For Joy Elizabeth Catalano, the breaking point came the night more than a dozen nurses and aides called in sick.
Then the director of nursing at Buffalo’s Ellicott Center for Rehabilitation and Nursing, Catalano recalled only three licensed practical nurses and one certified nursing aide on duty that night in June 2017 to care for about 150 residents. Normally, she said, there would have been 16 or more nursing staff.
A month later, Catalano resigned.
“I left because ethically and morally I couldn’t handle it anymore,” Catalano said.
Catalano shared her experiences at Ellicott Center after reading a Buffalo News story about a woman who lost her left eye in 2016 because of the nursing home’s failure to administer drops to her eye following cataract surgery.
Catalano said she was hired in 2017 to help implement a plan to prevent similar incidents. But after five months, she said, understaffing, a lack of supplies, including clean towels and sheets, and the failure of the facility’s out-of-town owners to correct those problems led to her decision to leave.
The News’ ongoing series of stories on nursing homes found that 16 of the 47 nursing homes in Erie and Niagara counties have been bought by for-profit, out-of-town investors in the last 11 years. Most of those homes are among the worst rated in the region, have a high rate of complaints that result in citations from the state Health Department and have a disproportionate number of fines. Time spent per day by registered nurses with residents at these homes is often less than the state average.
Ellicott Center is among those nursing homes. In October, it dropped from an overall two-star rating, or “below average, to a one-star rating, “much below average,” the lowest rating in the federal government's five-star system for nursing homes.
A lack of registered nurses at Ellicott Center was one of the concerns Catalano said she raised with Ellicott Center’s administrator at the time. She said the facility was frequently without an RN at night.
Mark Lazar, who became the home’s administrator months after Catalano quit, told The News there are now registered nurses on every shift at Ellicott Center. He said that was one of his priorities when he took over as administrator in December 2017, more than a year after Sally Keller lost her eye.
In his time as administrator, he has hired 11 registered nurses, according to the Centers Health Care, the New York City company that oversees the facility’s operations.
New York State does not require nursing homes to meet minimum staffing ratios for nursing staff and residents.
Staffing at Ellicott Center was rated in October at three stars, or "average."
But the registered nurses spend less time per day with residents there than they do at nursing homes across the state. At Ellicott Center, RNs spent on average 30 minutes a day with each resident; the statewide average is 42 minutes.
Not enough resources
Catalano began working at Ellicott Center in February 2017. Before then, Catalano said she worked at several nursing homes – first as a certified nursing aide and later as a registered nurse, after graduating in 2004 from Trocaire College.
“The first time I walked into a nursing home in 1993 and looked at the elderly residents, I knew that was the career for me,” the 46-year-old Orchard Park resident said.
But as time went on, Catalano says she came to realize the challenges caused by short staffing and lack of supplies were beyond her control.
At Ellicott Center, she said she frequently complained to the administration that there were not enough resources to provide quality care.
“They’d apologize and say things will get better. I heard that all the time,” Catalano said.
A lack of hand towels and sheets to clean residents and change bedding, she said, was among the most upsetting of the shortages.
“I’d have staff tell me, ‘Hey, I’m out of linens. How am I supposed to do my job?’ The laundry staff was given quotas, a count of how many linens to place on carts going up to the floors. But sometimes it takes more than one washcloth to wash a resident,” she said.
Nursing aides, according to Catalano, would hide clean towels and sheets in the drawers of residents’ rooms to make sure they could properly care for residents.
“Management knew there was a shortage of linen and we’d have to make ‘linen sweeps’ to find the linens aides had hidden,” Catalano said.
Catalano said low staffing levels and absenteeism at the Ellicott Center often forced her and other managers to help the kitchen staff fill food trays for residents, but sometimes the food was not delivered to the residents' rooms.
“We also had nourishment trays that were supposed to be taken at night to the rooms of diabetics and those who were malnourished and needed the calories,” Catalano said. “In the morning when I’d come in, the trays were still sitting at the nursing stations.”
She says that when she questioned the CNAs, the same explanation was repeatedly given: “We were too short-staffed. We didn’t have the time.”
Her attempts to make sure the trays were delivered included holding supervisors accountable, but they too cited short staffing.
Some employees, she said, were overworked, but others failed to grasp the need to work as a team. Low pay for CNAs, often just above minimum wage, was part of the problem, Catalano said.
Lazar, the current administrator, says services have improved since he has taken over because he has the financial support of the owners.
The Ellicott Center is operated by Waterfront Operations Associates LLC, a company owned by Kenneth Rozenberg and Jeffrey Sicklick, who are executives at Centers Health Care.
A Centers spokesman issued a statement defending operations at Ellicott: “We are confident that any concerns that were raised by former employees have been thoroughly investigated and addressed as needed. The leadership and front line staff at Ellicott...are all dedicated and caring individuals.
"We are proud of the staff and the care they provide to our residents. We welcome the community to come tour and see firsthand the welcoming staff, the comprehensive renovations, and the new innovative, state-of-the-art therapy gym. We take our residents' care very seriously and address all concerns, whether raised by staff or residents, with the utmost urgency.”
Catalano says she has no way of knowing if conditions have improved since she left in early July 2017, but she says she is upset at what happened to Keller.
“I’m saddened by the fact that this woman lost her eye in what could have been easily preventable,” Catalano said.
Since the summer of 2017, she said she has not worked in a nursing home. Catalano has instead stayed home raising her teenage daughter.
“The good get tired of no changes being made and say, ‘Why stay?’ That was me.”
The News' Lou Michel and Mike McAndrew spent six months investigating Western New York nursing homes. Click here to see the results of their work.
Story topics: Nursing Homes