From Frontline to Breadline: How Governor Andrew Cuomo’s Policies Have Created Financial Havoc for Nursing Home Workers

Governor Andrew Cuomo’s nursing home mandate, which helped to cause the deaths of thousands of patients, is just the tip of the iceberg. The residual effects from the governor’s onetime decision to force nursing homes to accept virus-positive patients will soon form an avalanche of problems too insurmountable to overcome.

As usual though, it’s the mainstream media -- both left and right -- that gets to pick winners and losers when it comes to any unfolding story. This is a shame. Not only do the media often push misinformation about crucial issues, they are obsessed with theoretical outcomes and not actual causes. This is why they are prone to jumping to illogical conclusions about critical situations. The pandemic led them to create false dilemmas for ventilators, Personal Protective Equipment (PPE), and now many of them, especially on the right, are doing this with what is happening in NYC nursing homes.

 

Cobble Hill Health Center in Brooklyn, where more than 50 deaths have been reported

YouTube screen grab

“Nursing homes” these days are called skilled nursing and rehabilitation centers: they are no longer places for the elderly alone. Gone are the days when a single licensed practical nurse managed a unit and would send senior residents out to the hospital if their temperature spiked above 100 degrees. In New York City for instance, these facilities serve as permanent homes for those in need of regular dialysis treatments, amputees, the mentally unstable, people who suffer chronic complications from HIV/AIDS, high risk diabetics, those who are on permanent life support because of near fatal accidents, hospice patients , and in some cases, homeless people.

One of the largest populations of patients however, are those who need post-surgery rehabilitative care. This is where many live for about four weeks after say, a knee replacement. So, LPNs, however experienced, can no longer run the show. It’s impractical and illegal. The skilled nursing and rehabilitation center is a place of diverse employment. Hands-on physical therapists, respiratory therapists, dialysis technicians, medical transporters, licensed dieticians, psychiatric nurses, phlebotomists, EKG techs, and in-house physicians, not to mention the CNA’s, LPNS, and RN’s that make up the majority of the staffing requirements, all receive paychecks from these organizations. Hence the name “skilled nursing facility.”

In early April, my phone was ringing non-stop with calls from recruiters, but because of Governor Cuomo’s edicts, all of those calls have stopped. In New York, the frenzy for healthcare workers is over. No more paychecks for many staff and no more commissions for the recruiters; not to mention all of the nurses from various parts of the country who uprooted their lives based on the promise of long-term contract employment. There are about 600 skilled nursing and rehab centers in New York, each with an average bed capacity of about 200. In the months leading up to the outbreak, as a freelance employee, I never worked at a facility with a census below 80%. I worked all of the time, when I wanted and where I wanted, but not anymore, a profoundly ironic twist to this ongoing saga particularly for those being called heroes, non-stop, by the media.

While that same media and some politicians on the right have been busy making this all about people’s elderly parents and grandparents, thousands of the other types of people described above have died in New York’s skilled nursing facilities. This why so many in the field are out of work. As someone who has been involved in many levels of hands-on care for virus patients, including helping to shroud and tag bodies once they had expired, I can tell you for a fact that the septuagenarian-plus demographic has not been the sole casualty of this virus. As stated above, there are a lot of people with “underlying issues” who live in these places. Furthermore, in an increasingly leftist and youth-orientated society, which at large no longer values the myriad contributions of those past sixty-five, the reporting on this just reeks of disingenuousness.

Andrew Cuomo completely mis-managed this situation. His leadership has been weak and emotional. His directives have been erroneous. The daily broadcasts which showcased him, unnecessarily as it turns out, harassing the Trump Administration for ventilators, PPE, and federal aid will live in infamy. The wrongful death lawsuits, financial ruin for many in the healthcare industry, the mental trauma dealt with by workers and surviving patients alike, and the mass exodus from New York City as a response to all of this -- all of which are already happening -- will be one for the books, I believe.

New York healthcare workers are one of the last key components of an aspiring middle class on the state’s economic pie chart. Although a lot of the workers come from the Third World, they are nevertheless a huge part of the window dressing that allows a city like New York not to be grouped in the Lonely Planet travel guides with places like Monrovia or Caracas. If there is a bounce back for the Big Apple, it will definitely take a long time.

