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By JOSEPH BERGER
Published: January 27, 2008, New York Times
THEY are recruited in their homeland with perks like free airfare. Some have been offered thousands of dollars in bonuses to relocate. And in the process, they have become a mainstay of the New York area’s hospitals and nursing homes.
They are nurses from the Philippines, and they are highly prized here because they speak English, are trained in American-caliber medicine and enjoy a reputation for tender care — the legacy of a society in which families tend to their own sick and aging relatives.
“We’re honest, industrious and don’t complain a lot,” explained Elmer Jacinto, 32, a registered nurse.
His voice, however, carried a palpable note of sarcasm. He and nine other Filipino nurses on Long Island did complain, and now they find themselves caught in what he called “a nightmare” — a disturbing new chapter in the upbeat story of one of this nation’s most successful immigrations.
The 10 nurses are under indictment in Suffolk County on charges of endangering the welfare of five chronically ill children and one terminally ill man. They are accused of walking off their jobs at the Avalon Gardens Rehabilitation and Health Care Center in Smithtown in April 2006 without providing sufficient notice for the nursing home to replace them on coming shifts.
Although their resignations were prompted by a seemingly commonplace dispute with their employers over what the nurses say were broken promises and shabby working conditions involving a total of 26 Filipino nurses and a physical therapist, the 10 defendants could each be sentenced to a year in jail and lose their nursing licenses. Their trial was scheduled to start Monday, but it appears that it will be put off until March.
The district attorney’s office conceded that the patients suffered no harm, and acknowledged that it could not recall a similar prosecution against nurses in the state. But it said the nurses’ crime was serious: four of the children they left behind were on ventilators that demand round-the-clock monitoring.
“They walked off their jobs, and the critical care patients didn’t have the health professionals to attend to their needs,” said Robert Clifford, a spokesman for Thomas J. Spota, the Suffolk district attorney.
The case has drawn wide attention and outrage in the Philippines, where legislators have held hearings into how the nurses were treated by the company that recruited them. Filipinos there and in the United States have rallied to support the nurses, joined by the American Nurses Association, which has said in a statement that “the real patient endangerment lies in the deplorable conditions that led the nurses to leave.”
The pushback has even taken on a political tinge. Commentators in both countries, citing an investigation by Newsday, have questioned whether favoritism was shown the nursing home owners because of their political influence and campaign contributions, and because of letters written to the Philippine president and other officials by Senator Charles E. Schumer. The senator and the owners have denied exerting any unusual pressure.
But what no one denies is that the case is a startling anomaly in what has been a remarkably successful migration of people seeking to work in a single occupation. More than half of American nurses trained abroad are from the Philippines, and they alleviate a perennial shortage of nurses in this country.
Of the New York area’s 215,000 Filipinos, 3 out of 10 work as nurses or other health-care practitioners, according to an analysis of Census Bureau data by Susan Weber-Stoger, a Queens College demographer. Many of the rest are their spouses, children or aging parents. That migration explains the large colonies of Filipinos in places like Jersey City and Bergenfield, N.J., a middle-class suburb, where Robert C. Rivas, mayor from 1999 to 2003, claimed to be the only Filipino mayor in the Northeast.
The indicted nurses pose a strange counterpoint to that success: the image of highly educated legal immigrants complaining about being exploited as green, overly trusting newcomers.
“You were treated like dirt,” said Juliet Anilao, 36, a mother of two and another of the nurses indicted. “All we wanted to do was work and send money home.”
MR. Jacinto, a soft-spoken native of a small Philippines island, saw medicine as his ticket out of poverty. He not only received a nursing degree, but also graduated from medical school in the Philippines in 2004 with stellar board scores.
Deciding to leave one’s homeland is always wrenching, but American salaries were a large incentive. “You can earn here $3,000 a month in America while a doctor in the Philippines earns $400 a month and a nurse $200,” Mr. Jacinto said.
He came to New York in November 2005 with 21 other nurses who had been recruited by a Filipino agency that works mainly for SentosaCare, a network of 16 nursing homes with headquarters in Woodmere, N.Y., and operated by Benjamin Landa of Brooklyn and Bent Philipson of Monsey, N.Y. Mr. Landa owns eight other homes independently, and together with SentosaCare, the network of 24 homes has more than 5,000 patients and 5,000 employees. The 22 nurses who came over here in November 2005 say they were promised they would earn the same pay as American nurses and would quickly receive green cards giving them the status of permanent residents.
But Mr. Jacinto says he soon got some surprises: for two months, he was paid as a clerk, at a salary far below that of a nurse. It took more than half a year to get the green card. And he was not assigned to the SentosaCare-affiliated home in Queens that had sponsored his entry, but to Avalon, 40 miles east.
For weeks, he said, he slept on a couch in a frigid living room of a nurses’ staff house in Smithtown where the only toilet was frequently clogged. When he finally received nurses’ pay, he said, it was $24 an hour instead of the $34 that federal law requires immigrant nurses be paid to prevent undercutting of American workers’ salaries. He did not receive the same health insurance and workers’ compensation benefits as other nurses, he said, and was not paid for sick days or holidays.
Ms. Anilao said Avalon employed so few aides on the night shift that she regularly had to change soiled diapers and sheets and cart them away. The nurses complained that raises they were promised were wiped out by a reduction in work hours from 37.5 per week to 35.
Howard Fensterman, SentosaCare’s lawyer, denied that the nurses were mistreated or shortchanged, and rejected complaints that staffing was inadequate. SentosaCare, he said, had successfully employed 350 nurses from the Philippines over the years and had never experienced a wave of resignations.
