Two Flew Over the Cuckoo's Nest

Solange Lambert and Cosmo Salerno can't wait to take their love outside the walls of an adult home on Coney Island. But for now, they have to wait.

Even Solange, who is frankly miserable in the home, admits that Surf Manor was helpful for her at one time. "I would say it helped me when I came here, because it's a protected environment," she says. "Like when you get here, if you have a lot of mental-health issues, you feel more safe than just being out on your own." But that time is past for her now, she says. "I feel very well, for the past four years. I really feel I don't need to be here."

'An Epidemic of Constipation'

Surf Manor is in a rundown section of Coney Island a few blocks west of the Boardwalk, on a block of Surf Avenue mainly populated by housing projects, bodegas, and the odd storefront church. The home is a squat four-story building surrounded by a low chain-link fence, enclosing a yard filled with scrubby yellow-gray grass and seeded with cigarette butts. Inside, it feels like an odd mixture of a hospital and a shabby hotel—a lobby filled with mismatched chairs and a TV that's always on, a wood-paneled cafeteria with a low ceiling, white-tiled hallways, and sea-foam-green elevators that are constantly breaking down. Most times of day, there are residents standing outside the front door or in the parking lot out back, chain-smoking and watching the traffic pass by.

The front yard, where the staff and residents bustle around one another, is also the prime spot to observe Surf Manor's curious demographics. As with most other adult homes in the city, Surf Manor's operator, Robert Lichtschein—who opened it in 1978—and virtually his entire administrative staff are Orthodox Jewish men. Meanwhile, the aides, "chambermaids" (Surf Manor parlance for housekeepers), and porters are all black or Latina, and predominantly women.

No one seems sure why Orthodox Jewish families run a high percentage of New York City's adult homes, but Jeffrey Sherrin, Surf Manor's attorney, has a few ideas. "They're a population that has, first, traditionally been in health care and social services, and, second, are very community-minded, charitable-minded," he says. "One of the mis-impressions you get is that this is just a group of evil, greedy, money-mongering people. It's just not the case. There's not big money to be made in adult homes."

Emily Berl

In 1990, the last time the Commission on Quality of Care and Advocacy for Persons With Disabilities (CQC) studied the revenues of adult homes, they found that New York facilities made an average profit of $2.20 per day for each resident they housed. Only 15 percent of the homes reported losses on their expenditure reports.

Residents have plenty of gripes, and many want to move out. "Many residents will not want to move out, and many will. Neither will necessarily be making the right decision," Lichtschein's son Rafael and the home's head administrator, Josh Teller, wrote to the Voice in response to written questions. "The fear we have is that they will become victims of overstated promises and an aggressively marketed and poorly planned social experiment."

The two strongly defended the operation of the home and contended that "a great many [residents] cannot live independently, if living independently means not having someone available at all times to deal with their problems."

They added, "If residents want to move out, and can do so, we help where we can. Many of those expressions are very unrealistic, not surprising when coming from the disabled population we serve."

Years ago, there weren't enough psychiatric clinics and halfway houses to catch the people emptied from the big asylums. Soon, privately run adult homes began stepping in to fill the void. But by the early '90s, the homes were being accused of many of the same failings as the asylums they replaced: understaffing, poorly qualified workers, and filthy living conditions. A 2002 series in the Times found that many of the homes were little more than "psychiatric flophouses" where residents were being exploited for their Medicare money.

Sherrin strongly criticizes that ballyhooed Times series. "That was the start of the public-relations nightmare for adult homes," he says. "But if you looked carefully at those articles, they weren't describing current conditions anywhere. The inspection reports cited, the pictures taken, the incidents alleged—many of which had been disproved, in one form or another—they were, generally speaking, old. They just weren't representative of where things stood."

The state disagreed. After a subsequent crackdown, Surf Manor and eight other homes were cited by the DOH for serious health and safety violations, including exposed wiring, dirty facilities, and "improper medication management."

The 2010 DOH inspection reports for Surf Manor revealed a number of ongoing issues. Inspectors found in June that at least 30 residents were taking medications at the wrong dosage or for much longer than the period of time for which they had been prescribed, and that at least two residents had been improperly admitted to the home even though they both had serious schizoaffective disorder, which the staff is not qualified to handle. Residents smoking in their rooms, blocked vents, leaky faucets, holes in the walls, peeling paint, mold, "excessive clutter"—the overall picture the reports provide isn't of malicious neglect, but of institution-wide disorganization and decay.

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