Who Would have Thought Ageing Could be So Lucrative?

 

What Happens When you Mix a Law firm, Politics and a Multimillion Dollar “Ageing” Industry?

Contributor Opinion, Lost Messiah, August 1, 2016

We are posting the following as a sort of related story to the picketing by Shlomo Rechnitz’s own nursing home employees, who seem to have more decency and care for their charges than Rechnitz. What follows is the East Coast’s version of the nursing home mafia, or at least one of them. We are fairly certain there is far more to follow.  

The AG has gone after Allure for ‘misrepresentations’ having to do with the churning of the Rivington House & CABs Bed-Stuy properties. Both of which were transitioned into luxury housing. The idea that ‘misrepresentation’ of bricks & cement are the priority for those in charge of justice shows you how ass-backward are the ethics of our elected officials.

Instead of preventing these unscrupulous amoral owner/operators from doing more harm to the frail and weak, to the disabled who cannot speak for themselves, and preventing these dangerous owners who lie about their intentions to care for their patients; it takes financial transactions to have the AG step up.  

Is it better than nothing? Yes…but not much.

Assertions of ‘supply and demand’ excuses and the parsing of deed restrictions in the lawsuit are the sole prioritized subject matter for the courts!? Killing off the disabled in sub-par nursing homes is not of any interest. The Department of Health “approves” the applications of these same owner/operators who have already been guilty of blatant disregard for the lives of those entrusted in their care.

Unless someone is maimed or dies…and a malpractice lawyer is hired (sorry, Mr. Fensterman, you would be conflicted) -these Nursing Home owners have unfettered access to more facilities, more fluid deed restrictions and more money.

Re the AG trying to stop Allure:

Context means so much…

The firm of Abrams Fensterman & Fensterman are Allure’s counselors in contesting the AG’s challenge for their effort to acquire the Greater Harlem Nursing Rehab facility and another nursing home. This case is currently being heard in Manhattan Supreme Court (Index 155305/2016). Fensterman, as already reported in Lost Messiah, has a long sketchy history and tentacles not only to Albany-and to Schumer in D.C. but also to deBlasio in NYC. We are posting prior forwarded links below as a matter of convenient reference.

Fensterman, dear Fensterman, is the Consigliere of the Nursing Home ultra-Orthodox mafia… The Rubin(s)/Landau -were the state’s DOH appointed Receivers in 2014 & were given the opportunity by a complicit NYS Public Health and  Health Planning Council (appointees of (corrupt) Cuomo) to get their foothold in this Harlem Rehab-in order to buy and inevitably (as they did with the churning of the Rivington Nursing Home and the Bed-Stuy CABS facilities) leverage it for sale. 

We also believe that they may have played financial “Twister” with Medicaid, Medicare and Workers Compensation in the process. They have employed the Fensterman attorneys as their defense team. In fact, Fensterman seems to have made defending the questionable business tactics of nursing home owners, and fighting for additional nursing homes for his clients a lucrative legal industry.

The coup d’grace is that Long Island’s Fensterman recently opened a branch of his office in Brooklyn with County Dem Boss and ‘appointer’ of  judges, Frank Seddio and his partner Frank Carone. Ready to make sure that all of the ultra-Orthodox Brooklyn owners of nursing homes and long term care facilities know who to hire as the lawsuits come rolling in. Hard to know which judges have Seddio to thank for their seats…

http://www.nytimes.com/2013/06/24/nyregion/reinventing-long-term-care-and-endorsing-firms-accused-of-fraud.html

Excerpt from above:

Mr. Fensterman is past chairman of fund-raising for Mr. Cuomo on Long Island, and his Lake Success law firm has donated more than a half-million dollars to candidates of both parties over the past decade, records show, including more than $17,700 to Mr. Cuomo and $43,291.25 to Senator Skelos, the Senate Republican leader. Excellent and the Fenstermans’ separate contributions include another $13,500 to Governor Cuomo.

https://michaelamon.wordpress.com/2008/01/05/how-a-long-island-nursing-home-empire-got-its-way/

Excerpt from above:

“Howard Fensterman, SentosaCare’s chief attorney, is Schumer’s Long Island finance chairman and a top fundraiser for the Democratic Senatorial Campaign Committee, chaired by Schumer. Fensterman, along with the SentosaCare executives he represents, said they had supported Schumer for years, well before he acted on their behalf.”

The Sick Looting of Home Health Care

Excerpt from above:

More problems surfaced when the media got wind that Fensterman, Landa’s attorney, was lining up contributions for Cuomo’s campaigns. Both the Voice and Newsday reported that Cuomo had received donations from partners in a company under investigation. The campaign quickly returned $6,000 from Landa. Fensterman said his own donations were fine, since he was no longer seeking to become a partner. Actually, he simply had his wife, Lori, replace him as a would-be shareholder.

http://www.howardfensterman.com/in-the-news/bill-de-blasio

In October, 2013, Mr. Fensterman hosted a fundraiser for NYC mayoral candidate Bill de Blasio at his Long Island residence, where over ninety Long Island community leaders gathered to show their support for the Democratic nominee.

So while the optics would seem to be promising-this case MUST be followed closely. Perhaps in his own evaluation, the political gains for Schneiderman from newsworthy attention of the public will be considered worth the ‘sturm und drang’ from the Hasidic community-Schneiderman’s former  ‘sponsors’ and patrons?

