Open Letter to Preet Bharara – ProPublica, Medicaid Fraud, Worker’s Comp…

Re: SentosaCare LLC, Ben Landa, Bent Philipson

Dear United States Attorney For the Southern District of New York, Preet Bharara:

To begin, we would like to apologize for the incorrect title posted yesterday. That is an error that should not have been made.

We are writing to respectfully request that you investigate the activities of SentosaCare LLC, Ben Landa, Bent Philipson and related family members.

We are further requesting that you investigate the corresponding activities of Attorney Howard Fensterman for activities which are based upon our collective opinion and findings set forth in a referenced lawsuit and a corresponding letter addressed to him.

We are writing to request that you investigate the activities of a number of “oversight” organizations which are failing miserably at overseeing the health and well-being of our most vulnerable members of the population, the elderly.

We are writing to provide you with a financial reason to perform this investigation, namely but not limited to Medicare/Medicaid Fraud, Tax Fraud, Workers’ Compensation Fraud, Conflicts of Interest, Self-Dealing and other potentially questionable activities.

We formulate a basis for this letter upon our review of the pleadings in Plaintiff’s motion in the below lawsuit, the underlying documents of the original ProPublica article, the defensive pleadings by Ms. Lehman’s attorney to the below referenced lawsuit and other publicly available information from referenced State Agencies.

We write this letter in the hope that finally these issues will get the attention they deserve. We write this letter with a level of care for the sanctity of the facts, opinions and our corresponding conclusions; and without malice, except to say that we think the parties should be quite ashamed of the deplorable treatment of the elderly. 

We ask for your assistance where many people have tried, and failed, to obtain the assistance of other interrelated government agencies. 

We ask for your assistance because we feel that our government agencies are failing in their duty to the taxpayers, who are also getting harmed. We feel that allowing this behavior and any possible frauds to continue sets a precedent. It sets a precedent for similar activities in other states, by other for-profit business or not-for-profit businesses. It creates complacence in people employed by agencies which have a duty of care to oversee, whether as related to the Nursing Home and Rehabilitation business, the activities of law enforcement, the activities of Yeshivas and other government assisted entities, the list is endless.

We, as taxpayers, ask for your help in preventing us from being defrauded. We as children ask for your help in preventing our parents from being harmed were they to need rehabilitative or nursing care. We ask you as families who have sat by and witnessed harm being done to our loved ones, and the devastating impact it has on families. We ask you as honest business people who have a hard time conducting business honestly when so many are willing to challenge the morality and ethics of a country of laws, laws which are hard to abide by when in so doing there is little way to compete.

We thank you for your attention to this letter and provide you with information as follows.

Your sincerely,

Lost Messiah, July 11, 2016

CONTEXT:

On March 21, 2016 a lawsuit was filed  by the nursing home consortium of  SentosaCareLLC, Ben Landa and Bent Philipson against Jennifer Lehman, a writer for ProPublica. It was filed in the Supreme Court, Kings County, under the Index # 504407/2016 (“The Lawsuit“). It is allegedly a defamation suit against Jennifer Lehman and ProPublica for the October 27, 2015 article  published in ProPublica criticizing a number of government agencies and condemning many of the practices of their facilities and the level of patient harm reported by government agencies. (How N.Y.’s Biggest For-Profit Nursing Home Group Flourishes Despite a Record of Patnient Harm”[https://www.propublica.org/article/new-york-for-profit-nursing-home-group-flourishes-despite-patient-harm] (“The 2015 Article“)

In The 2015 Article, Jennifer Lehman and co-author Allegra Abramo (special to ProPublica) condemned the government oversight system that allows Nursing and Rehabilitation Homes, with the record of the Sentosa facilities, to continue, grow and flourish. As a basis for their analysis, they called into question the level of care provided by nursing and rehabilitation facilities owned, operated or consulted by SentosaCare LLC (“Sentosa“), Landa and Philipson and potentially Howard Fensterman. Fensterman, to reiterate, is the attorney representing Plaintiffs in The Lawsuit. Fensterman also owns a number of quasi-related nursing homes and sat on an oversight committee with quasi-related authority to determine the outcome of decisions related to those nursing homes. 

