We have contended from the outset that the oversight agencies are ineffective, corrupt, complicit in or facilitators of abuse, neglect and exploitation. Full Stop. We have contended that many of the players within the elder-care guardianship and nursing home context are inextricably intertwined in wrongdoing, most with incestuous relationships with the oversight agencies. We have posited that there is no such thing as reporting if it is left to the good will of those entrusted with the care of the elderly. We maintain that too many people are making too much money for the nonsense legislation to have any substance.
Oversight agencies must be held accountable for their failures. Elder abuse MUST be accompanied by criminal penalties, whether to the guardians, the owners and operators, the magnates, the investors, the employees or the judges and politicians that allow the abuse to continue unchecked. Elder abuse MUST be deemed unacceptable. Full stop. Elders MUST have the power to decide their own destinies. Elders MUST be believed until their statements are proven unbelievable, if that is possible. An Elder’s human dignity MUST be respected before all else and not entrusted in the care of those who lack humanity and conscience.
New Jersey’s four-part legislation pays lipservice to intent but does none of that. It assumes unicorns and rainbows with respect to an industry which is no different that legalized human trafficking. When you build a beautiful house on a flawed foundation the house is doomed. So too is the fluff and nonsense legislation in New Jersey.
Assembly Panel Advances Murphy & Vainieri Huttle Bill Package to Combat Abuse, Neglect & Exploitation of Seniors and Vulnerable Adults
Measures to Modernize Conservatorships & Guardianships; Address Financial Abuse; and Strengthen Protections for Vulnerable Adults
(TRENTON) – The Assembly Aging and Senior Services Committee on Monday approved a package of four bills sponsored by Assembly Democrats Carol Murphy and Valerie Vainieri Huttle to protect elderly or vulnerable adults from facing abuse, neglect or exploitation.
About one in ten Americans over age 60 have experienced some form of elder abuse, including physical or emotional abuse or financial exploitation. Mental or physical impairments may make them more vulnerable to abuse, and many cases go unreported.
People with disabilities are also at a higher risk of abuse, neglect or exploitation. About 30 percent of individuals with disabilities who need assistance with daily care, maintaining their health and safety, and accessing their communities have experienced some form of mistreatment.
“As we age, many of us will need a support system to help manage our health, finances, transportation and other aspects of life. This is especially true for seniors with dementia or other cognitive impairments” said Murphy (D-Burlington). “Sadly, too often the person trusted with an elderly person’s care ends up taking advantage of them. We must ensure the people caring for our most vulnerable have their best interests at heart, and everyone knows how recognize and report elder abuse.”
“Every person deserves to age with dignity,” said Vainieri Huttle (D-Bergen). “We may face illness, disability or physical decline, but we should never face abuse. By strengthening protections for older adults and our most vulnerable, we are helping to keep our elderly loved ones safe and safeguard our own futures.”
Two bills in the package would modernize existing laws regarding conservatorship and guardianship in New Jersey. The first measure (A-4615) would require proposed conservatees or someone already under conservatorship to have counsel throughout the course of all court proceedings. The court would be required to appoint a counsel if they were ever unrepresented. The counsel would personally interview the conservatee or proposed conservatee within 72 hours before each scheduled hearing focused on conservatorship.
Counsel must also be provided to individuals under guardianships, or wards, as part of the second bill (A-4618).
We have been railing about for-profit nursing and rehabilitation facilities for years: when an elder care facility, any version of elder care, is for-profit, there is utter lawlessness. Money flows like water through a sieve, unencumbered by laws or oversight.
A thorough review of the names of for-profit nursing homes and rehabilitation facilities in New York, cross-checked with PPP Loans reveals that many of them (and/or their attorneys) were some of the largest recipients of PPP Loans during the first round of Covid relief. The second round remains to be seen. They will likely be the first to get PPP Loan forgiveness even though many of them did little, or more accurately nothing to protect their employees or their patients. In fact, the word “nothing” here is quite forgiving. It would mean a passive omission, simple apathy.
To put the narrative in a more truthful perspective, many of the for-profit nursing homes fed their own pockets with the Covid-19 funding. That money should have guaranteed staffing but they were underpaying wages or not hiring. And, many of the country’s nursing homes are owned by the same or similar groups of owners, and they actively manipulated and continue to manipulate the system to profit from Covid-19. Yes! To profit!
