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.”
California Gov. Jerry Brown signed legislation this month requiring nursing home owners to provide more information about “insider” companies that may siphon scarce resources away from nursing residents through nursing homes’ inflated payments for supplies, rents, and services.
The legislation authored by Assemblyman Wood (D-Healdsburg) stemmed from a state audit of nursing homes earlier this year that focused on Brius Healthcare, California’s largest nursing home company.
Wood and Sen. Mike McGuire (D-Healdsburg) requested the audit following concerns raised by the National Union of Healthcare Workers (NUHW), which published a report showing that during 2015 Brius nursing homes purchased $67 million in goods and services from 65 “insider” companies owned by Brius CEO Shlomo Rechnitz and his relatives.
In 2015, Rechnitz’s “insider” companies – including paper landlords – stood to gain as much as $12 million by charging inflated rents to Brius nursing homes, according to NUHW’s report. This money, says NUHW, should have been spent on care and services for nursing home residents who often lack adequate staffing, support and care.
The state audit, published in May 2018, found that the California Department of Public Health failed to perform necessary inspections or issue timely citations for substandard care. In addition, California State Auditor Elaine Howle found the reporting rules for nursing homes failed to show whether operators are profiting from business deals with “insider” companies owned by nursing home executives.
To improve transparency of these related-party transactions, Wood’s bill (Assembly Bill 1953) requires nursing home owners to disclose whether they have “an ownership or control interest of 5% or more in a related party … that provides any service to the skilled nursing facility.”
Under those circumstances, the nursing home must disclose all of the services provided by the related-party company, the number of people who provide the service, and any other information requested by state officials.
If the nursing home receives goods, fees, and services worth $10,000 or more per year from a related-party company, then this “insider” company must give state officials a copy of its profit and loss statement as well as data on caregiver staffing levels inside the nursing home.
The bill “will now ensure transparency and reporting that will allow us to make sure that these companies are not being used to generate excessive profits for the owners of these facilities on the backs of the residents,” Wood told Skilled Nursing News.
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Lawsuit alleges Roseville nursing home and others understaffed on purpose – to increase profits
A recently filed lawsuit alleges Roseville Point Health & Wellness Center knowingly understaffed to save money.
This case is among 15 class action lawsuits alleging purposeful understaffing at 15 nursing homes around California filed by elder abuse law firm Garcia, Artigliere & Medby and The Arns Law Firm, which represents workers and their families.
Aside from the 98-bed Roseville facility, the 14 other facilities are mainly located in Southern California and the Bay Area.
The Roseville lawsuit, filed on behalf of petitioner Diane Bechtold, a resident at the center, alleges the understaffing is “chronic and intentional” and an “effort to pocket unearned profit.”
The lawsuits name a number of defendants, including Shlomo Rechnitz, California’s largest nursing home owner, and Rockport Administrative Services LLC, a consulting company with a number of Rechnitz’s facilities as clients.
“This violation of each resident’s rights was directed and implemented at the mandate of the managers and owners of the facilities, Rockport Administrative Services and Shlomo Rechnitz, and his multiple layers of affiliated companies,” the lawsuit claims.
According to Mark Johnson, from the firm Hooper, Lundy & Bookman PC, representing Rockport, the consulting company provides services to skilled nursing facilities “including oversight of compliance with applicable staffing requirements.”
“Importantly, none of the lawsuits allege any harm to the residents of facilities which Rockport serves,” Johnson said. “Roseville Point Healthcare and Wellness Center … is in full compliance with applicable staffing laws including the increased staffing levels required as of July 1, 2018. In fact, its compliance has been confirmed during standard annual audits conducted by the California Department of Public Health.”
The health department could not immediately provide information about compliance with staffing requirements at the center.
Documents sent by Johnson appear to show the California Department of Public Health reported the Roseville facility had zero days of non-compliance with required staffing levels in 2016. The health department could not immediately authenticate the documents.
Glaser Weil trial lawyer Jill Basinger, representing all of the defendants in the lawsuits except Rockport, claims the nursing facilities “not only maintain the state required 3.2 nursing hours per patient day, they even exceed them.”
Whereas previously, 3.2 nursing hours per patient day was the minimum numeric staffing ratio required in a skilled nursing facility under state law, as of July 1, 2018, the new minimum required ratio is 3.5.
Brius has been hit with 15 class action lawsuits accusing the nursing home conglomerate of systemically understaffing its nursing homes to maximize profits, while delivering substandard care to thousands of elderly residents.
“These lawsuits are an effort on behalf of these vulnerable citizens to ensure that their needs are met,” Attorney Stephen Garcia told the Eureka Times-Standard. Garcia’s law firm and The Arns Law Firm in San Francisco allege that Brius homes across California misled potential residents about their compliance with staffing requirements.
In a statement to the Marin Independent Journal, Jill Basinger, a spokeswoman for Brius owner Shlomo Rechnitz, claimed that Brius homes “not only maintain” minimum staffing requirements, “they even exceed them.”
However, Brius has been cited multiple times in recent years for understaffing, including at the Novato Healthcare Center and San Rafael Healthcare and Wellness Center, which were included in the class action lawsuits. In March, Brius caregivers from both homes, represented by the National Union of Healthcare Workers, joined residents and their loved ones at a public forum to call on Brius to put an end to chronic understaffing.
Earlier this year, a state investigation found the 181-bed Novato facility “woefully understaffed,” forcing residents to go weeks without a shower and sit in their own excrement for hours waiting for assistance.
There has been heightened attention to nursing home staffing after recent reports found that major skilled nursing facilities were not providing accurate data to state and federal regulators.
In June, Medicare lowered its star ratings for staffing levels in one in 11 of the nation’s nursing homes because they either had inadequate numbers of registered nurses or failed to provide payroll data that proved they had the required nursing coverage, Kaiser Health News reported.
The lawsuits allege that understaffing at Brius, which is California’s largest nursing home operator, resulted in tragic outcomes for residents.
One lawsuit filed in Alameda County Superior Court alleges that understaffing at Brius’ Alameda Healthcare & Wellness Center contributed to the 2017 death of Cathy Campbell, a 61-year-old Stockton woman.
According to the lawsuit, Campbell, who suffered from hypertension and chronic kidney failure, developed a severe bedsore and urinary tract infection that worsened because the facility lacked sufficient staff to care for her. Her health continued to suffer after she was transferred to a second Brius home in Oakland.
Garcia, who wrote that Campbell’s needs were “flat-out ignored,” blamed the Alameda facility for failing to properly treat her in a statement to the East Bay Times. It “knew that by not elevating her to a higher level of care when the sore reached a Stage III, they were violating the law, but in the interest of profits over patients, they made a conscious choice to wrongfully deny needed medical care.”