The Lawsuit, in our our view, was filed not in reality as a claim of defamation, but rather a roadblock intended to silence Jennifer Lehman, who had been investigating allegations of Medicare/Medicaid and Worker’s Compensation fraud, amongst others. Publication of her next piece, which apparently focused on financial discrepancies in many of the homes cited by Ms. Lehman in The Article could potentially, and in our view did, represent clear and convincing evidence of various frauds perpetrated upon the government including, without limitation, tax fraud, social security fraud, medicare and medicaid fraud, Worker’s Compensation fraud and the list goes on. In our view, those frauds were and continue to be based upon the activities of the Plaintiffs.

WE BASE OUT CONTENTIONS ON THE FOLLOWING:

The pleadings in The Lawsuit, as discussed by the Defense Attorney representing Ms. Lehman and ProPublica, do not refute any of the allegations of Ms. Lehman in The Article, truth being a defense to a claim of defamation. Rather, Fensterman (Plaintiff’s counsel) focuses on a condemnation of The Article’s underlying editorial decision to use as its basis of criticism the deplorable conditions of the Sentosa Hursing Homes and Rehabilitation Facilities (“Sentosa Facilities“). They likely chose the Sentosa Facilities because they are the largest in the State and have some of the worst conditions. We believe that focus on Sentosa Facilities reflected sound judgement of the editorial staff in structuring any criticism and conclusions regarding the ills of a system, the States Public Health and Health Planning Council, the Health Department and the Department of Health and Human Services’ inspector general all of which it would appear ignore their own findings (cited in the October 2015 ProPublica Article).

Please be reminded that the Public Health and planning Counsel is an oversight committee with “substantial leverage to press nursing home applicants to improve quality, but an examination of dozens of transactions recent years show that power is seldom used.” [https://www.propublica.org/article/new-york-for-profit-nursing-home-group-flourishes-despite-patient-harm]

The letter written to Howard Fensterman (Exhibit 4 to Plaintiff’s Lawsuit and re-printed below) by Ms. Lehman to Mr. Fensterman was dated in March of 2016, not 2015 and related to what was to have been a follow-up article (“The Follow-Up Article“). The allegations set forth in that letter suggest Medicare and Medicaid fraud, Worker’s Compensation fraud, and potentially others, which based upon publicly available documents and The Lawsuit pleadings themselves is almost, in our view, undeniable. 

By way of a timeline, on March 18, 2016, Jennifer Lehman had sent a letter to Howard Fensterman asking for confirmation or denial of facts related to the finances of the Sentosa facilities and his involvement/connection to the nursing and rehabilitation facilities that Ms. Lehman was investigating, namely those owned or operated by the Plaintiffs (“The 2016 Letter“). Mr. Fensterman did not respond. Rather, he filed the The Lawsuit citing The Article. The Lawsuit was dated 3 days after The 2016 Letter to him.

Presumably the Follow-Up Article reflected that the ProPublica investigative journalist(s) had uncovered troubling and possibly criminal maneuvering of Medicaid/Medicare money and Workers Compensation billing, representing discrepancies upwards of $3.5M reported in Medicade costs reports which seems to have disappeared. Evidence of this, as apparently established by Ms. Lehman, can be found in Number 6 of the letter.

If Ms. Lehman’s allegations could be confirmed, and in our view they are legitimately conclusive based upon the numbers alone, publication of any story would have created, in our view a firestorm. It would have raised probable cause for investigating and issuing subpoenas for all financial information including personal financial connections between the Plaintiffs and Fensterman (and even their families) and perhaps would have placed Fensterman (and perhaps his firm) in the position of defendant to an action based out of your office, rather than as Plaintiff to a Defamation suit.

Howard Fensterman, attorney for the Plaintiff’s is himself intimately intertwined with the activities of these Nursing and Rehabilitation Homes. According to The Article (again not disputed by Fensterman as attorney for the Plaintiffs):

Fensterman also said that SentosaCare does not have “ownership or control” over the facilities in its network and only contracts with them to provide administrative and rehabilitation consulting, regulatory advice and purchasing services. Records show, however, that Landa and Philipson, or family members, have ownership stakes or directorships in nearly all of SentosaCare’s facilities. Fensterman also co-owns 14 nursing homes with Landa in several states, including one SentosaCare home.