 

 

Chabad – Plagued with Scandal… When will we find a collective conscience

Elder Abuse and Nursing Homes Continued….

THE SENTOSA STORY:

Lost Messiah comments, June 15, 2016

What follows is an article written by a contributor to Lost Messiah whose research on nursing and rehabilitation facilities and the malefactors who own them, profit from them and appear to care little about those entrusted in their care, has been impeccable.

On the anonymous contributor’s behalf we have accepted responsibility for bringing to light the ills of the Nursing and Rehabilitation homes and their owners, a profitable industry which effectively destroys the lives of many of this country’s elderly and their families.

We believe that the elderly, those who are in the sunset years of their lives, are entitled to respect, dignity and humanity. From the articles our contributor finds and researches, we believe that they are denied even the most basic of human comforts and we believe it a travesty.

We thank this contributor for his or her insights, passion and caring. We hope to one day be able to deserve some credit, if not just a small bit, for helping to better the quality of lives for our elderly. It will never happen until in our view the extremely wealthy minion that owns these homes, Shlomo Rechnitz, Braunstein and son, Ben Landa, Haysha Deutsch and so many others grow a conscience, right their skewed collective moral compass or one day  in the not so distant future lie in the beds they have made for the patients in their care.

OUR ELDERLY DESERVE BETTER – THE ELDER ABUSE WITHIN THESE HOMES MUST STOP!

In yesterday’s Lost Messiah someone commented: “One may be aware that Chabad is plagued with scandal.  Despite their efforts to appear religious and righteous, those willing to do their research on Chabad will find story after story about child sexual abuse cover-ups, financial crimes, building their infrastructure with donations of illegally obtained money, etc.  So it’s no surprise that Chabad of Port Washington, NY named the mafia figure in the WaPo [Washington Post] story “Man of the Year” in 2014.”

 This serves as no surprise.

 This organization is ground zero for malefactors feigning a moral imperative under the auspices of their misappropriated Judaism…the harm done to patients in the nursing homes owned by some of their members  is de facto criminal negligence.

 If one goes to that organization’s website one will find the disreputable Nursing Home Machiavelli Attorney Howard Fensterman on its Board of Directors:

Board of Directors – Chabad of Port Washington

 

Howard Fensterman’s Curriculum Vitae [Fensterman Bio] includes a myriad of fund raisers for the organization and government’s pay-to-play puppets who aid and abet Chabad. Our corrupt elected officials have been sponsoring harm to the disabled elderly for years.

 And these members dare to pontificate about phony morality while doing harm to the  most vulnerable within our society, the most deserving of our attention, our kindness and our compassion. What is most unbelievable is that the harm and abuse to the elderly is committed and then spun by “Philantrhopists” with straight face.

http://chabadpw.org/media/pdf/919/hIpu9199900.pdf

 

One of the Chabad’s listed “Supporters” is Ben Landa, who has been mentioned in our posts as part of Sentosa Nursing Home infamy. He who was the founder of Chabad of Port Washington. Landa’s Sentosa partner is Bent Philipson.

 

 

 

 

http://www.ltccc.org/news/documents/ltcjournalwinter2016.pdf

Sentosa Care facilities have been subject of numerous reports of poor care.  Based on a 2014 listing of Sentosa facilities, with 142 appeals they are in line to receive a piece of the multi-million dollar handout. 

TROUBLED NY NURSING HOMES WITH RATE APPEALS

 “The state has negotiated a “Universal Settlement” with the nursing home industry which, according to the industry’s lobbyists, will provide an $850 million pay-off to settle the appeals. Not only are the validity of those appeals unknown, many of the facilities which will likely receive a portion of the purported $850 million payoff have a history of poor care and abuse. These nursing homes are known to have failed to meet the minimum standards which they were paid to achieve. Now, in addition to their initial payment for providing substandard services, these facilities are likely to share in the $850 million payoff.”

 More on Sentosa from the ProPublica story – Oct 2015:

 How N.Y.’s Biggest For-Profit Nursing Home Group Flourishes Despite a Record of Patient Harm 

From ProPublica Oct. 27, 2015:

The state’s “character-and-competence” reviews are supposed to weed out operators with histories of violations and fines— but regulators don’t always act on the full story.

The nursing home is one of several in a group of for-profit homes affiliated with SentosaCare, LLC, that have a record of repeat fines, violations and complaints for deficient care in recent years.

Despite that record, SentosaCare founder Benjamin Landa, partner Bent Philipson and family members have been able to expand their nursing home ownerships in New York, easily clearing regulatory reviews meant to be a check on repeat offenders. SentosaCare is now the state’s largest nursing home network, with at least 25 facilities and nearly 5,400 beds.

That unhindered expansion highlights the continued weakness of nursing home oversight in New York, an investigation by ProPublica found, and exposes gaps in the state’s system for vetting parties who apply to buy shares in homes.

State law requires a “character-and-competence” review of buyers before a change in ownership can go through. To pass muster, other health care facilities associated with the buyers must have a record of high-quality care.

The decision maker in these deals is the state’s Public Health and Health Planning Council, a body of appointed officials, many from inside the health care industry. The council has substantial leverage to press nursing home applicants to improve quality, but an examination of dozens of transactions in recent years show that power is seldom used.