Many nursing homes (though not all) take out life insurance on their patients with them as beneficiaries of the policy, when the patient signs in. If that patients makes it past 30-days to 60-days depending upon the policy, the death of the patient generates income to the homes. It is a win/win. Well, the insurers are out – but there is little oversight there either. These are small money policies that generally are unregulated by the insurance industry.
LeadingAge, the “elder care facility advocacy group” believes that the failure of many of these homes cannot be fixed by oversight it can only be fixed by adding money. The comments by LeadingAge imply that there is not enough money to help these facilities take appropriate care of their patients. That is a vile and utterly false interpretation of events. The business model is profit above all else. A view from 30,000 feet shows his analysis doesn’t match the math with respect to many, if not all, of the for-profit elder care facilities.
The problem, in this blogger’s humble opinion: YOU CANNOT BUY MORALITY. IF YOU ARE LACKING IN A MORAL COMPASS, THERE IS NO AMOUNT OF MONEY IN THE WORLD THAT WILL FIX THAT. ADDITIONAL MONEY SIMPLY FEEDS THE MONSTER!
The nursing and rehabilitation home industry is a well-played, well-gamed and manipulated system run by super savvy individuals or groups who know how to game every aspect of the operation. Many are partially owned by the attorneys who represent them and some of those attorneys, at least in NY, help decide who runs on political tickets. These “moblike” industry is a web of somewhat incestuous industry connections. The Elder Care Centers will contract out linen and food services to friends, family or even themselves (a rose by any other name…). They buy drugs from distribution or drug companies owned or operated by their friends, colleagues or even their own corporate enterprises who provide a scratch on their proverbial backs. Foodservice is provided by friends, family or interrelated entities. Mobile medicine is provided by interrelated companies.
These facilities use inexpensive sharps for things like insulin and other injectable drugs that often result in more pain to the patient but less pain to the bottom line. Many reuse insulin or other injectable drug vials but charge each patient for their own, sometimes stockpiling the extra meds and sidestepping laws that prevent the reuse of needles or vials. Instead of giving their patients the name-brand drugs they may have used before admission to their facilities, they give them the generics and file claims for name-brand. They often fail to provide necessary services: occupational, speech, physical and other therapies, they claim to provide those services and bill for them; but many of the patients will attest to what they are not getting and therapy is on the top of that list. They charge for doctor’s visits that don’t happen or are substituted by RN’s, NP’s or PA’s so the doctors are often paid multiple times for the same hour in a day – a reward for often misdiagnosing ailments or over-diagnosing meds.
Facilities that have specialized Dialysis centers associated with their services have little reason to protect a diabetic’s kidneys when a slow destruction of the kidneys yields greater profit. Dialysis is far more profitable then kidney treatment and insulin.
These numbers can be obtained for the asking by law enforcement or anyone reading this blog. Nursing homes and rehabilitations centers need strict oversight absent loopholes. For-profit nursing homes need to be de-licensed – all of them. The ownership of the homes is available on public links. The links between owners in different states can be found by cross checking ownership state-by-state. We have done this analysis with respect to about 30 of the largest of the and most mafia-like ownership groups, which, by the way, own some of the country’s worst nursing homes. We are not stating anything that is not otherwise publicly available and we have been making these claims for years.
No one should be listening to the lobbyists. They have an agenda and quality care for elderly and vulnerable individuals is a far too altruistic endeavor. The lobbyists also have skin-in-the-game and it amounts to a fortune!
Among the 19 bills is one sponsored by Assembly Health Chair Dick Gottfried (D-Manhattan) that would prohibit the creation of any new for-profit homes and impose a morratorium expanding the capacity of existing homes.
“Lots of people have been discovering that there are enormous problems in our nursing homes. COVID may have brought them to light and made them worse but a lot of us know those problems have been there for many, many, many years,” Gottfried said during Thursday’s remote Joint Legislative Budget Hearing on Health.
He railed against the for-profit industry in an interview later Thursday evening with NY1, arguing those nursing homes often have higher infection rates and instances of bed sores among patients.
“We’re not going to license any more for-profit nursing homes or for-profit beds,” he said. “We should stop the creation of for-profit beds…you should [operate a nursing home] to care for people not because you want to make money.”