Fensterman is a former member of the state health council, as is Landa, who entered the nursing home business in the late 1980s and emerged as one of the sector’s biggest players over the next decade. Landa, Philipson or family members now hold stakes in at least 33 nursing homes in New York and an equal number in nine other states.

In 2013, the latest year for which state data is available, homes under the SentosaCare umbrella paid the company more than $11.5 million for financial, staffing and other services, and spent nearly $630,000 with Fensterman’s law firm.

[https://www.propublica.org/article/new-york-for-profit-nursing-home-group-flourishes-despite-patient-harm] )

While it may be financially prudent, perhaps, to be represented “pro se” by an attorney who stands to profit from the outcome of a lawsuit, as well as payments to his firm to aggressively fight in favor of the Plaintiffs, in our view the choice of representation raises questions of Mr. Fensterman’s activities and his personal desire to chill a follow-up article. We contend that the very fact that Mr. Fensterman is both attorney, beneficiary of the failing system and potentially involved in the frauds committed, may be reason enough to scrutinize this entire cluster of invests more deeply.

IN CONCLUSION:

IT IS OUR FIRM AND UNWAVERING OPINION THAT:

  • The Plaintiff and Attorney Howard Fensterman did not want that letter to be part of the public record and perhaps sloppy lawyering has provided us with an opening to bring this to your attention.
  • In researching The Article Ms. Lehman had uncovered what appears to be medicare/medicaid and Workers Compensation fraud of epic proportions. It is our hope  that Ms. Lehman’s Follow-Up Article will see the light of day, but if not as a follow-up in the ProForma publication, as “Probable Cause” for an in-depth review of SentosaLLC, Landa, Philipson and Fensterman by your office.
  • Ms. Lehman’s Follow-Up Article laid out a systemic pattern of frauds,which Mr. Fensterman and his legal team sought to silence. Indeed, the defamation lawsuit has had a chilling on any further publications; but we are hoping it will gain the attention of you and your investigators in delving into these potential crimes: tax fraud, medicare/medicaid fraud, Worker’s Compensation Fraud and the list goes on.
  • We believe that the letter, and the conclusions drawn by Ms. Lehman and the corresponding Exhibits to the lawsuit filed by the above-referenced Plaintiffs represent clear and convincing evidence of Medicaid/Medicare fraud and potential money laundering, which should not be ignored.

THE LETTER IS AS FOLLOWS, WE HAVE HIGHLIGHTED THOSE MOST RELEVANT ALLEGATIONS TO WHICH MS. LEHMAN SOUGHT A RESPONSE:

FILED: KINGS COUNTY CLERK 06/21/2016 10:40 PM
INDEX NO. 504407/2016
RECEIVED NYSCEF: 06/21/2016
NYSCEF DOC. NO. 14
EXHIBIT 4
Howard Fensterman March 18, 2016
Abrams Fensterman By Certified Mail 1111 Marcus Ave. Suite 107
New Hyde Park, NY 11042-1034
Dear Mr. Fensterman,
My name is Jennifer Lehman, and I’m a freelance journalist working with a colleague, Allegra Abramo, on a story about nursing home finances in New York. The story focuses on facilities that Ben Landa, Bent Philipson and family members own, including those affiliated with SentosaCare, and on lawsuits and related-party payments reported by the homes.
I want to make sure you and Mr. Landa and Mr. Philipson are aware of information our reporting has developed and give you an opportunity to respond. To this end, I am providing extensive questions. I want to be sure our story is accurate and that we have the benefit of any additional information you can provide.
As you know from our prior reporting on SentosaCare last fall, we are working with the investigative news organization ProPublica in Manhattan. The questions we have for you are organized by topic below. We have also sent them to Mr. Landa and Mr. Philipson.
Please respond no later than the end of business March 25. You can reach me at 303-506- 2470 or jlehman678@gmail.com. Thank you for your time.
Best,
Jennifer Lehman c/o Tom Detzel Senior Editor ProPublica
155 Avenue of the Americas New York, NY 10013