Moreover, records show that the council hasn’t always had complete information about all the violations and fines at nursing homes owned by or affiliated with applicants it reviewed. That’s because the Department of Health, which prepares character-and-competence recommendations for the council, doesn’t report them all.

 

How N.Y.’s Biggest For-Profit Nursing Home Group Flourishes Despite a Record of Patient Harm

Thirteen of SentosaCare’s homes (though not Avalon Gardens) have Medicare’s bottom score for nurse staffing. Inspection reports also show that at least seven residents have wandered away from the SentosaCare affiliated facilities in recent years — including one who froze to death in 2011. Inspectors and prosecutors have found that staff falsified records in some cases. Dozens of patients at SentosaCare homes have experienced long delays before receiving necessary care; some ended up in hospitals.

The Stewarts said the staff at Avalon Gardens showed “no sense of urgency” when they complained about missed meals, soiled sheets and unanswered call bells. Even though nurses dressed the wound on Charlie’s leg daily, and a doctor checked it each week, no one warned them about its worsening condition, the Stewarts said.

Dr. Kris Alman, a retired endocrinologist who reviewed Stewart’s medical records and photographs at ProPublica’s request, said that the two quarter-sized lesions on his foot when he was admitted to Avalon Gardens could not have “become what it did overnight.” That the condition “progressed as far as it did, with him coming in septic and needing an above-the-knee amputation, was inexcusable,” Alman said.

Landa’s attorney and business partner, Howard Fensterman, declined to comment on Stewart’s case for reasons of patient privacy. Fensterman defended Avalon Gardens and other SentosaCare facilities, however, saying that when inspectors have found problems, the homes quickly addressed them and secured state approval of correction plans.

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.

SentosaCare’s New York Nursing Homes

Medicare rates nursing homes on a scale of 1 (bottom performers) to 5 stars (best). Here are ratings for the homes

currenty listed as part of SentosaCare’s network in New York. See what’s in the ratings.

Home	City	Beds	Overall Score	Health Inspection	Nurse Staffing	Quality
Avalon Gardens Rehabilitation & Health Care Center	Smithtown	353	2	1	4	2
Bay Park Center for Nursing and Rehabilitation	Bronx	480	2	2	1	5
Brookhaven Nursing and Rehabilitation Center	Far Rockaway	298	3	2	2	5
Eastchester Rehabilitation and Health Care Center	Bronx	200	4	4	3	3
Forest Hills Care Center	Forest Hills	100	4	4	1	5
Garden Care Center	Franklin Square	150	2	2	1	5
Golden Gate Rehabilitation and Health Care Center	Staten Island	238	4	4	2	2
Grace Plaza Nursing and Rehabilitation Center	Great Neck	214	4	4	2	4
Little Neck Care Center	Little Neck	120	5	5	1	5
Nassau Extended Care Facility	Hempstead	280	2	3	1	4
New Surfside Nursing Home	Far Rockaway	183	2	2	1	5
Park Avenue Extended Care Facility	Long Beach	240	5	5	1	5
Parkview Care and Rehab Center	Massapequa	169	1	1	1	4
Pathways Nursing & Rehabilitation Center	Niskayuna	112	4	3	4	4
Rockville Skilled Nursing & Rehabilitation Center	Rockville Centre	66	3	2	4	4
Seagate Rehabilitation and Nursing Center	Brooklyn	360	3	4	1	4
South Point Plaza Nursing & Rehabilitation Center	Island Park	185	1	1	1	2
South Shore Rehabilitation and Nursing Center	Freeport	100	4	3	2	5
Spring Creek Rehabilitation and Nursing Care Center	Brooklyn	188	1	2	1	2
The Grove at Valhalla Rehabilitation and Nursing Center	Valhalla	160	4	4	3	4
The Hamptons Center for Rehabilitation and Nursing	South Hampton	280	3	3	2	2
Throgs Neck Extended Care Facility	Bronx	205	4	5	1	4
Townhouse Center For Rehabilitation & Nursing	Uniondale	280	1	3	1	1
White Plains Center for Nursing Care	White Plains	88	3	2	4	4
Woodmere Rehabilitation and Health Care Center	Woodmere	336	1	1	3	4

 

Sources: Centers for Medicare & Medicaid Services data as of Oct. 1, 2015; Nursing Home Inspect

The most critical nursing home deficiencies are known as “immediate jeopardy”violations — incidents or conditions that have caused or are likely to cause the “serious injury, harm, impairment, or death” of patients. Less than 6 percent of all New York homes were cited for four or more immediate-jeopardy violations in recent years.

By comparison, Avalon Gardens was cited for 10 immediate-jeopardy violations in the three years ending in August, the third-highest number in the state for that period. Two other SentosaCare homes — Woodmere Rehabilitation & Health Care Center and South Point Plaza Nursing and Rehabilitation Center — each have been cited for four.

Elopements — where residents leave the premises without the knowledge of a home’s operators — have been a repeat problem for Avalon and Woodmere, where SentosaCare co-owner Philipson has been listed as longtime managing partner.

Two days before Thanksgiving in 2011, a group of Woodmere residents walked to a nearby school for a holiday lunch. When aides took a head count, one of the 19 residents, a 55-year-old with dementia named Dennis Buckham, was missing.