Right now, there are 401 for-profit, privately owned nursing homes out of the roughly 619 in the Empire State, according to a January report from the office of state Attorney General Letitia James.
Anyone familiar with this blog knows that the cornerstone of the Lost Messiah blog has been, from its inception, the deplorable condition of nursing homes and the abuses of patients within those homes. And the fact that so many of them are run by Orthodox or ultra-Orthodox Jews just makes it worse.
Judaism is founded on the principle of humanity, the sanctity of life, charity and human decency. To criticize the ownership of these nursing homes is not to be anti-Semitic. It is to have a conscience. Anyone not critical of the deplorable condition within many of the country’s nursing homes, New York’s response to Covid-19, the lack of Federal oversight of nursing homes, the endless flow of money from nursing home magnates to politicians and/or to judges and/or to doctors and hospitals and social workers and guardians is to be in my mind, blind or morally bankrupt. That is a full stop.
It was not until recently that I learned to understand the magnitude of the nursing home problem when factoring in guardianship. I did not know. Now that I do, I am just sad. I have seen for myself how it all plays out and it is devastating. Social workers in hospitals are paid to call attention to patients who provide easy targets for guardians, doctors are paid to provide diagnoses like Alzheimer’s, behavioral maladies, mental incapacity or other conditions. Judges are either blindly trusting of guardians or believing of what they are told or are part of the system that awards custody to guardians. Guardians stick patients into nursing homes with which they are connected. When all else fails, or a lawyer willing to stick a thorn in someone’s side comes in, Patient Care Intake Reports are tailored to direct the ward into a particular nursing home usually the one that is in some way connected to the guardian, whether through ownership or a system of payments. Either the ward has problems that the unconnected home cannot handle or the ward’s insurance is not the right kind. It’s all in the narrative. Many guardians are connected to some of the most deplorable nursing homes; and it is to those homes that some proudly send their wards. In other words, they are paid to fill a bed and reward the elderly cash-cow with confinement. It’s all in a day’s work. And it should be noted, the financial connections are publicly available in most states albeit hard to find.
The pockets are so well lined and the wheels are turning constantly, a well oiled corrupt and broken system. The flow of money is a steady stream. The process has been worked out to the most fundamental, almost atomic levels. Politicians are provided with hefty donations. In New York Judges are elected, they too benefit from the donations they receive. The methods of trying to get someone out of guardianship or out of a deplorable nursing home, one in which a ward is placed by a court appointed guardian runs slowly, if at all. So while the system of harming the elderly runs smoothly, the possibility of a correction saunters along at a snail’s pace.
Judges frequently accept the words of guardians at face value, even when it should be apparent that the guardians are dishonest (to put it mildly). Court appointed attorneys, many of them, have been a cog in the wheel of the system for so long that they do not even know the system is broken, or alternatively, they are part of the influencers helping to create certainty that the system will keep running, and…. unencumbered.
Covid-19 has made the problems that much worse. Patients in nursing homes cannot get visitors. There is no oversight, none. The foxes run the henhouses. And the money flows…
The movie “I Care a Lot” a controversial work of art in my opinion, does not delve deeply enough into the abuses of the elderly within the guardianship structure. It does not approach the confounding ability of judges to turn their heads as they grant guardianship of healthy people to individuals who, for lack of a better word, traffic in human lives. The system is broken. From where I sit, it might only work if guardians are rewarded for setting people who do not need their assistance free. Pay someone a ransom, of sorts. Indeed, there are people who need help, need someone to watch over them; and there are perhaps guardians who really care, for whom money is not the ultimate goal. If so, they the unicorns.
But without attention, oversight, accountability and a complete overhaul, the system will keep running. There is simply too much money involved. A human being is worth thousands. And “I Care a Lot” should be teaching legislators, both state and federal a very important lesson: the system needs to be torn down and rebuilt. The guardians need to be stopped. The nursing homes need to be held accountable.
The elderly caught in the system are being abused, treated like animals. Many would have more rights if they attacked their captors and wound up in jail. It is simply a sick reality.
And attorneys who might be helpful in the area of setting people free have the threat of disbarment personal harm hanging over their heads. The system is broken. Without tearing it down, it likely will not get fixed.
