Tomika Lee was sitting at her security guard post in the lobby of the Terence Cardinal Cooke Health Care Center, when a nurse alerted her that two elderly men were fighting.
“It was getting really heated,” she said. One of the men was taking his wheelchair apart, piece by piece, and throwing it at the other resident. They were fighting over cigarettes, Lee, who was 23-years-old at the time, learned.
The facility’s rules dictate that security guards can’t physically restrain residents, they have to call a nurse, so Lee was verbally trying to defuse the situation to no avail.
“I actually left because I was fearing for my safety,” she said.
As the residents continued to beat each other, Lee paged a nurse for help but nobody came for nearly 15 minutes, she said. When someone finally arrived, a male security guard had already calmed down the two residents. Lee had only been on the job for a couple of months, but she had already grown used to the violence. Nursing homes are required to report fights or verbal altercations to the state Department of Health and ArchCare said it has no record of the fight in its system, according to the nonprofit.
The violence Lee witnessed during her two tumultuous years at Cooke were not unique to the facility. Former patients, employees, and advocates say that Terence Cardinal Cooke Health Care Center, one of the largest nursing home facilities in the city, has been plagued with violence, theft, drug use, and overdoses among other crimes, for years.
911 call data obtained by Documented from the NYPD revealed that the 679-bed nursing home and physical rehabilitation care facility in East Harlem had seen a 55 percent increase in crime-related calls, from 188 in 2017 to 292 in 2021, the last full year of available data. Ambulance calls also increased by 43 percent over the same time period, exploding from 310 calls in 2017 to 621 calls in 2021.
Security guards and volunteers at Cooke told Documented how they struggled to do their jobs as the facility descended into chaos during the pandemic. Drug use, drug dealing, theft, and assault are just some of the issues workers say they confront daily. In line with the data, security guards at Cooke say that police visits were frequent, with them showing up sometimes two or three times a day.
Inside Cooke: Plagued with drugs and violence
Almost immediately after he began working at Cooke in 2020, William P. Wickland, a 61-year-old former security guard at Cooke, who is originally from Guyana, said he felt something was off. Stationed at the front desk, he would often see residents begging for money in the lobby.
“I wouldn’t put my own mother there,” he said. “It’s evil.”
Visiting family members would complain to Wickland about the poor care their loved ones were receiving. Residents and visitors alike would also complain to him about the quality of the food. What was Wickland to do? He was only a security guard, so his hands were tied, he explained.
“If you’re a religious facility you’re supposed to show kindness to people, and I saw things that just weren’t right,” he said.
While employed at Cooke during the pandemic, Wickland said he often worked worked 70 hours a week, a claim ArchCare denies. On a routine basis, he says residents would try to flee because the conditions were so bad. Wickland also ran into trouble because the facility didn’t permit security to touch residents. In a statement to Documented, Scott La Rue, president and chief executive officer of ArchCare, said that “There has only been one resident elopement from TCC in the last three years; the resident was found and returned to the facility in a matter of hours.”
Once, Wickland was called when a resident fell and hit his head. He was forced to watch as the man lay on the floor for 45 minutes until someone came to help, he remembered. ArchCare says it has no record of this incident.
Wickland took a medical leave of absence from his job at the facility in 2021 after he said the conditions became impossible to work under. ArchCare says they fired him in 2022, which Wickland claims was illegal and is now in union arbitration with the organization.
Lee, the security guard, says it’s not hard to wonder why so many residents try to flee. According to Lee, the facility has dirty floors, broken elevators, constant construction, broken fire alarms that ring constantly, and poor food.
“There’s certain times and shifts where there is barely any housekeeping to cover the building. How are there only four or five people keeping this whole building clean?”
Shelia Thanes, 58, who was a resident at Cooke between 2018 and 2020, described her time at the facility as a nightmare. Thanes, who has HIV, was faced with the prospect of homelessness. Having no place else to go she ended up at Cooke as her last resort.
“The kitchen was dirty,” she said. “The food was dirty. Bugs was all in the food.”
Due to her complications with HIV, Thanes depends on a wheelchair for mobility. Thanes says, as a result, other patients took advantage of her by stealing her personal property. Because residents are so desperate for food and other amenities, Lee says they have begun to turn on each other, calling the police to frequently show up.
“A lot of them steal from each other,” she said. “I’ve seen residents fighting for taking each other’s soda and chips. I’ve seen people fight because they say their roommate stole their clothes or ate their food.”
Wickland agrees and argues that the overall atmosphere of neglect at Cooke created conditions that have forced the residents to fend for themselves. The lack of adequate food is enough to have the residents turn on each other.
