More than half of California’s nursing homes are asking to be exempted from new state regulations that would require them to spend more time directly caring for their patients.
The state’s new staffing requirements for nursing homes, quietly passed in last year’s budget bill, seem universally unpopular. Patient advocates say the new regulations don’t go far enough and that residents remain at risk in poorly staffed homes. Nursing home operators say they can’t hire enough staff to comply.
Under the new rules, which took effect in July but haven’t yet been enforced, skilled nursing facilities must provide at least 3.5 hours of direct care per resident per day, up from 3.2 hours of care previously. That care can range from inserting a feeding tube to changing an adult diaper or helping residents with eating and bathing.
The California Department of Public Health, which oversees nursing homes, is expected to announce in late January which — if any — facilities it will exempt from the new regulations. But some patient advocates don’t like the nursing homes’ balking.
“We’re appalled by the waiver system. It’s sending the worst possible message to California nursing homes that it’s OK to staff at levels that endanger residents,” said Mike Connors of California Advocates for Nursing Home Reform, a consumer advocacy group.
(Check to see which California nursing homes have applied for workforce shortage waivers here and here.)
Researchers have strongly linked more nursing staff with better care, with some experts recommending from 3.8 to 4.1 hours of care per patient per day as a bare minimum for quality nursing home care. Having enough staff helps prevent falls, pressure sores and other problems that can land fragile seniors in the hospital.
A recent Kaiser Health News investigation found that for years nursing homes nationwide overstated staffing to the federal government. Now, nursing homes are required to report actual payroll records to remain eligible for Medicare and Medicaid payments.
During the first three months of 2018, 58 percent of California’s skilled nursing facilities averaged at least 3.5 hours of patient care a day, according to a Kaiser Health News analysis of payroll records submitted to the federal government. That rose to 76 percent when including nursing homes where administrators also were counted.
In Our Opinion: Focus case doesn’t feel like justice
The news that two executives of the former Focus Otsego nursing home pleaded guilty to misdemeanor charges on Wednesday left us feeling a little flat.
Joseph Zupnik, majority owner of CCRN Operator LLC, the corporation that held the ownership certificate for Focus Rehabilitation and Nursing Center at Otsego, and Daniel Herman, a high-level manager, both pleaded guilty in town of Otsego court to second-degree endangering the welfare of an incompetent or physically disabled person, a misdemeanor. The charge was in reference to a 94-year-old woman who was left in a recliner for nearly 41 hours in 2016.
A felony complaint, filed by the state Attorney General’s office, alleged that Focus staff did not provide the woman with required care, feeding and other services, and that she developed a pressure sore as a result.
Zupnik and Herman originally faced charges of first-degree endangering the welfare of an incompetent or physically disabled person, a felony, and two counts of second-degree endangering the welfare of an incompetent or physically disabled person, a misdemeanor.
Each defendant also was also charged under Public Health Law with three counts of willful violation of health laws, a misdemeanor.
Under terms of the plea agreement, both men will be required to pay a fine and perform community service. Town of Otsego Justice Gary Kuch will announce the severity of those penalties during a sentencing hearing, set for Oct. 10. State Prosecutor Kathleen Boland mentioned during Wednesday’s plea proceeding that $1 million will be paid back to Medicaid by the corporation, CCRN.
The state’s separate eight-count felony complaint against CCRN will be taken to the Otsego County Court on Sept. 24.
The complaint laid out a pattern of behavior that promoted profit over care during CCRN’s management of the facility, which has since changed hands.
“Upon taking ownership and control of the home’s operation in October 2014, Zupnik, Herman and CCRN cut staff payroll, cut staffing, and cut other necessary services and supplies needed to provide safe and adequate care to more than 200 individual residents who were in the care of Focus through at least November 29, 2016, when Focus was designated as a Special Focus Facility by the Centers for Medicare & Medicaid Services,” the complaint dated May 24 said.
The defendants received but disregarded many communications from senior staff “that residents were at risk for harm,” plus warnings from outside sources, according to the Attorney General’s Office.
Four staff members were previously convicted by guilty pleas, admitting to neglect and falsification of records.
A misdemeanor conviction, coupled with a fine and a term of community service, seems like a slap on the wrist. A clawback of $1 million from the corporation is significant, but it does not promote individual accountability.
We can take some comfort from the likelihood that Zupnik and Herman are out of the health care business.
Jerome Allen allegedly took bribes to recruit a student-athlete. How good was the player to begin with?
Stats, interviews, and recruiting rankings from Morris Esformes’ career show the big picture
In the immediate aftermath of to designate Morris Esformes as a recruited student-athlete and increase his odds of admission, questions have arisen around one key issue: the qualifications of Esformes as a basketball recruit.
