By Steve Wishnia

SALAMANCA, N.Y.— Sondra Lamacchia, a licensed practical nurse at a nursing home in Salamanca, about 60 miles south of Buffalo, says she wishes her employer would hire temporary laundry workers.

The laundry room there is so understaffed, she says, that it “is stuffed from the floor to the ceiling with dirty laundry.” She and other workers recently had to use pillowcases to wash patients because they didn’t have any clean washcloths, she adds.

The Salamanca nursing home is one of four owned by the Personal Healthcare Management LLC chain in rural towns south of Buffalo – the other three are in Dunkirk, Eden, and Houghton — where more than 200 workers represented by 1199SEIU United Healthcare Workers are seeking a better contract. Their current one expired at the end of December.

The union will be doing “informational picketing” in Dunkirk and Eden on Wednesday, Feb. 8.

Their three main issues are understaffing, health care, and wages. According to 1199SEIU administrative organizer Darlene Gates, a former nursing-home worker, who is the union’s lead bargainer, they’re paid well below other nursing homes in the area. Service workers in the dietary, housekeeping, and laundry departments get the upstate minimum wage of $14.20 an hour.

Licensed practical nurses are getting $19.50 after a $2 “mid-contract raise” says Lamacchia, who has worked at the Salamanca nursing home for almost nine years. “Nurses just out of school make that much at other facilities.”

The workers’ health insurance only covers partial services, says Gates: It pays for diabetics’ insulin, but not for the pens or needles they need to administer it. Hospitalized workers can get hit with copayments of $500 and up — a lot of money for someone making $14.20 an hour, she adds.

A lot of providers also don’t take that insurance. Lamacchia says that when she had a strep throat in December, she had to go to an urgent-care facility because it wouldn’t pay her doctor.

The next bargaining session is scheduled for Feb. 14. “There’s been some movement at the table, but not much,” says Gates. For example, management wants to keep laundry workers at minimum wage. "They just got a $1-an-hour increase, when the upstate minimum went up from $13.20 on Dec. 31."

“This is a for-profit facility,” she notes.

Personal Healthcare Management LLC, based in Tarrytown, bought the four facilities from the Absolut Care chain in 2018 for slightly over $20 million. They have a total of 300 beds, 120 of them in Salamanca. The deal was structured in two parts: buying the businesses from Absolut Care and buying the land they’re located on from a separate company.

Personal Healthcare Management has said that it specializes in taking over “struggling and poor-performance facilities, turning them into high-quality nursing homes that provide healthy, safe, and positive environments.” The four facilities had racked up numerous complaints, citations, and fines from the state Department of Health while owned by Absolut Care, the Buffalo News reported in 2018.

Nepotistic outsourcing

Personal Healthcare Management, however, is taking advantage of state laws that let for-profit nursing homes do business with “non-arm’s-length companies” — enterprises owned or co-owned by the operators themselves, their relatives, or their business partners. Most for-profit nursing homes in the state do this, according to 1199SEIU.

According to state records the union analyzed, three women are listed as the owners of the four nursing homes, while Personal Healthcare Management, owned by three of their male relatives, owns the land. In 2019, the four facilities paid it $2.3 million in rent, the union says, while in 2020, they paid it $1.2 million and another $750,000 to other related real-estate companies.

It’s also common that for-profit nursing homes hire temporary staff through a related company, the Buffalo News reported last year.

The state nursing-home staffing law enacted in 2021 also requires nursing homes to disclose if they do business with a related company, and to name any of their investors or their relatives who own that company. A report released last summer by the Empire Center for Public Policy — an Albany free-market, often anti-union fiscal-watchdog group — found that 72% of the 394 for-profit nursing homes in the state did business with related companies in 2020. That business amounted to more than $1 billion, more than 2½ times what it was ten years earlier, it said.

A Kaiser Health News analysis of state records released last month, found that “nearly half the state’s 600-plus nursing homes hired companies run or controlled by their owners, frequently paying them well above the cost of services.” In 2020, it said, “these affiliated corporations collectively amassed profits of $269 million, yielding average margins of 27%, while the nursing homes that hired them were strained by staff shortages, harrowing injuries, and mounting deaths from COVID-19.”

Personal Healthcare Management put $1 million into the Salamanca facility, says Lamacchia, but nothing into the employees. Understaffing, she adds, is so bad that “even our long-termers have left,” and she recently had to work three double shifts in a week.

“We don’t have any management,” she continues. Both the director of nursing and the administrator quit last month. Meanwhile, the company pays “top dollar” to an agency to bring in temporary licensed practical nurses.

“They come in when we have holes, and we have a lot of holes,” Lamacchia says — and those holes aren’t always filled.

“I’ve never seen it so bad. It used to be a fun place to work,” she says. “I wish they’d agree to pay more so people would want to work here.”