NEARLY 40 years ago, Beverly Nichols made a vow that now seems prophetic.

The man with whom the nubile country girl was in love and at whose hands she eventually suffered rejection “will read about me one day”, she feverishly swore.

In recent years, not one man, but thousands have become engrossed in the life story of this woman, the default poster child for all those seeking plausible reassurance that they too can make it even against impossible odds.

Nichols, 60, operates a successful health care delivery agency in Queens, New York. But she first had to overcome a childhood marred by shameful neglect, and a young adulthood of unending struggle to recapture the lost opportunities of those early years.

Wilfully abandoned at age six by her mother, there was no playbook inside her deep rural Jamaican community to guide the future recovery of this vulnerable child.

Neither was there any comeback formula after the relative who took her in to feed pigs and goats, cynically frustrated her efforts to enrol in school — thinking no doubt, that even basic education would be a waste on a congenital farmhand.

In the 12 years since spending US$40,000 of mostly borrowed money to start Beverly’s Home Health Care Inc, Nichols now proudly counts nearly 200 on her weekly payroll, mostly Jamaican-born, entry-level healthcare providers who, like her, came to the Big Apple in search of a better life. Her company is profitable, she says, and is on target to produce US$5 million (J$425 million) in billable hours this year — an improvement on last year’s revenue of US$4.5 million.

The firm has a portfolio of about 180 long-term patients, from geriatric shut-ins and home-based children with special needs, to individuals incapacitated by dementia, and each day dispatches an army of health care personnel to take care of their medical needs inside their own homes.

The nurses develop the care programme for the patients — plans that have to be faithfully executed by the aides and other medically trained individuals who are also contracted to Nichols’ agency.

Private insurance companies as well as Medicaid — the federal government’s health programme for the old — reimburse management companies like Beverly’s Home Health Care that operate within this industry, using a rigid billing system and pre-existing cost recovery formula.

“I have all the insurance firms in my pool,” says Nichols in explaining the business model in which the wider the network of available insurance coverage, the greater the likelihood of patient referral. “Patients mostly have long-term insurance and business mainly comes from referral by geographical location,” she adds.

Beverly’s Home Health Care covers the five boroughs of New York City — Bronx, Brooklyn, Queens, Manhattan and Staten Island — in addition to Nassau County.

There is a 16-member support-staff — the supervisors, accountants, billers, collectors, and dispatchers — who closely collaborate with each other to ensure a seamless workflow, from the nurse’s care plan, to health care execution, billing and collection of insurance reimbursement.

Their job is also to make sure that the company is always in compliance with federal and state regulations, and that the field staffers operate within the bounds of the corporate ethos that places premium on patient care.

We always try to make sure that the patients are comfortable with the staff,” explains Nichols. “Good patient care is the lifeline of our business. For example, if a patient is not comfortable with a particular caregiver we immediately find a replacement.”

The practice of uncompromising patient care that Nichols says she has infused within her organisation is, unfortunately, not a culture that she can trace to her Jamaican experience.

The fourth of six girls, her eldest sister was barely a teenager when their mother left them in the care of their conscientious but clueless father, Frank, as she headed as far away from the deep rural community of Blackwoods, Clarendon, as she could get.

As was the case with many working-class folk — especially those from rural communities — for this struggling mother of six, England represented the easiest escape route out of her desperate poverty trap. Nevertheless, even by the standards of the pre-Independence era, there was something particularly sinister about the action of this mother.

“I believe she may have gone off with another man,” Nichols bluntly offers. “She never looked back, we never heard from her, she never sent a penny, our childhood was rough. All of us sisters had to help each other; we became like peas in a pod.”

At 11, her father sent her to live with an in-law whose husband had passed on. She wanted the little girl as a companion, she told the dad.

Nichols says it didn’t take her long to realise that “all she wanted was someone to take care of the pigs and the goats and was not interested in me or in my education”.

For example, this attentive young girl vividly remembers being often told by her titular caregiver to “out the kerosene lamp and go to bed” whenever she “tried to practise Maths”, her favourite subject, at nights.

