Sal and Mabel Mangano-

Sal and Mabel were of Italian descent and very nurturing by nature.they met 45 years earlier and quickly fell in love. Sal was a manual “ jack of all trades” and could fix anything, preferring such labor to academics where he quit school. Their introduction to business was a successful feed and seed store enterprise. However, Mabel became increasingly dissatisfied with the treatment of her grandmother in a nursing home in the 1970’s in which the quality of life in every way was non-existent. Mabel vowed that if she opened such a business no one would ever suffer as her Grandmother had. It was dark, dank, with awful food and no activities whatsoever. It was  truly “God’s waiting room,” as a social worker friend of mine used to say. 

Earlier family generations were public service oriented. Mabel’s father was  a fisherman turned deputy sheriff; others included the Captain of the parish fire department and a trusted family friend who rose in the ranks from Attorney to DA. 

Their immediate family consisted of Sal Jr, known as  “Little Sal” and Tammy, who in turn had two children, Sal III, a police officer and Tanner, a high ranking former Marine, and Tammy’s son, Johnny White.  

Sal was a husky man with olive complexion and strong hands. Mabel was also somewhat imposing with her curly white hairstyle coiffured in a 50’s style which made her presence known. 

In the 20-25 years, I have professionally worked in geriatric settings, I have worked with every race, ethnicity and personality from Administrator to CNA to custodian and found some gems at all levels who truly owned their job.

Sal and Mabel reportedly weren’t formally educated, nor were they sophisticated. They appeared to lead with their hearts and “what seemed right to them.” They had managed St. Rita’s Home (named after Mabel’s Grandmother) for 20 years. She, in fact, got assistance in applying to the State of Louisiana to meet all of the requirements of a business owner, and to apply for a Certificate of Need  Persevering, she went to school and trained to be a Nursing Home Administrator, with a “sea of paperwork” and achieved her goal after about eight years and hundreds of trips back and forth to New Orleans despite naysayers.

The Manganos chose a tract of land that was four to six feet above sea level, which was enough to keep them dry and safe in previous storms, but wholly inadequate for Katrina.

Fast forward to today and we learn that in order to be a Nursing Home Administrator,  they must oversee all operations at nursing home facilities, including both clinical and administrative tasks. These tasks include dealing with budgetary issues, marketing, patient care, and staff management. They must gain funding and manage the budget of the facility they operate so they can afford to pay qualified staff, obtain any medical equipment they need, and pay for advertisement. Additionally, they ensure federal and state safety standards are in place so their clients can live healthy and pain-free lives. Nursing home administrators also represent their facility at board or investor meetings. In addition to their administrative duties, NHAs manage the staff members at their facility, including caretakers, nurses, and administrative assistants.. They set work schedules, carry out performance reviews, and make sure employees are following best practices for patient care. Most states require at least a bachelor’s degree for licensure.

it requires… 

1. Step 1: Create a business plan; 

2. Step 2: Register with the state: 

3. Step 3: Obtain Medicare and Medicaid certifications: 

4. Step 4: Hire a great staff; 

5. Step 5: Recruit your clients; 

6. Step 6: Have a solid financing plan for growth.

The vast majority of skilled nursing homes are now owned by large corporate management companies that have many sites regionally or nationally that can assist with training, and often hire a separate   Rehabilitation staffing company for therapy services. 

Mabel and Sal began their “usual preparations” for the hurricane season on June 1. The season is typically June through November, with the majority of activity occurring in August and the first half of September. 

They stocked up on emergency food, medicine and other supplies. Sal had bought new gas generators to run washers and dryers to wash clothes rather than filling up their vehicles like everyone else to vacate.

In essence, they did everything a good Grandma & Grandpa would do based upon the cultural needs and former hurricane history in the past.  Their preparation had always worked in the past, so why not with Katrina? But, “one size does not fit all.” 

During a January post- Katrina interview with CBS News’ Harold Dow, Mabel was circumspect in her comments about the tragedy, but the “most hurtful thing” to her was that her former friends had spokenly badly, testified against her. To her, they were saying “a terrible mistake equated to her being a bad person.” I think she had to put her emotions first versus the lives lost… Otherwise, how could she sleep or carry on for the future? Even on a moral level, she seemed to distance herself about taking any responsibility.  Video, 2 min, 45 sec. https://www.cbsnews.com/news/no-way-out-31-01-2008/ ;

Many people have made tragic mistakes. Perhaps the difference here is that those who do not have the benefit of education and a more worldly view could only see their picture and not the colossal big picture unfolding. “What we’ve always done” is not proactive thinking when you are responsible for the lives of frail residents, some of their family members and your staff (who may or may not be your own family.)

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