Outcomes having been outlined, the next thing is to ask why this happened. Why did the nursing centers submit to the Governor’s mandates so obediently, killing thousands and rendering so many healthcare staffers as underemployed or unemployed without challenge? A big part of the answer is that in New York, skilled nursing is very big business, which in today’s terms, means that the industry’s financial solvency is implicitly tethered to government handouts and consequently, its mandates. These facilities might be acquired and managed by commercial conglomerates that own an array of businesses that have shown potential in becoming and remaining highly profitable (think Mitt Romney); they might be run by healthcare organizations that operate a cluster of facilities specializing in skilled nursing; or they may be small proprietorships run by a single family or a group of partners. But they all have the same thing in common: they rely heavily on Medicare and Medicaid. Private-pay only facilities are virtually non-existent in New York City. In the entire country, Medicare-funded skilled nursing centers account for over 90% of the industry. They must all comply with the edicts of state government agencies one of which is a Department of Health run by a governor.

The only way to prevent bad governance from having the power of poverty, life, or death over citizens is market competition. Here are three suggestions that take this into account:

1. Skilled nursing and rehabilitation centers need to be broken up -- no more one stop shopping. New healthcare recruits need to think more creatively about how they will use their certificates and licenses. Healthcare entrepreneurs focused on homeopathic nursing, alternative memory care, and restorative nutrition are desperately needed. Small health businesses have a much better chance of avoiding the government money-trap by offering consumers competitive rates and savings-based funding options.

·      2. Foreign low-wage labor is killing America’s healthcare industry. One of the main incentives for going into the business of skilled nursing is to turn a profit. The easiest way to do this is to take government money and then hire the cheapest labor available, disposing of it whenever necessary. Expired legislation like the Pensionado Act of 1903 have morphed into J-1 VISA programs, or other Exchange Visitor Programs that began after WWII. Some of these programs continue to produce devastating outcomes particularly in our healthcare care industry. Americans need to educate themselves about the history behind these projects and reject current versions of them.

·      3. Believing Christians must reclaim their right to heal the sick without government aid or intervention. Churches and Holy Orders need to re-dedicate themselves to running small teaching hospitals with attached recovery care units.

For everyone else, especially Red Staters, I suggest this: prepare more aggressively for an imminent Great Migration from pandemic-ravaged blue cities like New York. This is not a hypothetical. If you love your economic freedom; are conservative and religiously minded; don’t need a basket of government programs to exist and don’t want hordes of clueless immigrants, wholly ignorant of the U.S. Constitution or academic lefties overrunning your neighborhoods, then start networking now. I’m gonna say it: become a community organizer in some way, shape, or form. And do it right quick

Governor Andrew Cuomo’s nursing home mandate, which helped to cause the deaths of thousands of patients, is just the tip of the iceberg. The residual effects from the governor’s onetime decision to force nursing homes to accept virus-positive patients will soon form an avalanche of problems too insurmountable to overcome.

As usual though, it’s the mainstream media -- both left and right -- that gets to pick winners and losers when it comes to any unfolding story. This is a shame. Not only do the media often push misinformation about crucial issues, they are obsessed with theoretical outcomes and not actual causes. This is why they are prone to jumping to illogical conclusions about critical situations. The pandemic led them to create false dilemmas for ventilators, Personal Protective Equipment (PPE), and now many of them, especially on the right, are doing this with what is happening in NYC nursing homes.

 

Cobble Hill Health Center in Brooklyn, where more than 50 deaths have been reported

YouTube screen grab

“Nursing homes” these days are called skilled nursing and rehabilitation centers: they are no longer places for the elderly alone. Gone are the days when a single licensed practical nurse managed a unit and would send senior residents out to the hospital if their temperature spiked above 100 degrees. In New York City for instance, these facilities serve as permanent homes for those in need of regular dialysis treatments, amputees, the mentally unstable, people who suffer chronic complications from HIV/AIDS, high risk diabetics, those who are on permanent life support because of near fatal accidents, hospice patients , and in some cases, homeless people.

One of the largest populations of patients however, are those who need post-surgery rehabilitative care. This is where many live for about four weeks after say, a knee replacement. So, LPNs, however experienced, can no longer run the show. It’s impractical and illegal. The skilled nursing and rehabilitation center is a place of diverse employment. Hands-on physical therapists, respiratory therapists, dialysis technicians, medical transporters, licensed dieticians, psychiatric nurses, phlebotomists, EKG techs, and in-house physicians, not to mention the CNA’s, LPNS, and RN’s that make up the majority of the staffing requirements, all receive paychecks from these organizations. Hence the name “skilled nursing facility.”