She attended Longwood Primary in Orange Hill.

There was a final straw that broke the back of the proverbial camel.

Frankfield Comprehensive High School was newly opened and the principal was scouting neighbouring communities for suitable candidates to fill the classrooms.

Now 16 years old, Nichols was clearly excited about the prospects of attending ‘high school’.

“The woman said no, I cannot go to the school, so I packed up my things and went back home. She was very abusive.”

Nichols studied at nights for the Jamaica School Certificate (JSC) examinations which qualified her to register for a correspondence certificate course in practical nursing.

It was during her years as a practical nurse, working for a physician in May Pen, that a man whom this young woman was seeing, having discovered that she “was only a practical nurse and did not have the education of a real nurse” summarily made it clear that she no longer fit the bill.

The birth of two sons in her early 20s provided a timely reality check. Now, her priority shifted to ensuring a more secure future for her boys than her own parents were able to offer her and her siblings. For the first time, migration appeared on her mental screen as a viable option.

“My intention was to go to New York and work and study and earn enough money to set up a jewellery store in Jamaica,” she recalls. “I thought the streets were lined with gold, but when I reached I discovered that not having a green card was an impediment.”

In New York in 1981, the Jamaican found work in the care-giving industry, but decided that, on parallel track, she would take the educational route to her American dream. She enrolled in Medgar Evens College in Brooklyn in the gerontology certificate programme.

Within two years, her two children — then 11 and 12 — joined her in New York.

An associate degree at La Guardia College quickly followed, and by the late 1990s Nichols, now well-honed in the discipline of work and study, enrolled in York College for a BSc degree in gerontology.

The industrious caregiver says that her inspiration to start her own business came from the encouraging words of patients whom she cared for while contracted to other companies.

“I was caring for people and they would say to me ‘you are so good at what you do, why don’t you start your own service?”

The first steps towards self-employment were taken in 1999 with an application to the Department of Health for a home-care licence, followed by a trip to the bank for start-up capital.

The worker turned entrepreneur initially started off in a quasi-partnership with a group of Russian health care specialists, but they did not stick around for long.

“I had already spent $40,000 for start-up so I could not quit,” says Nichols.

During those frenetic early days, the Jamaican was a virtual one-person health care operation.

“I had a beeper service to be able to return patient calls,” she says. “Then I had to employ my first office staff.”

At various stages of her 30-year residency in America, Nichols sponsored up a sister, until all five were out of Jamaica.

For the past several years, she has had the luxury of being able to take regular vacations in Jamaica, but more recently, those visits have taken on a different character.

“I am now involved in charity work in Jamaica,” she lets on.

The biggest beneficiaries of her charity will be Jamaicans with chronic renal disease but who cannot afford regular dialysis. Nichols has already donated US$100,000 towards building a dialysis centre at the May Pen Hospital that will bear her name. She has committed another US$100,000 to the project.

To ensure continuous financial support for the centre, she has started the Push Start Foundation in New York, to raise funds on an ongoing basis.

“We will use the foundation to target grants and for other fund-raising activities,” she explains.

She has big dreams for the health complex.

“One company, Debeta, has already pledged 30 machines,” she points out. “The concept of the centre is that those who need the service and can’t pay will not be turned back.”

The entrepreneur has also contributed US$10,000 to the AIDS cause in Jamaica, and is funding the education of two Jamaican girls, one through law school and the other, medical school. She also funnels support for the less fortunate through her local church.

Nichols, who is married to an American, Leslie Crotty, has three children, none of whom is in her company. She describes her lifestyle as “one of modest living”.

On National Heroes Day in October, she was in Jamaica to accept a Badge for Honour for meritorious service, conferred on her in recognition of her charitable work.

“It will encourage me to work harder and give more to my country,” she says. “I prefer to live modestly, and choose to give back.”

Moses Jackson is the founder of the Jamaica Observer Business Leader Award programme. He may be reached at moseshbsjackson@yahoo.com