The indictment against Morris’ father, Philip, alleges that Morris “would not have been designated as a ‘recruited basketball player’ had it not been for the kickback and bribe payments” that Philip provided to Allen. Philip’s attorney, Howard Srebnick, has rigorously defended the Esformes family from such allegations, stating that Morris Esformes was qualified to get into Penn on his own academic and athletic merits.
Srebnick, who graduated from Penn in 1985, told , “[Morris] scored more than 150 points higher on his SAT than I did, and I cannot dribble a basketball with either hand, much less sink a three-point shot.”
As the situation unfolds, a glaring question remains: would Morris Esformes have been recruited by Penn men’s basketball without any intervention from his father? The Daily Pennsylvanian looked to Esformes’ past in search of answers.
In 2015, Esformes graduated from RASG Hebrew Academy in Miami, Florida before being admitted to Penn.
While he was never listed on the Penn men’s basketball roster, he appeared in a by the athletic department about the Class of 2019 recruits. Additionally, it is known that Esformes , strongly suggesting that Esformes received designation as a “recruited student-athlete.”
oth RASG Hebrew Academy Dean of Academic Affairs Avi Bossewitch and Penn’s Admissions Department did not respond to interview requests.
Various other key figures connected to Esformes also did not comment. Besides Morris Esformes and Jerome Allen, the following people either declined or did not respond to interview requests: two of Esformes’ teammates from his senior season of high school basketball, Morris’ high school head coach, the then-head coach of a rival team in RASG Hebrew Academy’s district, a Jewish Hoops America reporter, three former Penn men’s basketball assistants who were at Penn during Morris’ high school career, and head coaches at two other Division I schools that Future150 reported that Morris had been interested in. Another coach of a Division I school Esformes reportedly was interested in responded that he had never heard of him “as a recruit, or otherwise.”
Esformes has a , though ESPN’s Class of 2015 recruiting rankings did not list him on their , meaning that his player ranking was lower than two stars out of five. According to ESPN, players who have two stars “are overmatched versus the better players in the nation. These players have weaknesses that will be exposed against top competition, but have the ability to develop into solid contributors at the mid-major Division I level.”
Of the three other players in Esformes’ recruiting class at Penn to have graduated high school in 2015, all three appeared on their state’s respective list. However, it is not unprecedented for Penn to take chances on recruits who have yet to earn such credentials on a national level. Penn men’s basketball rising seniorsMax Rothschild and Tyler Hamilton, who both graduated high school in 2014, did not appear on ESPN’s state leaderboards in 2014.
Esformes’ high school, RASG Hebrew Academy, had a significantly weaker basketball program than the schools most Penn recruits come from. Although Esformes had solid statistics — , he averaged 15.5 points and 5.0 assists per game as a senior — his school’s low strength of scheduleduring his senior season contributed to it having a national ranking of 7,775, according to MaxPreps’ computer rankings.
By comparison, among the active Penn men’s basketball rising seniors, Jake Silpe’s Cherry Hill East (NJ) team was ranked 736th nationally during his senior year, Hamilton’s Greater Atlanta Christian squad was 255th, and Jackson Donahue’s and Collin McManus’ Northfield Mount Hermon (NH) was 217th. Only Max Rothschild’s University (IL) squad was anywhere near RASG Hebrew Academy, at 3,245.
Another potential indicator of Esformes’ skills could be his postseason honors. In both his junior and senior years of high school, he was named to the Jewish Hoops America honorable mention team.
Of the combined 11 seniors who were chosen over Esformes for JHA’s first, second, or third team in 2014-15, none ever played D-I basketball. The only player of any age to eventually make a D-I roster from a JHA team was Cornell’s Bryan Knapp, who was a high school sophomore at the time.
Additionally, Esformes finished his senior year ranked 17th in scoring out of players on Miami-Dade County’s lower-division teams, encompassing Division 2A schools through 5A. Online searches revealed that only five of the 16 players above him have been on a Division I roster at any point, and no one scoring at or fewer than Esformes’ 15.5 points per game was ever on a D-I roster.
“I mean, I didn’t think he was ever Division I necessarily caliber,” Adam Barnes, a basketball trainer who worked with Esformes in 2013, said about the student. “He wasn’t gonna get a scholarship probably. But when you’re an academic kid like he was, a lot of places will take you as a walk-on, you know, just to help out,” he added.
“When I heard he was actually going to Penn, I didn’t think it was even anything to do with basketball.”
