method of accomplishing this, she said.
“You may have a facility that on paper looks like it’s struggling,” she said, but in fact it’s taking its profits before paying for care.
Cuomo on Monday voiced support for reforms that would mandate a degree of investment by nursing home operators in their facilities.
“We were gratified to see Governor Cuomo put front and center earlier this week that there does need to be reform,” Silva said.
Individual legislators, meanwhile, are pursuing parts of 1199SEIU’s Invest In Quality Care agenda, she added.
Silva said she could find things to say about Centers Health Care or other individual operators but the goal is systemic reform rather than piecemeal solutions.
Centers Health Care is one of the larger operators in the industry, with 50 skilled nursing/rehabilitation facilities that have more than 7,000 residents. Combined with its other operations, it employs more than 25,000 people to provide a continuum of care.
Its facilities in the Capital Region have had mixed experiences through the pandemic, with some severely impacted and others lightly affected, sometimes right in the same community. Warren Center in Queensbury has had seven resident deaths through Feb. 9, according to data the state was forced to release, while Glens Falls Center, four miles south, has lost 32 residents. Fulton Center in Gloversville has lost 40 residents, the most of any facility in the region. Slate Center in Granville has lost just two.
Schenectady Center has had eight resident deaths.
Each of the facilities maintains a daily online dashboard showing the number of infections, a step many facilities don’t take.
Spokesman Jeff Jacomowitz said all of the company’s facilities have complied with all state and federal guidance through the entire crisis, and each Capital Region facility has now received three vaccination visits from Walgreens pharmacists.
He said some of the facilities are now COVID-free after a spate of infections. What causes one facility to have a surge of deaths and another to escape relatively unscathed, and why that might mirror or go directly opposite the trends in the surrounding community, is a question for the federal Centers for Disease Control, he added.
For the specific complaints lodged against the for-profit industry — inadequate staffing and siphoned profits — Jackomowitz said Centers immediately addresses staffing gaps with floating and traveling nurses and with bonus days to staff who agree to work on a day off.
The idea of revenue being siphoned to spinoff companies is a false claim that disgruntled employees make, he added.
Jacomowitz said vaccination and preparation are making a difference as the one-year mark nears.
“All in all, we hope that the hard COVID times are behind us and like the beginning of the post-holiday wave, our facilities were better equipped in the winter versus last spring when testing was nearly non-existent. If another spike happens, we will be ready for it.”