MANHATTAN — As the number of long-term health care facilities across the borough has declined over the past decade, Lower Manhattan has been hit the hardest by a string of closures, according to data from the New York State Department of Health.
That includes facilities for long-term care for seniors, for those with disabilities and traumatic brain injury, and for HIV/AIDS patients. The decline has not gone unnoticed by community members who have expressed concern about an increasingly thin supply of long-term care options for their loved ones.
Lower Manhattan has lost more than half of its certified long-term care facility beds within roughly the last decade, according to the state data, going from 1,085 beds across eight facilities since the start of 2006 to 418 beds across three facilities this year.
The losses in Lower Manhattan account for the majority of nursing home bed losses across the entire city during that 10-year period — the number of certified nursing home beds in Manhattan has declined by 1,197, going from 6,948 beds across 22 facilities at the start of 2006 to 5,751 beds across 17 facilities.
Of those beds, 219 were lost in February 2015 when the city lifted a deed restriction on Rivington House that had for decades kept it a nursing home for HIV/AIDS patients. As a result, the building is now undergoing a condo conversion.
But nursing home beds in Lower Manhattan had already been on the decline for years:
• St. Rose’s Home, holding 35 beds at 71 Jackson St., ceased operations on March 31, 2009.
• The 95-bed Bialystoker Center for Nursing and Rehabilitation at 228 East Broadway shuttered Oct. 24, 2011.
• And 240 beds were lost when the Cabrini Center for Nursing and Rehabilitation at 542 E. 5th St. closed on June 27, 2012.
According to most recent facility occupancy reports via DOH, nursing homes in Manhattan were at 95 percent capacity as of July, meaning there are roughly 300 available beds.
'WHERE AM I GOING TO GO?'
The data shared by DOH confirms the anxieties of Lower East Side locals, who have spoken to the dearth of nursing homes in the area.
When searching for a place where her increasingly frail mother could comfortably live out the rest of her life, longtime resident and community activist Kathleen Webster said she ultimately had to give up on keeping her mother nearby due to the lack of nearby facilities.
"It got really bad and I needed to find a care facility," said Webster, who is the president of the Sara D. Roosevelt Park Coalition. "There were no beds available, so I couldn't have her here anymore.”
Bialystoker had already closed at the time, said Webster, and the other facilities had no empty beds, forcing her to send her mother to Baltimore, Maryland, where she lived with Webster's sister until her death in May 2015.
Webster is one of many locals now demanding the reversal of the deal that led to the sale of Rivington House — which for years operated as a facility for HIV/AIDS patients, then briefly as a short-term senior nursing home — dismayed at the loss of a place that could have offered much-needed community services.
There are now two nursing homes left in the Lower East Side — a 255-bed facility within the New Gouverneur Hospital on Madison Street, and the 58-bed New East Side Nursing Home on Willett Street.
There is one nursing home in Greenwich Village — another VillageCare facility on Hudson Street, where the number of beds has shrunk from 200 to 105, according to the DOH.
Activists who work with the elderly say the lack of options often leads to the exacerbation of seniors' existing health problems, which are neglected without long-term care facilities.
"Sometimes people stay in their homes, not addressing health problems until it's too late," said Melissa Aese of the University Settlement, which is part of the Neighbors to Save Rivington House coalition.
A 64-year-old lifelong Lower East Side resident — born in Beth Israel and now settled on Montgomery Street — says she fears the day she may have to consider long-term care options for her 90-year-old mother, who currently lives alone in a Rivington Street apartment.
"Where are the places for us to take care of the elderly in our neighborhood?" said Miriam Cohon, adding she is overcome with emotion when discussing the lack of care options. "If there was a need for me to put her somewhere, where am I going to go?"
Bob Humber, who's retired and helps tend to Sara D. Roosevelt Park's community garden and provides volunteer opportunities and mentorship to both the area’s homeless and youth, says he had looked to the Rivington House as one of the last of dwindling neighborhood resources as she gets older.
“I was hoping, in my twilight years, to have somewhere to go in the community,” said Humber, who's also a community activist, during a town hall about Rivington House in June. “But I look around and I see nothing.”
Check out the map below, showing open care facilities, closed facilities, and facilities that have increased or decreased their number of beds.
ALTERNATIVE CARE OPTIONS
The state has been working on transitioning vulnerable populations out of institutions and into home care or community-based options, according to officials.
The Dept. of Health has enacted a handful of policies in line with this plan, allowing members of vulnerable populations to eschew nursing homes for alternative options that allow for more independence.
The Money Follows the Person (MFP) Demonstration, for example, helps transition vulnerable populations — the elderly, those with disabilities or those with traumatic brain injury — into the community care options they prefer.
Additionally, the state has launched several supportive housing programs to transition individuals from nursing homes into home care, which have helped fill in the gaps left by facilities downsizing and closures.
For example, when the Coler-Goldwater facility on Roosevelt Island shrunk from 574 to 164 beds, many patients were relocated to nearby “independent housing” care facility Metro East 99th Street.
The number of individuals enrolled in the state’s Managed Long Term Care (MLTC) plans, facilitating home care, has more than doubled within the last four years alone, going from 43,478 at the start of 2012 to 123,418 in August 2016.
Meanwhile, as the state works out alternative care options, city officials have announced plans to build an affordable senior housing and health care facility in the Lower East Side, which the mayor's office said would replace about half of Rivington House's beds.
Critics, however, of the plan say it will not help the city's current elderly population.
"It would take many years of a ULURP process to create. The seniors with need right now would not live long enough to see it," said a Neighbors to Save Rivington House statement in response to the plan.