2021 | R | 1h 58m | Dark ComediesA court-appointed legal guardian defrauds her older clients and traps them under her care. But her latest mark comes with some unexpected baggage.Starring:Rosamund Pike, Peter Dinklage, Eiza González
You can make a lead character reprehensible — even repellent — and still hold on to an audience, but you’d better not make her dull. “I Care a Lot” is a pitch-black karmic comedy of bad behavior and worse payback; it made a stir at this year’s online Sundance festival and landed unexpectedly on Netflix last week. It features just about the worst person imaginable, a woman who bilks senior citizens out of their life savings by becoming their court-appointed guardian. But in Rosamund Pike’s chilly, hollow central performance you may find it difficult to care at all.
A stranger knocks on the door. The older woman who answers the door is informed that the visitor is now her legal guardian and will make all decisions for her. Within days, the older woman has been placed in a nursing home and her home sold so that the stranger may profit.
It’s a perfect opening for a psychological thriller. In fact, it is the opening for Netflix’s new featured movie “I Care a Lot,” starring Rosamund Pike as Marla, a ruthlessly ambitious woman who has made a business out of exploiting older adults. Her method: petitioning a local court to appoint her as emergency guardian for older adults whom she alleges cannot make decisions for themselves.
Unfortunately, the plot of “I Care a Lot” — despite its share of plot twists and theatrics — is not as far-fetched as it might seem. Every state allows courts to appoint a third party (called a “guardian” or “conservator”) to make decisions for someone the court determines is at risk because they lack the ability to make decisions for themselves. The process can provide needed protection to those who are unable to care for themselves. Yet it also has real costs. Not only do individuals for whom guardians are appointed lose the right to make some or nearly all decisions for themselves, but reports of unscrupulous guardians using the system to exploit vulnerable adults are far too common.
This exploitation is made possible, in part, by outdated state laws. Take Marla’s first “trick:” petitioning for a guardianship without telling her elderly mark. State guardianship laws permit courts to appoint “emergency guardians” without notice to either the person alleged to need a guardian or family or friends who might come to their defense. Even when state laws say that individuals are entitled to notice before a guardian is appointed, courts can (and do) waive giving that notice. And long-term guardians are also routinely appointed without the subject of the proceeding being present in court.
EXCLUSIVE – Rep. Doug Lamborn, R-Colo., demanded that the Department of Health and Human Services investigate New York nursing home deaths, citing the state attorney general’s report that Gov. Andrew Cuomo’s administration may have undercounted nursing home coronavirus deaths by as much as 50%.
Throughout the pandemic, there has been perhaps nowhere more dangerous than a nursing home. The coronavirus has raced through some 31,000 long-term care facilities in the United States, killing more than 163,000 residents and employees and accounting for more than a third of all virus deaths since the late spring.
Nurse Ratched does not reflect the caring, self-sacrificing nursing profession. Richard Gere’s nefarious legal tactics in “Chicago” would get a real attorney disbarred. Steve Martin’s sadistic, nitrous-oxide-huffing Orin Scrivello in “Little Shop of Horrors” is certainly not representative of the dental profession. Similarly, Pike’s portrayal of guardianship is a performance designed to engage viewers and generate an emotional response, but it is not rooted in reality. All of these are examples of art created to tug at viewers’ emotions to make the respective films more captivating.
But, so too are most nursing homes and rehabilitation centers. Many of them represent the greatest constitutional violation of life, liberty, happiness and dignity for those most vulnerable who are confined to many of the nations homes.
There are very personal reasons why this blogger knows so much about them and their deplorable conditions. Setting aside visits to upwards of 45 different nursing homes and rehabilitation centers throughout New York, New Jersey and Pennsylvania and being asked to negotiate a bid on Personal Protective Equipment by an unsuspecting client, research on homes and their owners has made the entire industry stomach-turning. That client did not realize at the time that the equipment he was asked to broker had been taken from a nursing home (paid for by Medicare, Medicaid or private insurance) and warehoused in New Jersey. Someone else likely did the deal, the client walked away.
So, perhaps Covid-19 was necessary to open people’s eyes to the dangers of nursing homes and rehabilitation centers and to provide much needed incentive for the government to oversee them with vigor, zeal and a passion that reflects our need to protect the elderly and most vulnerable.