Miami exec bribed basketball coach to get son into Ivy League school, indictment charges
A wealthy Miami Beach businessman at the center of a massive Medicare fraud case has been charged with paying bribes to former University of Pennsylvania basketball head coach Jerome Allen so his son could be accepted as a “recruited” player to the Ivy League college.
In an indictment, Philip Esformes was charged anew on Friday of using proceeds from defrauding the taxpayer-funded Medicare program to pay about $75,000 to Allen, now an assistant with the Boston Celtics, in bank wire transfers, hotel rooms, private jet travel and limo transportation.
The indictment does not identify the university, coach or student-athlete, only that the college is in Philadelphia, Pennsylvania. A Justice Department prosecutor, prompted by a question from a Miami federal judge, disclosed on Friday that the college is Penn, the basketball coach is Allen, and the student is Esformes’ son, Morris. He entered the university in the fall of 2015 but never made its basketball team.
Morris Esformes, Hebrew Academy Class of 2015
It is not clear from the indictment, which expands upon the $1 billion Medicare fraud case that led to Philip Esformes’ arrest two years ago, whether other people may face charges, including Allen. The former Penn player and NBA journeyman resigned as the Penn head basketball coach in 2015 after a series of losing seasons and was hired as an assistant by the Boston Celtics.
Allen could not be reached for comment. Representatives for the University of Pennsylvania and the Celtics declined to comment on Saturday.
According to the indictment, Esformes paid the coach so that he would designate his son as a “recruited basketball player” to support his application to Penn in 2014.
Philip Esformes’ lawyer denied any bribery scheme, saying his client’s son was qualified to get into Penn on his own academic and athletic merits. Defense Attorney Howard Srebnick told the Miami Herald on Friday that Morris Esformes was a standout “A” student and basketball point guard at Hebrew Academy in Miami Beach.
Srebnick, a Penn grad himself, said “[Morris] scored more than 150 points higher on his SAT than I did, and I cannot dribble a basketball with either hand, much less sink a three-point shot.”
He added that Esformes’ son has maintained a nearly 3.6 GPA, made the Dean’s List at Penn in the last semester and plans to graduate from the Wharton School with the class of 2019.
In a June 2015 interview with College Hoops Daily, Morris said he started playing basketball in middle school and his private coach and trainer was Demetrius McDaniels, whose stepbrother is Miami Heat superstar Dwyane Wade. At the time, the aspiring college point guard spoke about why he chose Penn over other Ivy League universities that he wanted to attend.
“I got a lot of looks from Cornell and Columbia, but I chose Penn rather early for a couple of reasons,” Esformes told CHD. “I want to go into business and the Wharton Business School is great. I also had a great relationship with Coach Jerome Allen. I saw how much he loved the school and just fell in love with it over a couple of visits.“
Srebnick said Philip Esformes hired Allen when his son was a sophomore in high school to help him improve his game, “as many parents do when their kids show athletic promise.”
But the indictment accused Esformes of paying a series of bribes to the coach, who is not identified in the indictment, and of tapping Medicare reimbursements to do it.
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Allure’s $2 million settlement clears it to grow again
The Allure Group, a Brooklyn nursing home chain, has been mired in a major real estate scandal during more than 20 months of city and state investigations. Now it’s finally poised to pursue its stalled growth plans after reaching a settlement with the state late last year.
Allure, run by operators Joel Landau and Marvin and Solomon Rubin, agreed to pay $2 million in penalties and charitable contributions to local nonprofits in a deal with state Attorney General Eric Schneiderman, announced Jan. 5.
The agreement marks the end of the state’s investigation into Allure’s closing and subsequent sale of Rivington House on the Lower East Side as well as its closing of a second facility, CABS Nursing Home, in central Brooklyn. For community groups, it opens up the possibility that the city will finally get new long-term-care facilities in neighborhoods that sorely need them. But mistrust persists. “They have to be watched,” said K Webster, who leads the Lower East Side community group Neighbors to Save Rivington.
In February 2015 Allure purchased Rivington House, an HIV/AIDS facility on the Lower East Side, for $28 million. It sold the building a year later to luxury housing developers for $116 million, provoking an outcry from the community, the media and the city.
Allure will pay $750,000 in fines and contribute $1.25 million to health care nonprofits on the Lower East Side. It also committed to spend $10 million in the next five years to establish health care facilities both in central Brooklyn and on the Lower East Side. Allure must run them for at least eight years each.
Schneiderman withdrew his objection to Allure’s purchase of Greater Harlem Nursing Home on West 138th Street, where Allure has served as the state-appointed receiver of the financially distressed facility since 2014. Under the settlement, Allure must keep the facility open for at least nine years.