1. Payments to related parties and members
We have reviewed cost reports for 27 homes affiliated with SentosaCare, Mr. Landa, Mr. Philipson or their family members for the years 2012 through 2014 (see list at the bottom of this document). During this time, according to Medicaid cost reports, at least $126.2 million was paid out to related companies, including $57.5 million in rent to related real estate companies; $15.2 million to SentosaCare; $24.6 million to Prompt Nursing Employment/SentosaServices; $5.2 million to New York Health Care Insurance; $4.9 million to the Abrams Fensterman law firm; and $18.8 million to miscellaneous management, consulting and service companies/vendors.
> Please confirm, dispute or clarify this information.
> Please tell us why the nursing homes use these related parties and how their use might benefit the facilities. Related-party expenditures exceeded 8 percent of revenue at 14 of the homes in at least one year between 2012 and 2014. Pathways Nursing & Rehabilitation Center and Golden Gate Rehabilitation & Health Care Center each spent more than 22 percent of operating revenue with related parties in at least one year.
> Please confirm, dispute or clarify these findings.
> Nursing home finance experts have said that large payments to related parties, particularly when they are not eligible for Medicare/Medicaid reimbursement, can endanger homes’ financial stability and the ability to provide adequate care. Please respond to that assertion.
> If your facilities are paying upwards of 20 percent of operating revenue to related parties, how do you ensure that there are sufficient resources to adequately care for patients?
Between 2012 and 2014, according to Medicaid cost reports, member equity draws on these homes totaled $28.6 million.
> Please confirm, dispute or clarify this information.

2. Golden Gate Rehabilitation and Health Care Center
Between 2012 and 2014, Golden Gate Rehabilitation and Health Care Center paid Golden Gate Nursing Home Management, a declared related company, $4.7 million in fees, according to Medicaid cost reports. The cost reports state that the fees were in excess of fair market value, and that Golden Gate Nursing Home Management had no accompanying costs. In 2013, the facility’s cost report shows that the home had an
operating loss of $2 million, while paying nearly $1.9 million to Golden Gate Management.
> Please confirm, dispute or clarify these findings.
> What percentage of ownership do you hold in Golden Gate Nursing Home
Management?
> What services did Golden Gate Nursing Home Management provide to the
nursing home in that period, and who provided those services?
> How can a company provide services, but have no associated costs?
> Why are payments to Golden Gate Management represented as fees, rather than as a dividends or distributions to owners?
> Please explain why the company charges the facility fees “in excess of fair market value,” according to cost reports.
> Why would the home be paying management fees in excess of fair market value in a year that it lost money?
> Did the facility claim or receive Medicaid reimbursement for any portions of
these fees? Did it forgo reimbursement of any portions of these fees?

3. Diamond Hill Nursing and Rehabilitation
Diamond Hill Nursing and Rehabilitation Center, owned solely by Mr. Philipson since 2010, has one-star Medicare ratings overall, and for health inspections and quality measures. CMS data states that the home does not currently have a staffing rating because of “data-quality” concerns. Between 2012 and 2014, the facility paid $2.52 million to related parties, including almost $657,000 to Prompt Nursing Employment.
> Please explain the reasons for these low ratings and what is being done to address them.
> How do you explain Diamond Hill’s low staffing rating despite using a related nursing employment agency?
> Why does the facility currently lack a staffing rating?

4. Loans to/from facilities
In recent years, Mr. Landa and other unnamed members made at least 12 loans to at least seven facilities at interest rates between 11.5 and 15 percent, according to facility cost reports from 2012 through 2014. For example, Avalon Gardens has a $1 million loan from Mr. Landa at 15 percent interest. Avalon and some other facilities are making interest-only payments, according to cost reports.
> For what purpose(s) were these loans made?
> What factors explain interest rates seemingly above-market interest rates?
Eastchester Rehabilitation made a $1,550,000 no-interest loan to members, according to the facility’s cost report. The facility also made a $1,225,000 no-interest loan to NFFT, another related party.
> Who were the recipients of these loans, and what were the purposes of the loans?