Well, this might just be wishful thinking.
Suffice it to say, most owners and operators are looking to the bottom line. It is about the money, the profit and loss, the quasi virtual auction of human life by social services, guardianship, social workers in hospitals and the individuals that make the wheels of the human life industry turn. Many are morally bankrupt and the more their pockets get lined the more soulless they become.
The pandemic is reshaping the way Americans care for their elderly, prompting family decisions to avoid nursing homes and keep loved ones in their own homes for rehabilitation and other care.
Americans have long relied on institutions to care for the frailest seniors. The U.S. has the largest number of nursing-home residents in the world. But families and some doctors have been reluctant to send patients to such facilities, fearing infection and isolation in places ravaged by Covid-19, which has caused more than 115,000 deaths linked to U.S. long-term-care institutions.
To continue reading in The Wall Street Journal, click here.
“We should be able to provide more services in the home setting that can enable somebody to be independent,” said Seema Verma, administrator of the Centers for Medicare and Medicaid Services. “Covid is going to force a national conversation about how we take care of our elderly, and clearly there are issues in nursing homes that go beyond infection control,” she said.
During his campaign, President-elect Joe Biden promised to spend $450 billion to make sure people who need long-term care can get support in the home and community.
They had survived so much already — war and dust storms, cancer and poverty, lost eyesight, lost spouses, lost memories — and still went on to find moments of grace inside the corridors of America’s nursing homes.
In Windsor, Conn., Johnny James ate chocolate bars with his visiting great-grandchildren. In Lewiston, Idaho, Edna McBride celebrated her 100th birthday. In Providence, R.I., Florence Tilles, who had two knee surgeries, liked to joke she would one day die at the 18th hole of her favorite golf course.
One day came on May 30, when 98-year-old Tilles fell victim to covid-19 amid a soaring death toll that included James and McBride and would soon grow to more than 80,000 residents in nursing homes across the country. They suffered alone, in homes locked down to visitors, peering at the masked faces of weary nurses and aides who risked their own lives to be there.
The industry and the government could have done far more, watchdog groups have said from the beginning, shoring up infection-control protocols and staffing, delivering stronger oversight of troubled homes and ensuring that coronavirus stimulus payments reached patients and caregivers rather than corporate owners.
Instead, 10 months later, thousands of families are learning to live without goodbyes.
The 51 residents whose stories are told here, one from every state and the District of Columbia, left behind at least 129 children, 230 grandchildren, 210 great-grandchildren and 41 great-great-grandchildren. Some blame the nursing homes for questionable care. Others say they are enormously grateful for the work of caregivers.
Law Firms prized for their Knowledge of Elder Care and Novel Approaches to Protecting the Elderly, and the conflicting interests of the Partners and Associates who Own Financial Stakes in Subpar Nursing and Rehabilitation Centers [OPINION]
The right to “sepulcher” in the law is the “right of a family member or next of kin to find solace and comfort in the act of burying a loved one.” Protecting this right alone can be the basis for a highly respectable and extremely lucrative boutique practice for attorneys. A lawsuit based upon that right can be relevant in situations where fallen soldiers are not returned home, victims of terrorist attacks are not returned to their families; and during the Covid-19 pandemic, bodies are improperly buried or even lost. A recent example is the case of Elayne Boosler, wherein a family members was buried at the hands of a guardian’s signature in the wrong cemetery at significant cost. That case is eliciting calls for an investigation. Her story is gruesome and complicated by a system of guardianship that itself is enshrouded in secrecy and disenfranchisement.
In the United States many law firms with highly intelligent and respected attorneys and practices focused on elder care, geriatric medical abuses, estate planning, insurance and disability, medical malpractice and related practices, simultaneously represent some of the worst offenders in nursing home care abuses. Many of the partners in these firms also own financial stakes in nursing homes, either with their clients or not. It is our opinion that these are diametrically opposed practices; and it is nearly impossible for a law firm to maintain the integrity of one practice area while being paid millions to represent the others. That is an opinion premised on what may be a debatable notion of ethics and moral integrity.
