A “Bucket List” President Biden, Demand Nursing Home Transparency and Accountability by Owners and Operators

As our regular readers know, the lack of accountability of nursing home owners and operators is one of our central focuses. If this blog could solve just one problem on the “Bucket List” it would be improving the quality of care for our nation’s elderly and infirmed and ending the associated fraud scheme that makes neglect profitable.

As a single example, the pardon of Philip Esformes was a travesty of justice and a slap in the face of every elderly resident who suffered in his nursing homes, and a disregard for the taxpayers who fund Medicare and Medicaid. The lack of transparency and accountability fosters an environment fraud and neglect and likely President Trump and members of his party benefited from the pardon.

Owners and operators should not be able to deny accountability when their patients die of Covid-19. In many cases, the deaths were the result of lacking staff, rationing of PPP and profit. Many of the owners and operators of some of the worst homes had a “last clear chance” to add safety measures (though that is not generally the standard of care used).

The Covid-19 pandemic has brought years and years of neglect within nursing care to the surface. This is nothing new. These homes have been historically understaffed and many of them are not strangers to subpar care. Death is harder to hide than neglect, though many continue to hide their mortality rates.

Nursing home owners and operators should not be allowed hidden protections of LLC’s, foundations, trusts and other corporate structures, to either prevent a cross referencing of ownership for licensure purposes or to manipulate the math when homes go sideways. There must be complete transparency and personal accountability and liability.

The ownership of many of the most deplorable homes is difficult to decipher and cross reference. Many of the worst run homes have a joint group of owners some of which are comprised of attorneys and other professionals with different percentages throughout each of the cross-owned homes. First, owners and operators who are also licensed professionals should be held to higher standards of care or some form of specific registration should be in place that distinguishes these professional-owned homes from others. Second, their professional licenses should be at risk when they fail to provide adequate care. Third, professional firms that have partners who own and operate nursing homes should not be permitted to donate to political or judicial candidates or campaigns. Nursing home neglect should not be a lobbying cry. If owners and operators, particularly professional owners and operators can curry favors with politicians and judges, patients are simply not safe.

To the victor goes the spoils and for-profit nursing care is rarely an altruistic endeavor. Humanity should come before profit.

Continue reading

Hypocrisy, No. Cuomo Finally Understanding the Magnitude of Nursing Home Abuse – Covid-19

Gov. Cuomo and his Health Commissioner Dr. Howard Zucker are penalizing nursing homes for filing COVID-19 paperwork late.
The New York Post

Holding Nursing Home Magnates to Account for Their Flippant Handling of the Covid-19 Pandemic

From our perspective, it is about time that nursing homes in the State of New York are being held to account for their reporting of nursing home deaths. To this point, many have been poorly managed and the oversight of that management has been staggeringly absent. The reason? Well, Governor Cuomo, Tish James and many political candidates in both parties have nursing home owners, their lawyers, their vendors, their advocates all supporting political campaigns. Either that support comes in the form of direct check-writing or through Super PAC’s, courtesy of Citizen’s United. Trying to hold the same people who got you elected accountable for the horrors within their nursing homes is a risky gamble when it comes to a political future.

And then there are the lobbyists. You know. The ones who lobby the government for leeway, some wiggle room. This applies both to standards of healthcare, or rather, standards of moral human decency and financial accounting methods. That accounting is also Medicaid, Medicare and Private Insurance companies who are being defrauded time and time again. Why they have not thrown the breakers on eludes us.

Continue reading

Esformes – Convicted of one of the Largest Healthcare Frauds in History Gets Sentence Commuted

Dear Reader:

Our theory is that someone in Trump’s government or advisory group is in the process of going into business with Philip Esformes and the commuted sentence helps to facilitate that. Just a theory…

Suffice it to say, we have no other statement than that this is a disgraceful decision. It is everything wrong with the Presidential pardon power and a shining example of Trump’s failures as a human being, setting aside his failures as President. Yes. Some would disagree.