5. Staffing levels
Twenty of the 27 homes we examined (see list below) have ratings of one or two stars for staffing on Medicare’s Nursing Home Compare. One home, Diamond Hill, does not have a staffing rating due to “data quality concerns.” Please confirm, dispute or clarify this information.

6. Jack Janklowicz and Leonard Janklowicz v. Benjamin Landa, Bent Philipson et al. (501420/2012); and Wausau Business Insurance Company v. SentosaCare, LLC (No. 10-CV-07484)
According to documents and claims in both of these lawsuits, Allstate ASO managed insurance and benefits for SentosaCare from 2008 to 2011. Janklowicz v. Landa alleges that Allstate ASO (at the time owned by Samuel Schlesinger) invoiced SentosaCare for more than the premiums owed to Wausau. Mr. Landa allegedly then made payments to Allstate ASO on behalf of SentosaCare in those inflated amounts, and Mr. Landa allegedly would receive some of the excess.
> Please confirm, clarify or dispute these allegations.
Documents available through Wausau Business Insurance Company v. SentosaCare, LLC (No. 10-CV-07484), show that Allstate ASO shared an address with SentosaCare’s business office, at 20 Franklin Place, Woodmere, NY, 11598. Allstate ASO was also included on the Wausau insurance policies.
> What is/was Allstate ASO and Mr. Schlesinger’s relationship with Mr. Landa and Mr. Philipson?
The agreements for three policies and the audits of payrolls for the insured nursing homes were made public in Wausau v. SentosaCare. The audits show that 23 nursing homes owed a total of $5.3 million to Wausau for February 2, 2008 through March 1, 2009, per the standard final audit conducted after the policy expired. The agreement for the 2008 to 2009 policy shows an estimated premium of just over $3 million. The same homes separately reported $8.7 million in workers’ compensation insurance costs on their 2008 Medicaid cost reports.
> Please explain the difference in the amount of workers’ compensation reported in the facilities’ Medicaid cost reports and the premiums Wausau determined were owed to it.
> If this difference of approximately $3.4 million was not paid for workers’ compensation insurance, where did the money go?

7. Pathways Nursing and Rehabilitation Center
According to cost reports, this facility spent nearly a quarter of its revenue with related parties in 2014. Bent Philipson is the sole owner of both the operating and real estate companies, according to Medicare data and cost reports.
Based on the home’s 2014 cost report, Mr. Philipson’s real estate company charged the home $2.5 million in rent that year, 20 percent more per square foot than any of the group’s downstate facilities paid to related-party realty companies.
> What is the reason for this amount in rent at Pathways?
> What about this upstate facility makes its per-square-foot rental rate higher than facilities in more expensive areas?
> Is the Philipson real estate company overcharging for rent?