Admittedly, Covid-19 has created a mitigating factor in recent history. But our opinion is unwavering: the lack of care for the welfare of the elderly, the lack of interest in dignity and humanity has governed, with a wholehearted disregard for humanity, particularly in law firms with competing interests. This has occurred throughout our entire system of care and of justice. With respect to dignified and responsible elder care, the Covid-19 tragedy has denied the right to tens of thousands of families of nursing and rehabilitation homes’ patients to be physically present for their loved ones in life and, in many cases, to bury those same people who have had their lives taken by the virus.
We would argue that the fault lies though not entirely, with the owners and financial stakeholders of many of these nursing homes and rehabilitation centers. We would posit that they did not take proper precautions during the pandemic, choosing instead the path of least cost routing. Precautions would have undermined owners’ bottom lines. We maintain that the owners and operators were looking at their P/L Statements (Profit and Loss), and ignoring the potential loss of human life. Some nursing homes carry life insurance for their patients and are themselves beneficiaries of those policies. They therefore profit whether their wards live or die. This makes the situation all the more unpalatable.
For those owners whose real life profession is an active and lucrative legal practice, one which focuses on elder care, the rights of the elderly, estate planning and healthcare services, in our view there has always been a weighing of financial averages and significant conflicts. Moreover, the pandemic has increased the value of lobbying governments to reduce nursing home and even medical accountability, a conflicting premise if you are an elder care lawyer.
To add another wrench in the cogs of a lucrative attorney practice that plays both the elder care and nursing home ownership game, it is less expensive to lobby the government for Covid-19 related immunity provisions which protect owners (often themselves) from liability than to save lives and actually engage in “elder care.” It is a simple financial calculation. And at the end of the day, the elderly lose and the attorneys win.
A reasonable analogy would be a car company that hides known and foreseeable danger in manufacturing because the cost of reimbursement for the death of drivers and passengers is less expensive than recalling the vehicles in question. The outcome is based upon purely financial decisions which will continue status quo unless and until significant financial accountability is mandated.
In our view, both in the nursing home context and in the vehicle scenario, conscience and morality simply do not a play a role in the decision-making of owners and operators. In both instances manipulating political clout to obliterate the chance for families to seek financial compensation for loss of life or consortium has made and continues to make the most financial sense. In both analogous situations, if the people in charge are not held to account, both civilly and criminally, these financial equations will take precedent over the value of human life and lives will be lost.
And please remember, in the situation where the lawyers are the owners and operators of nursing homes, they make money either way. Their legal representation on behalf of owners generates bills for tens of thousands if not hundreds of thousands if not millions of dollars in yearly billables. The nursing home ownership is gravy and the more immunity they obtain for themselves and their clients (who are often partnered with them) from liability the richer the returns on all fronts.
The nagging question is this: how can a law firm, any law firm, simultaneously have a blossoming and distinguished practice of elder care, “rights of sepulchre”, estate planning and other related practice areas and at the same time represent owners of some of the most deplorably run nursing homes in the country? We do not think that it is possible without an inescapable conflict of interest, setting aside the ethical and moral obligations to clients within those practice areas. As a securities matter, we would argue that the LLC interests associated with nursing home ownership represent securities interests and that it should be possible to implicate the SEC and its trading regime. That’s just a thought.
With 242 residents who have tested positive, Father Baker Manor in Orchard Park has the most confirmed Covid-19 cases among all nursing homes statewide, according to a Buffalo News review of federal data.
But fewer than half that number of Father Baker Manor residents actually had Covid, according to Catholic Health, the facility’s owner.
Four other Erie County nursing homes also are in the top 25 in the state for total confirmed coronavirus cases: Absolut Center for Nursing and Rehabilitation in East Aurora; Harris Hill Nursing Facility in Lancaster; Garden Gate Health Care Facility in Cheektowaga; and Beechwood Homes in Getzville. They each reported 112 or more total confirmed Covid-19 cases among residents at their facilities through Nov. 15, the latest data available from the Centers for Medicare and Medicaid Services.
Covid-19 at nursing homes across the country – including 617 across New York State and 70 in Western New York – is being monitored weekly by the federal agency, which in May began requiring nursing homes to report coronavirus data.
There were 14,982 nursing home residents statewide who had the virus; another 7,786 were suspected to have contracted Covid-19. In Western New York, 1,963 nursing home residents were confirmed with Covid-19, 13% of all confirmed nursing home cases in the state.