In early April, my phone was ringing non-stop with calls from recruiters, but because of Governor Cuomo’s edicts, all of those calls have stopped. In New York, the frenzy for healthcare workers is over. No more paychecks for many staff and no more commissions for the recruiters; not to mention all of the nurses from various parts of the country who uprooted their lives based on the promise of long-term contract employment. There are about 600 skilled nursing and rehab centers in New York, each with an average bed capacity of about 200. In the months leading up to the outbreak, as a freelance employee, I never worked at a facility with a census below 80%. I worked all of the time, when I wanted and where I wanted, but not anymore, a profoundly ironic twist to this ongoing saga particularly for those being called heroes, non-stop, by the media.

While that same media and some politicians on the right have been busy making this all about people’s elderly parents and grandparents, thousands of the other types of people described above have died in New York’s skilled nursing facilities. This why so many in the field are out of work. As someone who has been involved in many levels of hands-on care for virus patients, including helping to shroud and tag bodies once they had expired, I can tell you for a fact that the septuagenarian-plus demographic has not been the sole casualty of this virus. As stated above, there are a lot of people with “underlying issues” who live in these places. Furthermore, in an increasingly leftist and youth-orientated society, which at large no longer values the myriad contributions of those past sixty-five, the reporting on this just reeks of disingenuousness.

Andrew Cuomo completely mis-managed this situation. His leadership has been weak and emotional. His directives have been erroneous. The daily broadcasts which showcased him, unnecessarily as it turns out, harassing the Trump Administration for ventilators, PPE, and federal aid will live in infamy. The wrongful death lawsuits, financial ruin for many in the healthcare industry, the mental trauma dealt with by workers and surviving patients alike, and the mass exodus from New York City as a response to all of this -- all of which are already happening -- will be one for the books, I believe.

New York healthcare workers are one of the last key components of an aspiring middle class on the state’s economic pie chart. Although a lot of the workers come from the Third World, they are nevertheless a huge part of the window dressing that allows a city like New York not to be grouped in the Lonely Planet travel guides with places like Monrovia or Caracas. If there is a bounce back for the Big Apple, it will definitely take a long time.

Outcomes having been outlined, the next thing is to ask why this happened. Why did the nursing centers submit to the Governor’s mandates so obediently, killing thousands and rendering so many healthcare staffers as underemployed or unemployed without challenge? A big part of the answer is that in New York, skilled nursing is very big business, which in today’s terms, means that the industry’s financial solvency is implicitly tethered to government handouts and consequently, its mandates. These facilities might be acquired and managed by commercial conglomerates that own an array of businesses that have shown potential in becoming and remaining highly profitable (think Mitt Romney); they might be run by healthcare organizations that operate a cluster of facilities specializing in skilled nursing; or they may be small proprietorships run by a single family or a group of partners. But they all have the same thing in common: they rely heavily on Medicare and Medicaid. Private-pay only facilities are virtually non-existent in New York City. In the entire country, Medicare-funded skilled nursing centers account for over 90% of the industry. They must all comply with the edicts of state government agencies one of which is a Department of Health run by a governor.

The only way to prevent bad governance from having the power of poverty, life, or death over citizens is market competition. Here are three suggestions that take this into account:

1. Skilled nursing and rehabilitation centers need to be broken up -- no more one stop shopping. New healthcare recruits need to think more creatively about how they will use their certificates and licenses. Healthcare entrepreneurs focused on homeopathic nursing, alternative memory care, and restorative nutrition are desperately needed. Small health businesses have a much better chance of avoiding the government money-trap by offering consumers competitive rates and savings-based funding options.

·      2. Foreign low-wage labor is killing America’s healthcare industry. One of the main incentives for going into the business of skilled nursing is to turn a profit. The easiest way to do this is to take government money and then hire the cheapest labor available, disposing of it whenever necessary. Expired legislation like the Pensionado Act of 1903 have morphed into J-1 VISA programs, or other Exchange Visitor Programs that began after WWII. Some of these programs continue to produce devastating outcomes particularly in our healthcare care industry. Americans need to educate themselves about the history behind these projects and reject current versions of them.

·      3. Believing Christians must reclaim their right to heal the sick without government aid or intervention. Churches and Holy Orders need to re-dedicate themselves to running small teaching hospitals with attached recovery care units.

For everyone else, especially Red Staters, I suggest this: prepare more aggressively for an imminent Great Migration from pandemic-ravaged blue cities like New York. This is not a hypothetical. If you love your economic freedom; are conservative and religiously minded; don’t need a basket of government programs to exist and don’t want hordes of clueless immigrants, wholly ignorant of the U.S. Constitution or academic lefties overrunning your neighborhoods, then start networking now. I’m gonna say it: become a community organizer in some way, shape, or form. And do it right quick