8. Individual Related Companies
B&L Consulting is a related company according to Medicaid cost reports. It shares an address with Woodmere Rehabilitation, according to business records. B&L Consulting charged the nursing homes nearly $4.6 million over three years, and nursing home members received “compensation in the form fees of fees” in amounts equal to payments to B&L, according to cost reports.
> Please confirm, dispute or clarify this information.
> Who are the owners of B&L Consulting?
> Are members employed by B&L to provide services in exchange for these “fees”?
If yes, what positions do the members hold at B&L Consulting?
> What services does B&L provide in exchange for these fees to its related nursing homes? Does it provide similar services to non-related facilities?
Highview Management is a related company and was paid almost $5.8 million by the nursing homes between 2012 and 2014, according to Medicaid cost reports. Cost reports further show that members of one or more nursing homes received compensation in amounts equal to payments to Highview Management. Bent Philipson is Highview Management’s board chairman, according to business records.
> Please confirm, dispute or clarify this information.
> In addition to Mr. Philipson, who are the owners of Highview Management?
> What services does Highview Management provide to its related nursing homes?
Manhigut Partners, Ltd., a related company, made a $6,000,000 cash advance for working capital to The Hamptons Center in 2008, according to the nursing home’s cost report. The answer in Robert Kolman v. Martin Farbenblum (605901-2015) alleges the interest rate on the loan was 16 percent. According to New York Department of State records, Howard Fensterman is the CEO of Manhigut Partners.
> Please confirm, dispute or clarify this information.
> Why was this loan necessary, and what factors explain the seemingly above-
market rate?
County Agency of NY, LLC, is a frequent vendor to SentosaCare facilities, and its main place of business is 945 Broadway, Woodmere, NY 11598. County Agency of NY, LLC and Prompt Nursing Employment Agency, LLC both list this as their processing address. While Prompt Nursing Employment Agency, LLC is a declared related company in cost reports, County Agency of NY, LLC is not.
> Please confirm, dispute or clarify these findings.
> Is County Agency of NY, LLC a related party to SentosaCare-managed nursing homes? If so, which homes? If so, why is County Agency not listed as a related- party?
> Who are the owners of County Agency of NY, LLC?
> What ownership do County Agency and Prompt have in common?
Related companies Prompt Nursing Employment Services and Sentosa Services are staffing agencies listed interchangeably on cost reports. The owners are Mr. Landa and Mr. Philipson, according to cost reports. Are they effectively the same company?

9. OMIG Audits
Based on audits, the state Office of Medicaid Inspector General has required a few of your affiliated homes to pay back disallowed related-party expenses. These include a nearly $12,000 fee to SentosaCare, according to a 2014 finalized audit for Throgs Neck Extended Care. The office disallowed a $92,000 payment to B&L Consulting due to lack of documentation of the expense, according to a final 2013 audit for Avalon Gardens Rehabilitation and Health Care Center.
> Please confirm, clarify or comment on these audit findings.
OMIG finalized an audit of Golden Gate in 2013. In response to a disallowed increase in laundry equipment rent, the facility stated that the new contract was “the most efficient and cost effective way for obtaining the equipment.” OMIG responded that the increase in rent, which was paid to the same vendor for the same equipment, was not in line with CMS’ “prudent buyer” provisions.
> Please confirm, clarify or comment on these audit findings.
The laundry equipment vendor in this audit is listed as Confident Management. According to cost reports, SentosaCare facilities paid a company named Confidence Management at least $3 million between 2012 and 2014. Relatives of the company’s owner, David Zahler, co-own at least three nursing homes — Little Neck Care Center, Seagate Rehabilitation and Nursing Center and Cypress Garden Center for Nursing & Rehabilitation — that are affiliated with Mr. Landa, Mr. Philipson or their families.
> Please confirm, deny or clarify this information.
> Do your facilities regularly pay more than market rate to vendors?
> Are Confidence Management and Confident Management the same company?
> Have you paid higher than market rates to this company for laundry services?

10. SentosaCare’s corporate structure
An internal Wausau company memo made available in the Wausau v. Landa case outlines the “prospect’s history.” SentosaCare, it says, “will be a separate corporation to limit liability through separating assets from the management company … and the operating companies for the sole purpose of maximizing reimbursement and protecting the liability of the beneficial owner [Landa and Philipson] from frivolous suits against them.”
Each facility’s real estate, the memo states, “is the beneficial owners MOST VALUABLE asset.” Once the real estate and management companies are separated from the operations, “the result is that tort claims will usually never reach the beneficial owner … which afford protection AND more so allows the operating entity to run at lower margins and allows maximization of reimbursement.”
Even though individual facilities may not show a profit on paper, the memo says, “the group itself is able to manage a very solid profit through the LLC concepts.”
> Please confirm, clarify or dispute the contents of this memo.