Buckham wasn’t found until four days later, face down on a Brooklyn sidewalk, frozen and without a pulse. He died of cardiac arrest and hypothermia, according to the chief medical examiner’s report cited in the Department of Health investigation.

Fensterman said Woodmere overhauled its policies and procedures, and that the state signed off on an official plan of correction. Two years later, however, a 64-year-old Woodmere resident with schizophrenia left a secure unit 10 times over three months. Staffers found her in the basement and at the front door, but according to the state’s report, the home did not investigate, change her care plan or conduct a doctor-ordered psychiatric evaluation.

About a month later, the woman walked past a security guard and was found in the road. Fensterman said no harm resulted, the home fired the security guard who let the resident slip out, and the state again approved a correction plan.

Residents also wandered from Avalon Gardens in 2011 and 2013, state inspection reportsshow. In all, at least seven residents wandered away from SentosaCare facilities between 2011 and 2014, according to state inspection reports.

The reports also document dozens of cases of delayed treatment at SentosaCare homes. At Woodmere in 2012, staffers failed to promptly send four patients to the hospital, two of whom died. Two years later, a resident at Parkview Care and Rehabilitation Center in Nassau County suffered from a collapsed lung for four days while staff failed to check results from a chest X-ray or assess his breathing or vital signs.

Fensterman said that each SentosaCare home is distinct. “There is no pattern of delayed treatment among facilities,” he said, “as each facility cited had separate issues, which in no way relate to each other.” He said the Health Department found the incidents to be isolated and that all were corrected.

On multiple occasions, state inspectors discovered that staff at SentosaCare facilities tried to cover up lapses in care — allegedly lying about elopements or the failure to spot bedsores, for example. After a 2012 investigation by New York Attorney General Eric Schneiderman, the administrator of The Hamptons Center for Rehabilitation and Nursing, a SentosaCare home in Suffolk County, pled guilty to falsifying records after a resident wandered away and was found walking on the highway five hours later. The administrator was sentenced to a $2,500 fine and probation.

In June, after another investigation by Schneiderman’s office, four Woodmere nurses were arrested for falsely signing off on forms saying they had checked on a resident who fell three times in a week and ended up hospitalized. Three pleaded guilty to misdemeanors; the fourth case is pending.

Additional sourses:

Filipino nurses targeted for exposing abuses

The criminally charged nurses within the Sentosa 27 stood firm and united during their last criminal court appearance Dec. 17 at a state supreme courthouse in Suffolk County on Long Island, N.Y., when the assistant district attorney advised that they take on separate legal counsels.

The Avalon 10 and their lawyer, Felix Vinluan, have been leading a popular campaign to appeal to New York Gov. Elliot Spitzer to appoint a special prosecutor independent of the Suffolk County district attorney’s office on Long Island.

Photo: anakbayan-ny.blogspot.com

The Sentosa 27 nurses, with the assistance of the National Alliance for Filipino Concerns or NAFCON, have been waging a justice campaign since 2006, in a clear case of human trafficking, illegal recruiting and indentured servitude at the hands of SentosaCare LLC. Sentosa is a major health-care management agency managing over 12 nursing homes in New York, New Jersey and Connecticut.

Sentosa is owned and managed by Bent Philipson, a major political contributor to Sen. Charles Schumer as well as former Philippine Executive Secretary Mike Defensor. The nurses claim political interference on Sentosa’s part has been a major obstruction to justice in their campaign thus far, and has enabled the fraudulent Sentosa Recruitment Agency in Manila to continue to operate.

“We are very concerned that anyone affiliated with District Attorney Thomas Spota will not afford us a fair and objective trial,” said Vinluan. “This has been an uphill battle wherein all signs point to the reality that the Sentosa camp is working in collusion with Sen. Charles Schumer and other local government officials. These political ties yield power and influence to the multi-million-dollar Sentosa camp and disenfranchise us of our rights as immigrants.”

The nurses say that a Spota trial would establish a strong anti-immigrant and pro-Sentosa bias was further substantiated by the fact that before the indictment, Spota had a series of private meetings with the principals of Avalon Gardens, the Riverhead nursing home owned and managed by SentosaCare LLC.

Despite standing firm that all nurses were satisfied being represented by one legal counsel for the course of their criminal trial, attorney James Druker, it was evident that Judge Robert Doyle felt compelled to advise them to seek more than one attorney for the case.

“These are divide-and-rule tactics,” stated Rico Foz, executive vice president of the NAFCON. “It is not beyond the Sentosa camp and the Suffolk district attorney to seek to weaken the unity of the Avalon 10 by dividing them up by legal counsels and giving them uneven advise. We admire the example of the nurses’ unity at this critical time.”

Vinluan had advised that the nurses had the right to resign after working for more than a year under violated employment contracts and after suffering intolerable work place abuse. SentosaCare LLC owner Bent Philipson retaliated by filing criminal charges against the 10 nurses for patient endangerment, while Vinluan was charged with tortuous interference.

“This is not just about the rights of immigrant nurses, but the rights of lawyers to offer their clients sound legal advice are also being called to question,” Vinluan defended.

The Avalon 10 maintain that none of their patients faced endangerment and that they fully resigned only after completing their shifts and making sure the incoming nurses were already in. Since then, the Sentosa 27, along with NAFCON, have launched an international campaign for justice and to shut down the fraudulent and illegal operations of SentosaCare LLC and the Sentosa Recruitment Agency in Manila.