Allure can now resume the expansion plans that Schneiderman blocked in 2016 during the investigation. “Now that the roadblocks holding up our full control have been lifted, we look forward to turning our Harlem center into a world-class facility similar to all other Allure facilities,” Landau said.
Landau and the Rubins entered the nursing home business in 2010 with the backing of Leibel Rubin, Marvin and Solomon’s father, who has run nursing homes for decades. The partners bought the vacant nursing home portion of the former Victory Memorial Hospital in Bay Ridge for $20 million and set up Hamilton Park Nursing and Rehabilitation Center.
Landau and the Rubins went on to acquire four more Brooklyn facilities. They successfully raised occupancy at these struggling locations. Its six homes generate about $200 million a year in revenue, according to Landau.
When they sought to buy Rivington House from nonprofit VillageCare, the property had a deed restriction that required it to be used as a nonprofit residential health care facility.
Because Allure is a for-profit company, the city informed Landau and Marvin Rubin that they would have to pay $16 million to lift that restriction. Landau told the city that the price, which was five times higher than anyone had ever paid to lift a deed restriction, undermined the financial viability of operating a Medicaid-funded nursing home.
Another Attempted Nursing Home Purchase by Allure – Whose Pockets Will be Lined and How can the Public Help?
The below-referenced case is being heard. The Greater Nursing Home owners are attempting to sell the facility to the Allure Group cast of characters: Joel Landau (not photo attached, of cours), and the Rubin(s). The AG is attempting to prevent the sale. It’s calendared for 8/15/17 per the alert below.
Oral arguments will be heard at that time. Frank Carone (disinterest? – NO) (partner of Brooklyn Democrat Boss Seddio and Mayor deBlasio’s L.I fundraiser) Howard Fensterman – the lawyer attempting to facilitate the hand-over of yet another facility to predatory owners (you’ve seen his name before).
With all of the money that incestuously changes hands among this cast of characters it’s a wonder why they don’t just all share the same bank account and be done with it.
Being clear, it is yet another effort facilitated by the co-opted NY State DOH and its Public Health & Health Planning Council (think Rivington House) to sit back and lets these corporate takeovers happen. This cast of characters is a group of morally challenged individuals who make millions of dollars off the backs of elderly and infirmed patients.
Where is the San Francisco Bee when you need it?
Index Number: 155305/2016 The following case which you have subscribed to in eTrack has been updated. Changes from the last update are shown in red and are annotated.
Court: New York Civil Supreme Index Number: 155305/2016 Case Name: GREATER HARLEM NURSING vs. X Case Type: E-Other Special Proceedings Track: Standard Upstate RJI Number: Disposition Date: Date NOI Due: NOI Filed: Calendar Number: RJI Filed: 06/28/2016 Jury Status: Justice Name: KOTLER, LYNN R.
Attorney/Firm for Plaintiff: ABRAMS FENSTERMAN FENSTERMAN/ 3 DAKOTA DR, STE 300 LAKE SUCCESS, NY 11042 Attorney Type: Attorney Of Record Status: Active
Last Appearance: Appearance Date: 07/12/2017 — Information updated Appearance Time: On For: Supreme Trial — Information updated Appearance Outcome: Remove Stay — Information updated Justice: KOTLER, LYNN R. — Information updated Part: STATUS CONFERENCE 8 — Information updated Comments:
Future Appearances: — Information updated Appearance Date: 08/15/2017 — Information updated Appearance Time: — Information updated On For: Motion — Information updated Appearance Outcome: — Information updated Justice: KOTLER, LYNN R. — Information updated Part: IAS MOTION 8EFM — Information updated Comments: 10AM — Information updated ORAL ARGUMENT — Information updated Appearance Date: 08/15/2017 — Information updated Appearance Time: — Information updated On For: Motion — Information updated Appearance Outcome: — Information updated Justice: KOTLER, LYNN R. — Information updated Part: IAS MOTION 8EFM — Information updated Comments: 10AM — Information updated ORAL ARGUMENT — Information updated
Older appearances may exist but are not shown.
Motions: Motion Number: 2 Date Filed: 07/26/2016 Filed By: PLAINT Relief Sought: Leave To Intervene Submit Date: — Information updated Answer Demanded: No Status: Open:
Before Justice: KOTLER Decision: Order Signed Date:
Motion Number: 1 Date Filed: Filed By: Relief Sought: Other Reliefs Submit Date: Answer Demanded: No Status: Open:
Before Justice: KOTLER Decision: Order Signed Date:
Scanned Decisions: None on file.
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