11. Nursing homes examined by ProPublica and affiliated with SentosaCare and/or Landa, Philipson or their family members in 2012 through 2014, per Medicaid cost reports:
Avalon Gardens Rehab & Health Care Center
Bay Park Center for Nursing & Rehab
Brookhaven Rehab & Health Care Center
Crown Center for Nursing & Rehab
Diamond Hill Nursing & Rehab
Eastchester Rehab & Health Care Center
Forest Hills Care Center
Garden Care Center
Golden Gate Rehab & Health Care Center
Grace Plaza Nursing & Rehab Center
Little Neck Care Center
Meadow Park Rehab & Health Care Center
Nassau Extended Care Center
New Surfside Nursing Home
Park Avenue Extended Care
Parkview Care & Rehab Center
Pathways Nursing & Rehab Center
Rockville Skilled Nursing and Rehab Center
Rosewood Rehab & Nursing Center (2012-2013 only) South Point Plaza Nursing & Rehab Center
Spring Creek Rehab & Nursing Care Center
The Hamptons Center for Rehab & Nursing
Throgs Neck Extended Care Facility
Townhouse Center for Rehab & Nursing
West Lawrence Care Center
White Plains Center for Nursing Care
Woodmere Rehab & Health Care Center

 

ADDITIONAL SOURCES:

Please see the video with Halpern’s interview. If you scroll to 32:00 minutes in-you’ll also hear how Ben  Landa and his ‘Excellent’ agency were able to merely pay a fine for violations. There is a reference made to Howard Fensterman who was not only connected to Cuomo but also to AG Schneiderman.
As is clear business is thriving years later and who knows how many elderly have been destroyed in their final time on earth? In addition, even in this context, the finances have not been examined.

 

 

Jack Halpern, an Elder Advocate, has spelled out in this May 28, 2015 interview of the gaming of the nursing home system which he claims were abetted by Governor Cuomo -the Governor’s appointed commission-the Public Health and Health Planning Council and those legislators and state agencies who have failed to mitigate state sponsorship of harm and the denial of human rights to the disabled elderly.
If you scroll 20 minutes in and then again later in the interview, you note Landa (Sentosa) and Fensterman are mentioned.

 

 

After 90 days of so-called ‘rehab’ which is paid for Federally by Medicare, if the patient is not able to be discharged, then private pay kicks in or “Institutional Medicaid” pays the bills after the patient is wiped out of their money. The ‘rehab’ then magically becomes a ‘nursing home’.  Medicare stops paying after 90 days, then it’s the patient or the state’s responsibility. Every state has different criteria for payments by Medicaid.
NY is considered among the more generous. The average cost of for-profit Nursing Home care is approximately $18,000/month. When an elder has any financial resources, it is gutted by these facilities, even as understaffed nursing homes which over-medicate the vulnerable with anti-psychotic and anti-seizure drugs to keep them somnolent and in a state of uncomplaining limbo, poorly attended to by underpaid and overworked aides and nurses.
It should be noted that many of the Nursing/Rehabilitation centers bill out prescriptions in 1-3-month windows. They are reimbursed by medicare or other family/insurance resources accordingly. If the patient is released or dies during that time, the facility has the benefit of that remainder medication.

 

 

Nursing home complaints from Long Island, NYC and Hudson Valley

http://data.newsday.com/long-island/data/health/nursinghomes/

The percentage of nursing homes residents on antipsychotic drugs exceeds the state average at 34 of the 78 institutions on Long Island, according to data from the New York State Department of Health. Here is state information about nursing homes on file as of March 10, 2015, coupled with data from the federal government about antipsychotic drug levels. Deficiencies (problems found by inspectors) and complaints resulting in citations are during the past three years, while the amount of fines listed account for those levied since the beginning of 2005. Nursing homes classified as voluntary are non-profit. For more details, get a complete state report on any institution by clicking on the institution name in the table below. Database posted on March 27, 2015.

See corresponding chart. 

http://data.newsday.com/long-island/data/health/nursinghomes/

 

 

 

 

 

 

 

 

 

 

 

 

6 thoughts on “Open Letter to Preet Bharara – ProPublica, Medicaid Fraud, Worker’s Comp…

  1. He is not the “Attorney General”. Preet Bharara is the Assistant United States Attorney for the Southern District of New York. I was successful here https://www.justice.gov/usao-sdny/report-crime in reporting an issue to him and his incredible career prosecutors by using the info on that page. They received it, read it and notified me within a very short period of time that they took the matter on.

    Preet and his lawyers are my real time heroes.

    Like

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