The nurses and Vinluan maintain that the immediate battlefront at this point, before the Jan. 28 start date of the criminal trial, is to convince Spitzer to appoint a special prosecutor before then. A letter-writing campaign to Spitzer has already been launched by NAFCON, the New York Nurses Association, the American Nurses Association, the Philippine Nurses Association, Region 1 of the National Federation of Filipino-American Associations, as well as the California Nurses Association.

 

 

 

Barry Braunstein and Oxford – Rejected in Red Hook

Victory for Community Activists, You Succeeded in Preventing the Red Hook Deal… Kudos!

May 20, 2016

We have been following the story of Braunstein’s bid to acquire the location in a Red Hook flood zone, and the people within the community who were opposed. Those of us who have followed the activities of Barry (and son Sully) Braunstein knew that his plan was inevitably going to do nothing for the community except perhaps create a perilous situation for Oxford’s patients.

We suspected that the Braunstein clan either intended to move the current facility from Fort Greene, along with the already existing employees from the Fort Greene location to Red Hook; or they planned to coerce a change in zoning flip the property to a luxury complex, similar to Joel Landau’s Allure and many others before him.

While Oxford promised to sign a restrictive covenant to assure that the location would not be flipped, there are few who would have relied upon the enforceability of such a covenant. Mounting evidence suggests that the laws in this area are somewhat inconsistent in practice. Braunstein and Oxford did not promise to sign, as a condition of remaining on the property, a covenant to hire members of the community and utilize its services and providers, which might have improved the community. It also likely would have meant nothing given issues with specific performance.

In the end, we hope that no compromise will be offered in the LONG TERM and we give kudos to the Committee members who took a stand and voted against and to the community activist who worked so hard to achieve these results. Hopefully more communities will follow suit.

 

Plans for Red Hook nursing home shot down by City Council committee

The Daily News is reporting: 

“A City Council committee shot down plans for a Red Hook nursing home, nixing what would have been the first new home approved by the city in a decade.

Now the nursing home’s operator say their current facility may have to shut down because it’s not up to code, displacing 200 seniors and just as many workers.

The rejection was driven by staunch opposition from local Councilman Carlos Menchaca, who says the plan would endanger residents by housing them in a flood zone, and the land should be used for manufacturing.

The Council land use committee voted 12-0 to reject the plan Thursday, following the body’s usual practice of following the local member’s lead. But it’s rare for the Council to outright reject a land use proposal, instead of making a deal with the developer or seeing the application withdrawn.”

To read the article in full click here.

A Consorted Effort – The Braunstein Empire, the Zupnik Empire… A Healthcare Scheme…Scam…Sham??

Healthcare, Rehabilitation and Nursing Care Businesses Web of Inter-Connected Entities

May 18, 2016

An investigation into the Healthcare, Rehabilitation Care and Nursing Care businesses has unraveled webs of inter-connected entities and huge finances. With regard to the Summit Park Hospital and Healthcare Facility, it would appear that Rockland County missed a poison dart by not accepting Allure Group/Allure Healthcare LLC as the acquiring party, evident in new reports regarding the principal in Allure, Joel Landau.

According to Freedom of Information Act requests, the parties that bid on the Summit Park Hospital and Healthcare Facility were:

1. Allure Group – Allure Healthcare LLC (see articles associated with Allure)
2. Summit Acquisition Group/ Summit Park Acquisition Group (Braunstein Entity)
3. Sympaticare – Sympaticare Healthcare (Braunstein Entity)
4. Northern Riverview Healthcare/Northern Services Group
5. Bronx Rehabilitation Care/Center for Care LLC
6. Focus Investment (Zupnik) (See article Associated to FBI Raids at 386 Route 59 in Airmont)

In the case of Summit Park, Sympaticare won the bid, but in actuality, Summit Acquisition Group won the bid as well because they are owned by the same principals. The way in which the Summit Park deal was supposed to unfold, had everything gone as planned, Sympaticare Acquisition Group, would have acquired the real property of the 50 Sanitorium Road, Pomona, New York facility. In the case of Summit Park, the application with the Public Health Planning Council of the State of New York stated “There is a relationship between Sympaticare, LLC and Summit Park Acquisition Group, LLC in that the entities have common membership. According to the Project #’s related to Summit Park, the Purchase and Sale Agreement, entered into on April 16, 2013 or thereabouts was between Sympaticare, LLC (the proposed operator of the residential healthcare facility) and Sympaticare Health, LLC (the proposed hospital operator). The deal was structured in such a way that the hospital operation component was to be subsequently assigned to Sympaticare, LLC and Summit Park Acquisition Group, LLC (who we already know is the proposed real property owner). Additionally Sympaticare, LLC was to have entered into a Purchase and Sale Agreement for the real property interests in the actual facility.

It should be noted that ALL OF THESE ENTITIES ARE PART OF THE BRAUNSTEIN CONSORTIUM. So, whether or not the real property and tangible assets ever actually transferred title would not have mattered because the Braunsteins were interested parties in Sympaticare Acquisition Group and all of the conglomerated entities. The plan, and apparently not unusual, is that there was to have been a lease on the property, the Braunstein’s Sympaticare, LLC would be making payments to the Braunstein’s Acquisition Holdings LLC. Once final approvals were obtained, the lease was to be terminated and the property’s ownership transferred. If for some reason, that could not materialize, it would not really have had any financial implications on the Braunsteins.