“The residents are stealing food because they are not being fed enough,” he said. “Families are complaining, but if you don’t know who to talk to, they are not going to get results.”
Lee puts it more bluntly.
“It’s like the streets up in there.”
Jon Goldberg, a spokesperson for Terence Cardinal Cooke, attributes many of the issues to the sheer size of the facility as well the challenges of providing services to historically economically and socially disadvantaged communities.
“It’s a 609-bed facility that serves a disproportionate number of residents that have mental health issues, cognitive disabilities, history of experiencing homelessness, addiction, and other social challenges,” he said. “The fact that many of the residents have mental health issues, they tend to call on 911 for all sorts of things.”
Years of nursing home neglect leads to increase in crime
Originally, what would be known as Terence Cardinal Cooke was home to the Flower Free Surgical Hospital, first built in 1889 and served as the first teaching hospital in the U.S. to be owned by a medical college.
In 1935, the hospital was transferred to its current location in East Harlem. By 1978, Flower Free Surgical Hospital came under the ownership of ArchCare, the health care arm of the Archdiocese of New York, spearheaded by the then-Archbishop of New York Terence Cardinal Cooke who was quietly battling leukemia throughout his 14-year tenure. Archbishop Cooke was renowned for his commitment to serving the sick and disadvantaged.
In the 1980s, the hospital shifted its focus to providing long-term nursing care for elderly patients as well as short-term rehabilitation care. A year after the death of Archbishop Cooke, in 1984, the facility officially changed its name to Terence Cardinal Cooke Health Care Center in his honor.
And, as of 2021, ArchCare has grown to become one of the largest nursing home operators in the country with $1 billion in annual revenues. ArchCare’s president and chief financial officer La Rue, who has been president since 2011, has a compensation package worth $1.47 million.
Salvadoran immigrant Gilbert Sabater, 86, remembers a time when Cooke was a model facility. Sabater’s mother and aunt were both residents at Cooke and since his mother passed away in 2004, he has volunteered his time to assist the residents and to serve on Cooke’s family council, which, as per federal law, residents and families have the right to form. The independent councils meet regularly to discuss quality-of-life issues as well as give family members and residents a voice in decision making. Nursing homes are required to listen to the council’s recommendations and respond to any concerns brought up in meetings.
Sabater first came to the United States in 1951, and proudly served in the U.S. Marine Corps in the 1960s. His role as the family council makes him the eyes and ears of the facility. According to Sabater, over the years, the quality of care at Cooke had plummeted. Sabater was banned from the facility after being accused of inappropriately touching a resident in 2015. However, the New York City Department of Health found “insufficient credible evidence to substantiate the allegation,” according to a letter Sabater shared with Documented. He remains banned from the facility, which he says is due to his patient advocacy.
Sabater, a devoted Catholic, says that the facility became corporatized and slowly lost sight of its original mission to serve the needy. Sabater says that in an effort to maximize profits, Cooke began employing fewer certified nursing assistants (CNAs) to assist a growing residential population.
“If you have one CNA with 15 residents, you have a problem,” he said. “That’s where the care begins to deteriorate. It’s not rocket science.”
However, according to the U.S. Centers for Medicare & Medicaid Services, Cooke provides 2 hours and 47 minutes of CNA hours per resident per day, which is higher than that state and national average. Cooke also had higher numbers of total nurse staff hours on average than the state and national.
According to data from the New York State Department of Health, between 2016 and 2020 Terence Cardinal Cooke Health Care Center accumulated 34 citations for violations of the public health code; 26 of those citations are health-related.
Many of the citations were for violations of residents’ rights, nutritional deficiencies, and neglect. In 2011, the facility received a $2,000 fine for violations regarding its quality of care. One citation from 2016 found that on multiple occasions the facility failed to report incidents of resident-to-resident abuse to law enforcement. Following an incident in 2021 with a resident 81-year-old Alzheimer’s patient, a third party contractor X-ray technician was charged with misdemeanor sex abuse and endangering the welfare of an incompetent or physically disabled person while working at Cooke.
Cooke’s parent company, ArchCare has also directly engaged in unlawful behavior. In 2018, Cooke was found to have stolen $32,942.74 in worker wages, according to New York State Department of Labor data obtained by Documented. The U.S. Attorney’s office forced ArchCare, in 2015, to pay $3.5 million to the federal government for systematically overbilling Medicare patients at the highest therapy reimbursement level. It wasn’t the first time the facility was caught overbilling Medicare. In 2005, the State of New York ordered Cooke to repay $2.3 million to the state for billing Medicare for services provided to patients who had already died.