The nurses say that when their complaints went unaddressed, they turned to the Philippines consulate in New York, which put them in touch with an immigration lawyer, Felix Vinluan. Mr. Vinluan concluded that their contract had been breached and on April 6, 2006, he filed a discrimination complaint with immigration officials in Washington. He also advised the nurses that one option was to resign.
On April 6 and 7, 14 nurses in four SentosaCare homes other than Avalon submitted their resignations, and late on the afternoon of April 7, 10 Avalon nurses followed suit. They say they offered so little notice because they were worried that SentosaCare might drum up charges against them that could jeopardize their licenses.
Still, the nurses say, they left confident that the elderly and the patients in a pediatric unit would be taken care of because they knew of nurses waiting for assignment in two other SentosaCare staff houses. According to the nurses and their lawyers, only one of the 10 indicted Avalon nurses was working at the time the resignations were handed in and only two were scheduled for 7 a.m. shifts 12 hours away. Some had as many as four days off before resuming work.
“No patient was ever placed in jeopardy,” Ms. Anilao said. “Not a single shift was unattended.”
Susan O’Connor, Avalon’s administrator, has said, associates say, that she had only 12 hours to rustle up replacements for five nurses who had resigned and were scheduled to start the 7 a.m. shift. In her 30-year career — enduring snowstorms, fires and strikes — the walkout created the single scariest night of her professional life, she has said. Ms. O’Connor is a major witness in the criminal case and has been advised by SentosaCare lawyers not to comment publicly.
Mr. Fensterman has argued that finding substitutes was especially difficult because the replacements had to be experienced in monitoring ventilators for sick children. “If they vomit into the tubes and the tubes are not cleared, they can asphyxiate themselves,” Mr. Fensterman said. Sharon Bannon of Farmingdale, whose severely brain-damaged daughter Jodie, 24, is a patient in the pediatric unit and requires a breathing apparatus, said she was upset that the nurses resigned abruptly.
“They left my child unattended and it could have been a potential hazard,” she said in a telephone interview. “Jodie is critical and she can’t be left. Luckily, the home was able to handle it.”
THE case escalated. SentosaCare filed a civil suit charging the nurses with breach of contract and lodged a complaint with the State Department of Education. The nurses filed complaints against SentosaCare’s recruiting arm in the Philippines, and the government effectively suspended the company’s recruiting privileges.
But in June 2006, the suspension was lifted, and last September Newsday reported that Senator Schumer had written four letters over two months to officials in the Philippines — including one to the president — to get the suspension reviewed. In the two months after the suspension was revoked, the newspaper reported, the Democratic Senatorial Campaign Committee, whose chairman is Mr. Schumer, received nearly $75,000 from investors, vendors and lawyers associated with SentosaCare.
Josh Vlasto, a spokesman for Mr. Schumer, said all the senator asked for was due process, not “any outcome in any direction.” Mr. Schumer, he added, writes letters for many constituents and SentosaCare “was a major employer on Long Island and operates in an industry Schumer is active on.”
Newsday also reported that the SentosaCare partners, allied investors and their lawyer, Mr. Fensterman, have donated $750,000 to Democratic and Republican campaign funds, though Mr. Fensterman said that the amounts lumped together the contributions from his associates in other industries. In 2003, Mr. Fensterman contributed $1,500 to the campaign of Mr. Spota, the district attorney prosecuting the nurses, the newspaper said.
Mr. Fensterman is chairman of the Nassau County Industrial Development Agency, which awards leases and tax incentives, and is Mr. Schumer’s campaign finance chairman for Long Island. Mr. Landa was, during the governorship of George E. Pataki, a member of the state’s Public Health Council, which reviews proposals for new health care institutions like nursing homes.
Mr. Fensterman and spokesmen for Mr. Schumer and the district attorney’s office deny that campaign contributions played any role in the prosecution of the nurses or the Philippine government’s actions.
“Because I made a $1,500 contribution to Tom Spota four years before, does that mean that I’m disenfranchised from seeking the help of an elected official?” Mr. Fensterman asked.
In September 2006, after two hearings, the New York State Education Department, which licenses nurses, rejected SentosaCare’s charge that the nurses had abandoned patients. (That finding has been buttressed by the results of a New York State Department of Health review, announced on Jan. 16. “The shifts were covered,” said a department spokesman, Jeffrey Hammond, “and the patients were not placed in jeopardy.”)
But last March, the district attorney, who had met 10 months earlier with Mr. Fensterman, Mr. Landa and Mr. Philipson, secured the grand jury indictment, which also charged the nurses’ lawyer, Mr. Vinluan, with conspiring in the resignations.
James O. Druker, a lawyer for the nurses, argues that the case should never have been brought. Mr. Vinluan, he said, was “indicted for giving the nurses legally correct advice” and his clients “were indicted for following his advice.”
It took months for some of the nurses to find other jobs, they say, because every time they applied employers would Google their names and up would pop articles about the indictment. Mr. Jacinto and Ms. Anilao now work at a hospital in Queens.
Something of a mystery still lingers: Why were matters allowed to reach such a state? Why would nurses who forsook their homeland to seek well-paying work risk those jobs? And why would SentosaCare’s owners risk their successful recruitment of Filipinos by seeking prosecution?
Company officials say they sought to keep nurses from imperiling fragile patients.
“A message needs to be sent,” Mr. Fensterman said, “that if nurses can simply walk out on patients with impunity, that is a danger for all Americans, whether in nursing homes or hospitals.”
One nurse, Ms. Anilao, said some things were more important than a salary.
“I wasn’t raised by my parents to bow down,” she said, “ and take all those things just for the money.”