Tax implications of the LLC’s notwithstanding, a structure like this represented a win/win for, in this example, the Braunsteins.

But, that’s not where it ends. In addition to ownership interests in the umbrella entity, Sympaticare Acquisition Group, the Braunsteins (and potentially other members of the investor group) also own a stake in or have licensing/service provider contracts with their service providers. They get everything from foodservice to ambulances to medicare/Medicaid collections, to hospital referrals (which are generally done (if done legally) by a numerical grading system) and the list goes on. In the case of Sympaticare, father and son Braunstein are the main principals but also have stakes in service-related entities.

Braunstein:

The Sympaticare deal: Shalom Braunstein was to have 35% and Barry Braunstein 10% making up 45% of Sympaticare, LLC, d/b/a Summit Park Hospital d/b/a Summit Nursing Care Facility. The remaining interests were spread across other “Sympaticare” entities like Sympaticare New Jersey, LLC and Sympaticare Lakewood, LLC, both of which had overlapping membership stakes.

The effort to buy Summit Park went south in September 2015; and since that time, Sully Braunstein has filed a lawsuit against the County for, amongst other things, a return of the deposit, claiming that the fault of the failure to close was not his.

Currently, according to an article dated December 11, 2015, Barry Braunstein (the father of the pair) is also looking to purchase a nursing facility in Red Hook, which is meeting with some community concerns, and with good reason. The name of the entity in that particular endeavor is Oxford Nursing Home. In an article in Cranes, dated December 11, 2015, entitled Nursing home’s $65 million Red Hook site gets community-board nod, while the community board apparently approved what is listed as a $65M Red Hook site, of greatest concern is the fact that the site is in a Flood Zone. That really should be the least of their concerns.

According to Cranes, “The nursing home would have a generator on-site in case residents need to remain in place, and it has worked out agreements with hospitals and other nursing homes to take on patients in the case of an evacuation. It also has a contract with an ambulance company to transport patients in an emergency.”  [http://www.crainsnewyork.com/article/20151211/REAL_ESTATE/151219958/nursing-homes-65-million-red-hook-site-gets-community-board-nod]

As mentioned above, the ambulance contract comes as no surprise. What would be a surprise is if the Braunsteins don’t have an interest in an ambulance company as part of the Oxford or another conglomerate of businesses associated with the Braunstein empire. Again, a win/win for the Braunsteins.

Unsurprising, the Braunsteins have their hands in the pockets of numerous elderly and infirmed (as distinguished from informed). Barry Braunstein’s LinkedIn profile lists him as administrator of the Laconia Nursing home (http://www.laconianursinghome.com/)  (https://www.linkedin.com/in/barry-braunstein-37942360). The NYS Health Profiles Website (http://profiles.health.ny.gov/nursing_home/view/150669) lists Laconia Nursing Home on 1050 East 230^th Street in the Bronx. The government websites list the ownership of the Laconia as Laconia Nursing Home, as follows:

• Ownership: Proprietary–Business Corporation
• Operated by: Laconia Nursing Home, Inc 1050 East 230th Street  Bronx, NY 10466
• PFI: 1248
• Operating certificate: 7000370N
• DOH Regional Office: New York Metro – New York City
• Medicaid, Medicare certified
• The HIPAAspace website lists about the same information. /NPI_1457435877.pdf) According to the “findthecompany.com” site , Barry Braunstein is the President of Laconia Nursing Home Inc.

 

More to follow…

NURSING HOMES PART II – Corporate Ownership

Corporate ownership changes linked to poor nursing home quality

Justin Schwartz, MPH

Director of Healthcare – Education (K-12) IT Solutions / Special Projects

https://www.linkedin.com/pulse/corporate-ownership-changes-linked-poor-nursing-home-schwartz-mph

Ms. Emily Monogan, a staff writer, for Mcknights  (a Long-Term Care News pre-eminent magazine for long term care giving professionals) reports that; nursing homes that are bought and sold by corporate chains tend to provide a lower quality of care, according to research from Harvard Medical School released on Monday.

 Many nursing homes that experienced a chain-related transaction between 1993 and 2010 had a higher number of deficiency citations than facilities that did not undergo a transaction, according to researchers from Harvard, the University of Michigan, the University of Rochester and Vanderbilt University.

 In many instances, nursing homes that were the subject of a transaction were already having quality issues, which continued after the transaction. Those pre-existing quality issues led the researchers to believe that the transaction wasn’t to blame for any drops in quality, but rather that corporate transactions can be an indicator of a low-quality facility.

 The study’s results could spur policymakers to create legislation that requires more comprehensive reporting of ownership for nursing homes chains, as well as increased accountability, oversight and transparency for corporate chains, the researchers said. The researchers also suggest that notices of nursing home sales should be publicly available, an idea that was recently set as a rule in Massachusetts.

 The researchers noted that consumers may be able to use the number of a facility’s chain-related transactions as a potential indicator of a facility’s quality.

“A large number of mergers, sales and acquisitions have occurred over the past two decades among nursing home chains, and we wanted to see how residents living in these nursing homes were affected by these transactions,” explained lead researcher David Grabowski, Ph.D., a professor of healthcare policy at Harvard.