It is hard, however, to make a case for commuting the sentence of Esformes, though some have done it and we question their judgement. It would be like setting Bernie Madoff free. That, at this point, would come as no surprise.

Esformes spent years perfecting the craft of defrauding the healthcare industry and patients in nursing homes paid the price. He is a godless creature of habit and no amount of prayer in our view diminishes the harm he caused to vulnerable people and the healthcare industry at large. This opinion is yet another condemnation of the lack of nursing care oversight in the United States.

We submit that Trump should spend a few months in one of Esformes’ worst homes and see what he thinks afterwards. It could be almost like “Undercover Boss.” Trump would be forced to allow no one to know he is the President and get treated like other patients. If only…

Trump Announces Wave Of Pardons Including Orthodox Jew Phillip Esformes

Philip Esformes – Today, President Trump commuted the term of imprisonment of Philip Esformes, while leaving the remaining aspects of his sentence, including supervised release and restitution, intact.  This commutation is supported by former Attorneys General Edwin Meese and Michael Mukasey, as well as former Deputy Attorney General Larry Thompson.  In addition, former Attorneys General Edwin Meese, John Ashcroft, and Alberto Gonzalez, as well as other notable legal figures such as Ken Starr, have filed in support of his appeal challenging his conviction on the basis of prosecutorial misconduct related to violating attorney-client privilege.

While in prison, Mr. Esformes, who is 52, has been devoted to prayer and repentance and is in declining health.

To read the article in its entirety in Yeshiva World News, click here.

Nursing Homes and Covid-19, The Dangers, the Money, the Lack of Oversight, Time for Home Care

Dear Reader:

Covid-19 is a pubic health disaster.

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.

More to follow. For now, The Wall Street Journal:

U.S.

Covid Spurs Families to Shun Nursing Homes, a Shift That Appears Long Lasting

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.

ADDITIONAL SOURCES:

COVID-19 spurs families to shun nursing homes in a shift that appears long lasting

“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.

51 lost lives: A portrait of the pandemic’s
tragic toll in America’s nursing homes

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.

To continue with The Washington Post, click here.

Nursing Homes and their Attorney Owners – Covid-19 and the Staggering Conflicting Interests that Exist – Part I

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]

Dear Reader:

The right to “sepulcherin 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.

Continue reading

An Alluring Question and the Termination of the Rivington House Whistle Blower

Ricardo Morales (left) and NYC Mayor Bill de Blasio (right)
Ricardo Morales (left) and NYC Mayor Bill de Blasio (right) (Andrew Savulich/Mayor’s Office/New York Daily News)

De Blasio dodges questions on firing of Rivington House whistleblower

By MICHAEL GARTLAND

Mayor de Blasio ducked questions Friday about the firing of Ricardo Morales, the whistleblower who’s suing the city for his termination in the wake of the Rivington House scandal.

Morales was canned from his post at the Department of Citywide Administrative Services in 2017, a year after the scandal first came to light.

The controversy centered around the city’s lifting of deed restrictions on a Lower East Side nursing home, which eventually paved the way for its sale to a private developer for $116 million.

At the time, de Blasio denied any involvement in the firing of Morales, who has maintained that City Hall was directly involved in the removal of the deed restrictions. Morales filed his lawsuit in February 2018, claiming that he was terminated because he wouldn’t go along with covering up City Hall’s involvement.

More recently, documents filed in Manhattan federal court suggest there’s more to this story.

In a March 25, 2016 email submitted as evidence in the case, de Blasio wrote to top advisor Emma Wolfe about Morales.

“I spoke to Dom,” de Blasio wrote at the time, referring to advisor Dominic Williams. “This is about the riccardo morales issue. Pls follow up with Dom.”

Around that time, DCAS Commissioner Lisette Camilo was emailing with Williams about Morales’ fate at the agency, court records show.

To continue reading at The Daily News, click here.

New York Nursing Home Covid-19 Related Fatalities Through December 10, 2020

State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020
State of New York Covid-19 Related Nursing Home Fatalities as of December 20, 2020