“They used to cop drugs for us”
In addition to having to constantly contend with residents fighting and stealing from each other, Wickland and Lee were also forced to deal with a more dangerous issue.
“Patients are openly taking drugs and employees are bringing drugs in,” said Wickland. “Patients are selling drugs to each other.”
Thanes said residents would openly deal drugs inside the facility and staff would often purchase marijuana for her from outside the facility.
“They used to cop drugs for us,” she said. “They used to buy liquor for us, reefer, cigarettes, and contraband. And they used to use it with us.”
For Thanes, drug use was her way to cope with the conditions at Cooke. “I couldn’t take that place no more because it’s like a prison,” she said.
Although visitors are checked in by security, Wickland says that they still are unable to vet everyone properly. “They’re dealing heavy drugs, cocaine, heroin,” he said. “As being a security person, we are trained to check the things they bring in but we can’t check their person. We can only do but so much.”
On several occasions, Wickland and Lee said security has caught residents smuggling in drugs through baskets they threw out the window and pulled back in. Visitors have also been caught smuggling drugs in food.
“We’ve seen people come back from the store with an open sandwich with drugs in between the meat,” Lee said.
According to a police report from July 2020, the NYPD was called when security intercepted drugs being hidden inside a bagel sandwich.
“Upon inspection of the package Security Officer Wayne Knight found nine zip lock bags of alleged crack/cocaine inside a bagel,” the report stated.
“Terence Cardinal Cooke has a zero-tolerance policy in regards to drugs,” Goldberg said. “If the nursing home has reason to believe a resident possesses illegal drugs or has tried to sell illegal drugs that is a matter for law enforcement and the police are called without exception.”
Lax state oversight
Richard J. Mollot, the executive director of Long Term Care Community Coalition, a nonprofit organization that advocates on behalf of people in nursing homes and serves as a nursing home watchdog, called it “one of the worst of the worst facilities as far as I know,” he said.
Although New York has strong nursing home regulations, Mollot says they are barely enforced. “State oversight across the board is pretty weak,” he said. “Which is why nursing homes tend to be, to put it frankly, pretty crappy places to live and to work.” Because of weak oversight, Mollot argues that poorly run nursing homes are continuing to generate huge profits with near impunity.
“As a result, it makes it a more profitable place to invest money because you are very unlikely going to be held accountable for low satisfaction and the neglect and ultimate abuse that results because of low staffing.”
New York State Assemblyman Ron Kim, whose uncle died in a nursing home after battling Covid-19, was not surprised to learn about the level of crime that appears to be occurring inside the City’s nursing homes. Kim, who has long been a leading advocate for nursing home reform, says that the spike in 911-related crime calls is the inevitable result of the overall decline in nursing home care.
“People are feeling like they are stuck in the middle of Hunger Games inside nursing homes,” he said. “Literally they are fighting each other for food. It’s crazy.”
Kim points to an overall lack of urgency in Albany to not only enforce existing state regulations but to hold nursing home companies accountable for their cost-cutting measures, especially when many nursing homes rely on public funds through Medicaid and Medicare, to operate.
“Unless we have the capacity to say that we can do a better job running these publicly funded facilities, all we’re doing is playing catch-up and putting bandaids on a completely privatized space that’s out of control,” he said.
As a result of the 2008 recession, many local municipalities in New York privatized county-run nursing home facilities. In Kim’s view, one of the only ways to significantly improve the conditions for both nursing home residents and workers is to reinvest in publicly run facilities.
“That’s the only way we can put a check on the for-profit, privately run facilities as well as non-profit institutions that have no incentive to do better,” he said.
In January, Lee quit her job at Cooke. The pressures of the workplace were too much for her, she said.
“Time to do something different,” she said.
As for Thanes, who now lives in ArchCare’s San Vicente de Paúl Skilled Nursing and Rehabilitation Center in the Bronx, she says her new facility is much less violent and chaotic than Cooke was. Although her quality of life has improved since leaving Cooke, the experience left her traumatized, she said. When asked if she would ever go back she winces at the idea.
“It was hell, just hell.”
Update: This article was amended on March 30 to remove a false statement that ArchCare did not respond to a request for comment.
Update: After this article was published, ArchCare reached out to Documented with a rebuttal to this story. On March 31, we incorporated some of their context throughout the piece and corrected an error in describing the 2021 incident when a facility contractor was charged with sex abuse.
Update: This article was amended on April 3, with new information about Gilbert Sabater’s relationship with Terence Cardinal Cooke Healthcare Center.