Each year, between 1,200 and 2,000 nursing homes in the United States — 7% to 13% of all facilities — are involved in a corporate chain transaction. Despite that, the amount of nursing homes owned by a corporate chain remains the same as it was in the 1990s, the study’s authors note.

 The most common type of transaction is mergers across chains, with eight of the 10 largest nursing homes chains — which comprise 12% of all facilities — undergoing some sort of ownership change within the study period.

Results of the study appear in the May issue of Health Affairs.

 

Nursing Home Evictions is the excuse to Drop Difficult Patients its nothing but to Human Dumping

NURSING HOME EVICTIONS

By Justin Schwartz, MPH – LinkedIn

Justin Schwartz, MPH

Director of Healthcare – Education (K-12) IT Solutions / Special Projects

May 9, 2016

 Sadly, it’s a term you may come to hear more often: ‘nursing home evictions.’ While it is true that nursing homes and chronic care facilities have the right to evict a resident for just cause—and those causes are generally limited to six—a trend has been growing where residents have been evicted more for reasons of convenience.

Or worse—because the facility thinks it can earn more revenue for the bed from a more well-heeled source.

“When they get tired of caring for the resident, they kick the resident out,” said Richard Mollot of the Long Term Care Community Coalition, a New York advocacy group. Complaints and lawsuits across the U.S. point to a spike in evictions even as observers note available records only give a glimpse of the problem.

An Associated Press analysis of federal data from the Long-Term Care Ombudsman Program finds complaints about discharges and evictions are up about 57 percent since 2000. It was the top-reported grievance in 2014, with 11,331 such issues logged by ombudsmen, who work to resolve problems faced by residents of nursing homes, assisted living facilities and other adult-care settings.

The American Health Care Association, which represents nursing homes, defends the discharge process as lawful and necessary to remove residents who can’t be kept safe or who endanger the safety of others, and says processes are in place to ensure evictions aren’t done improperly. Dr. David Gifford, a senior vice president with the group, said a national policy discussion is necessary because there are a growing number of individuals with complex, difficult-to-manage cases who outpace the current model of what a nursing home offers.

“There are times these individuals can’t be managed or they require so much staff attention to manage them that the other residents are endangered,” he said.

The numbers of both nursing homes and residents in the U.S. have decreased in recent years; about 1.4 million people occupy about 15,600 homes now. The overall number of complaints across a spectrum of issues has fallen in the past decade, though complaints about evictions are down only slightly from their high-water mark in 2007, the federal figures show. Meanwhile, the share of complaints that evictions and discharges represent has steadily grown, holding the top spot since 2010.

Offending facilities routinely flout federal law, attempting to exploit and widen justifications for discharge. They say hospitalizations are a common time when facilities seek to purge residents, even though the Nursing Home Reform Act of 1987 guarantees Medicaid recipients’ beds must be held in their nursing homes during hospital stays of up to a week.

“They try and take the easy way out and refuse to let the person back in,” said Eric Carlson, an attorney who has contested evictions for the advocacy group Justice in Aging.

Federal law allows unrequested transfers of residents for a handful of reasons: the facility’s closure; failure to pay; risk posed to the health and safety of others; improvement in the resident’s condition to the point of no longer needing the home’s services; or because the facility can no longer meet the person’s needs.

Though that final category is often cited in evictions, advocates dispute how often it fits.

“The majority of the time, it’s because the resident is considered difficult,” said Tony Chicotel, an attorney for California Advocates for Nursing Home Reform. Chicotel says involuntary discharges are almost entirely focused on Medicaid beneficiaries and that economics sometimes play a role in the ousters. Rather than a long-term Medicaid patient, many facilities would prefer to fill a bed with a private-pay resident or a short-term rehabilitation patient, whose care typically brings a far higher reimbursement rate under Medicare.

Red Hook, Flood Zones, The Braunstein Family Affairs…

More About the Braunstein Healthcare Empire, Medicaid and…. David Greenfield – the guy who gets to oversee zoning

Thank you to our contributors. We did our best to edit as little as possible on this. May 10, 2016

LM has reported on the Braunsteins several times. The father and son pair can be found in Ramapo, New York, and in Red Hook, Brooklyn, just to name a few. But wherever they are, scandal is not far behind.

In Red Hook, papa Braunstein is attempting to relocate his Oxford Nursing Home from a  hot real estate neighborhood in Ft Greene Brooklyn (where he can turn a huge profit or create expensive housing) to Red Hook where there have been numerous protests within the community. However, what is not being considered is permitting Braunstein to be the steward of old people in a storm surge evacuation facility!!

Braunstein is, as far as we can tell, a despicable owner/operator of numerous healthcare facilities who, not only potentially defrauds the Medicaid system; but keeps his patents heavily sedated – more than most facilities. In some cases, they are arguably so drugged that the Braunstein team can keep payroll for aides low.

Just think: if the patients are largely comatose, there is little need for people to watch over them.

