End of an era for an AIDS center

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Improvements in AIDS treatment have left empty beds at Rivington House


  • Rivington House on the Lower East Side has seen its occupancy drop as AIDS drugs have become more effective.

Lawrence Carter begins each morning ingesting 10 pills with breakfast, then another seven at lunchtime, then another 15 in the evening, and so it continues. His 60-pill-a-day regimen is a difficult feat to achieve in and of itself.

Carter, 59, a former janitor for the New York City Housing Authority, has been living with AIDS for nearly 20 years. He also suffers from seizures, liver problems and his slurred speech stems from a stroke he suffered almost two decades ago, leaving him permanently paralyzed on his right side. The New York native, who had no relatives to care for him, felt like he had found a family of his own at Rivington House—once the largest solely dedicated AIDS nursing home in the country and the only such facility in New York City.

Carter lived at Rivington House since it opened in 1995. Three months ago, he was told that the only home he has known since his HIV diagnosis and stroke would be closing in November due to the beds remaining half-empty for two years.

“When I heard they were closing,” he said, “I was scared. The nurses were crying. I cried later.” Carter’s soft-spoken murmur befitted his wilted frame, which sunk deep into his wheelchair. His legs, as thin as boughs, and the cast on his right wrist, were offset by a spry esprit.

Rivington House, a Romanesque Revival-style building that consumes an entire block on the Lower East Side, was not your average care facility. The seven-story structure featured meditation rooms, art studios, a media center and physical therapy rooms on a penthouse level overlooking the Manhattan skyline. The facility boasted a smoking room to make its residents feel more at home.

When it opened in the mid-1990s, HIV and AIDS had decimated New York City. According to the Centers for Disease Control, the same year that Rivington House opened its doors, the AIDS mortality rate in the United States had reached an all-time high with 50,877 deaths. That year, The New York Times reported that AIDS had become the leading cause of death among Americans between the ages of 25 to 44. Because of the fear that the disease instilled in the medical community and general population, many of those infected were turned away. Consequently, VillageCare, a nonprofit organization purchased the building and transformed it from a public school into the facility as it stands today.

“When people first came here, honestly, they were dying. They were dying everyday,” said Marcia Moodie, a registered nurse who has worked at Rivington House for 18 years. According to a Times article that ran two years after the facility opened, the average stay was 12 to 15 days, with the death rate reaching almost 50 percent.

“At the time, we couldn’t keep the beds empty. These days we can’t keep the beds filled,” said Rob Goldman, director of communications at VillageCare.

Today, antiretroviral drugs, the most advanced form of treatment to suppress HIV, have reached such a level of sophistication that the life expectancy for patients has been expanded into geriatric years.

“People suffering from HIV are not dying from HIV. They die from heart disease, from getting run over by a bus,” claimed Matthew Lesieur, director of public policy at VillageCare.

If Rivington’s lack of residents is a positive indication of the success of HIV and AIDS treatment, its termination marks the latest of a series of nationwide shutdowns that have unfolded over the last few years. Nevertheless, the building’s closure dealt a painful blow to its residents and staff.

“People find respect here. They felt like somebody here,” said Washon Montgomery, a security guard for the building. “Even though they had a disease, they felt like they was somebody. Now it’s like a ghost town here.”

On Sept. 9, Community Board 3’s Health and Human Services committee held a meeting in which VillageCare executives laid out their problems with the building. With 126 of the 219 beds having been filled for two years, the organization felt that the need for the facility was no longer there.

VillageCare purchased the building in 1993 with a stipulation that it be used as a nonprofit residential healthcare facility. Realizing the decline in use, the organization tried unsuccessfully to transform it into the country’s first HIV assisted-living facility and then to a general geriatric home. Since the government is attempting to eliminate 5,000 nursing home beds statewide, Gov. Cuomo rejected their efforts.

“We have this building, we can’t use it for a geriatric nursing home and the assisted living option has been closed to us,” said Lesieur. The only option, he said, was to change the original agreement from nonprofit to a for-profit nursing home. But the majority of Community Board 3, many of whom have had loved ones live there, was against the prospect of transforming the building into a for-profit facility.

VillageCare originally purchased the building for $72 million and is still paying off the mortgage. It also has $20 million-worth of pension obligations to the employees of Rivington House.

While the VillageCare representatives maintained that the transition for patients has been smooth, some staff members at Rivington House tell a different tale. “Some people got sick from the move. I think it was from the stress,” said Moodie. “There was a resident who was blind but could do for himself, and as he heard about the move, he got sick, went to the hospital.”

Anthony White, an occupational therapist at Rivington House, also detailed the difficulties the presented for his patients. “It’s been hard for them because they been here so long, it’s like their home. To go someplace else—it’s a new environment and it’s going to be difficult for them,” said White.

In addition to the stress that the closure has caused many of its patients, on Oct. 31, some of the 251 employees were laid off, while the rest will lose their jobs by Nov. 21, the official closing date.

“It’s a hard hit for all of us. A lot of us have been here 18, 19 years,” said White. “I got a lot of bills to pay and the people on top they don’t care about that. They think about themselves.”

After learning of the building’s closure, Rivington’s patients were given the choice of transferring to one of five facilities in the area. Carter chose Terrence Cardinal Cooke, a hospice facility, as his new home. His former roommate from Rivington had transferred there a few years earlier—a history that made the unfamiliar a little less ominous.

While Carter was delighted to discover that the nurses at Terrence Cardinal Cooke were nurturing, he hasn’t yet embraced his new surroundings. He complains about the qulity of food and a lack of privacy. “There are no showers in the rooms. At Rivington House I had my own shower. This is an old building—no privacy,” he said.

Carter yearned for the days when he was taken on excursions to parks and gardens, on picnics and to the movie theater. These days, he can no longer decipher the weather outside his diminutive hospital window.

At Rivington House, only two patients remain and they will soon be transferred to other facilities. The building’s future for now is uncertain.

As for Carter, adjusting to his new living environment, “I don’t like it here,” he said, aware of the fact that this may well be his final destination.

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