And from what we can see, while Borough President Adams seemed to “get it”. We are skeptical regarding David Greenfield, the Chair of the Land Use Committee of the City Council who will undoubtedly be the flack to rezone the Red Hook location to accommodate his comrades.

http://www.brooklynpaper.com/stories/39/12/dtg-adams-disapproves-nursing-home-2016-03-18-bk.html

http://www.star-revue.com/eric-adams-rules-nursing-home-george-fiala/

Rewind to an old New York Times Article, little has changed since:

“Consider three homes in the Bronx. The operator of the Laconia Nursing Home, which receives 90 percent of its revenues from Medicaid, earned $3 million in salary and profit. At the Grand Manor Nursing Home, also 90 percent financed by Medicaid, the operator and three family members earned a total of $2.4 million in salaries and profit. The owner and operator of the Morris Park home, 75 percent financed by Medicaid, took in $1.5 million in salary and profit.

Advocates for nursing home residents acknowledge that the homes’ operators and executives are entitled to make decent profits and salaries. But the advocates insist that it is unseemly for the profits and salaries to reach such high levels, given what the advocates contend is the industry’s longstanding record of poor care. They point out that at New York nursing homes, the staffing levels are lower than the national average, a crucial indicator. All three of the Bronx homes have staffing levels lower than the national average, according to federal statistics.

“It’s unconscionable to give yourself high salaries and not give some more money to hire people so some of these quality problems can be dealt with,” said Cynthia Rudder, executive director of the Long Term Care Community Coalition, an advocacy group for nursing home residents.

Trade groups representing nursing homes counter that most homes in the state are actually in financial distress because Medicaid does not pay enough.

Many hospital executives in New York also receive high salaries, but hospitals earn significant revenues from sources other than government social programs, including H.M.O.’s and private insurance. The 550 public, private and nonprofit nursing homes around the state, by contrast, earn more than two-thirds of their revenues from Medicaid, taking in roughly $6 billion last year from the program, according to state records. Many clinics receive most of their revenues from Medicaid as well.

Morris Berkowitz, operator of the Morris Park home, said he deserved his profits because he worked long hours and provided excellent care.

“Do you know how much I have invested in this place?” he said. “A lot of money. And I am constantly investing in this place.”

Earlier this year, after residents repeatedly wandered from Morris Park, federal and state officials accused the home of grievously poor supervision, and it was fined $86,000.

Mr. Berkowitz said the home had done nothing wrong. “It was a political thing, and we got caught up in it,” he said. “People with power, they abuse their power.”

Martin Liebman, operator of Grand Manor, said it was misleading to focus on salaries and profits.

“This is a family-owned business,” said Mr. Liebman, an officer of the state trade group of private nursing homes. “I’m third generation in the business. We have taken care of thousands of residents and given quality care for many, many years.”

Barry Braunstein, operator of the Laconia home, did not respond to three calls seeking comment.

Besides their high salaries, some executives profiting from Medicaid were also taking part in another tradition: cheating the program.”

Fast forward to an op-ed comment we received from one of our contributors:

“While I understand the aesthetic and contextual objections to the proposed 200 bed rezoning to accommodate a would-be Nursing Home…I’d like to also point out that the current operator/owner of the facility in Ft Greene has been a poor steward of his patients: Conover King Realty LLC aka Motechin. An in-depth review of the questionable standards of care deserve “equal time”…!

There’s a moral and ethical question which must part of the conversation. Why and how can the City [Greenfield] give a for-profit business special dispensation by rezoning community property on behalf of those who feel no compunction about over-medicating and sedating the elders who at their mercy? It’s just not good enough to say because there is a real need for more long term care and nursing facilities, that it’s perfectly okay to make a ‘pact with the devil’…The owner will make a tidy profit from the sale of his South Oxford facility…this neighborhood is the wild west of property churning…his avowals of a Red Hook nursing facility will be the precursor to market rate housing…I’m willing to bet the farm…Do not be fooled…his interest has nothing to do with providing seniors with a “more modern facility”…

Here’s a reference to the dismaying history of this nursing home and its owner/manager…some history on one of the owners.  Please note this from Norman Motechin -the Oxford Administrator in an article in the Gotham Gazette in Feb 2013-an excerpt:

“More than half of the 205 residents at Oxford Nursing Home in Brooklyn were administered the potent drugs. Oxford’s administrator, Norman Motechin, said he was not familiar with the numbers and declined to discuss them.”  

http://www.gothamgazette.com/index.php/health/4143-investigation-how-nyc-nursing-homes-drug-seniors-into-submission

Multiply this by who knows how many…and understand that too often these places where we send our loved ones are only holding sites for would-be developers…These “operators” suck up Medicare and Medicaid and keep their charges over medicated…understaffed…and immorally un-cared for.  
Red Hook…please…it may well be about property…but even more, it’s about the sub rosa oblivion we in the community have about our responsibility to care for our family members and our neighbors with some ethical concern!
  

 As we age…we are next…

Attention MUST BE PAID to the perpetuation of assisted living senior residences as well as “nursing homes” by real estate interests masquerading as administrators of care for the vulnerable. The churning of property is at the expense of the fragile and weak who cannot speak for themselves and who are additionally victimized by an oblivious NY State Department of Health and removed Federal oversight and… it’s repugnant.  
The city agencies MUST NOT abet via MIH, rezoning, subsidies or programs of that ilk, bad actors. Authenticity and an examination of track records must be mandatory first, if we are to protect fragile seniors from predatory greed.

 

Before privileges are given integrity MUST be verified.

http://www.nyc.gov/html/dcp/pdf/env_review/eas/15dcp193k_eas.pdf