From KKD: The victims continue to tell their stories to the authorities

Time to do somehing

It is time for the people who care about the elderly and the disabled to take action.    The government has two task forces out there to prosecute those who prey on the elderly and the health care system and they are impotent if all that we do is give them lip service and complain.     It is time for action.  It is time for action that is meaningful and useful.
In the past few days I talked with a number of family members of victims.   The frustration is monumental.   I understand the plight of the victims.    I wrote many letters to elected representatives and noted that the interest was slim and none.   The political animal knows that the nursing home operator, medicare fraudster et al can deliver VOTES and money while you and me most probably will deliver neither.    Thus, Senator Durbin answers my letter with a copy of some stupid speech that he gave as to social security  – he can care less — the health care fraudster will deliver him enough votes for him to be elected!   Worse yet, he by experience knows that I and people like me will probably not vote or vote in ignorance.   His re-election is safe!  So you and I don’t count!
The new administration has vowed to “drain the swamp.”   I take the promise seriously and I want to assist.   One way to aid the draining of the swamp is to assist law enforcement in its quest to put public officials who have breached the public trust in jail.   We can do this by making meaningful complaints to law enforcement and watching the result.    The investigations conducted by JoAnne Denison, JP ***** and others have made it clear that there is big money in HEALTH CARE FRAUD.   The Seth Gilman and Philip Esformes have given an insight into just how much money is involved.    The government has rooted out a scintilla of the fraud with little fanfare, but the government has neither the inclination or the staff to do a complete job; we can fill in the blanks.   Indeed, we must do so or we will lose our democracy as easily as a Court appointed guardian ad litem was able to orchestrate the recovery of the gold fillings from Alice Gore’s mouth!  (and of course not inventory them!)
Most of the complaints that we make are disjointed, unintelligible accumulations of arguments, conclusions and a few facts.     The investigator is bogged down in material that is a gold mine of information, but so disorganized and disguised that it is almost unintelligible.    Hours are wasted separating the facts out and too often the statute of limitations has run, or the miscreants are out of reach.  A silk purse cannot be manufactured from a sow’s ear.
Lawyers who work on the ‘front line’ are required as trial preparation to separate the wheat from the shaft.   We use a device called a TIME LINE.    We start from day one and list the facts that are important day by day.   We then annotate the list of facts with annotations filing in the details.    We supplement each listed fact with the documents that prove that fact labeling them accordingly and we detail by other means what the fact is intended to prove.     Sometimes we even supplement the work sheet (called a time line) with case citations and other references.
I for one did not work in a vacuum.    I usually requested that the client provide me with a timeline.    I did this because it fixed the transaction in the client’s mind and gave me a leg up.    I was fortunate as most of the time when I requested the ‘time line’ my client was obliging and relatively accurate (and concise).    (The document is protected by attorney client privilege).    Even a poorly prepared time line does aid the lawyer not only in doing his/her investigation, but in trial preparation – the client recalls the facts written vividly and accurately.
Thus, let me suggest that we communicate with the hundreds – if not thousands – of victims of the ELDER CLEANSING/HUMAN TRAFFICKING scandal and induce them to prepare TIME LINES airing their greivances fully and completely – completely with documents proving the claim and send them to LAW ENFORCEMENT and in particular the task forces set up to do HONEST INVESTIGATIONs.    For the Time line, let me suggest:

Preparation of a time line

The purpose of a time line is to provide law enforcement with a concise, accurate, and usable set of facts upon which they can evaluate the claim that you are presenting to them.      In particular, the object of a complaint to law enforcement is to obtain an HONEST INVESTIGATION coupled with an accurate and honest evaluation of the facts of your case.   Ergo, innuendos, adjectives, conclusions and attempts at persuasion are counter-protective.    An intelligent law enforcement agent is well aware, as an example, that a judge who accepts something of value from a litigant is dishonest, a crook, and a criminal and therefore does not need to be told.     An unusual fact, such as the Court file being devoid of a Sheriff’s return or a notice to the next of kin.     The fact of the file revealing that the petitioner directed the sheriff to serve summons on the elderly person in Cook County, when the elderly person respondent was living with the petition in DuPage County speaks for itself.    The investigator does not have to be told that there is something wrong.

The time line should be objective and as accurate as possible.     If dates are not readily available, the time line should endeavor to make that clear and arrange events in chronological order.      The preparation of the time line should be annotated with documents.     For instance:

1.      Date   – Summons filed seeking Sheriff to serve respondent with summons.     Copy of summons attached as exhibit 1.   Note:   Sheriff directed to serve summons on respondent at 11234 x street, Chicago, Illinois.   See docket entry 12 – being a letter from GAL John Doe to Court requesting a 2nd GAL to be appointed as respondent resides in DuPage County.    Copy of letter to Judge attached as exhibit

2.      Date – Court appoints Adam **** as GAL   see Doc entry.

Later on in the time-line when the chronology is appropriate.    The time will reveal–

1.      August 2010 – Court appearance before Judge M*** C****.     Status – File reveals:  1) service of summons has not been had.     No summons in the file directing Sheriff to serve respondent in DuPage County.   2) no physician’s affidavit in file.    See Transcript attached hereto and made part hereof as exhibit 45.    NB.  Note GAL and Court stating to Petitioner that Dr. X has been co-operative and has testified in the past as to incompetency.   See lines 20, 21 page 5 of transcript of proceedings.

In certain instances, the clerk has prepared the record for appeal.    You will find that every page of the record is numbered.   References to those numbers are important.    The more relevant information that you provide the investigator the better.

Indeed, the preparation of a timeline is tedious work and time consuming.     The frustration of being given the runaround is equally frustrating and not productive.     An HONEST INVESTIGATION is going to require someone to detail all the facts and to put them into a discernible form.    The preparation of an accurate time line not only provides you with all the facts and documents “in hand” but it also provides the investigator with a bird’s eye view of the entire situation, a list of witnesses, and documents.

If after the relevant tim line has been accurate and concisely prepared it would not be out of line to write cover letter.    In this cover – letter you can vent your gripes.    For instance, the fact that the Judge was in August 2010 giving legal advice to the Petitioner is grounds for you to suggest that the Judge’s conduct was wrongful.    The Judge is not on the bench to aid a Petitioner, the judge is there as a trier of fact and pursuant to Illinois statute 755 ILCS 5/11a – 3 and following the Petition must prove the incompetency and the degree of incompetency by clear and convincing evidence.    A judge who is an advocate has breached the public trust as the judge is, pursuant to the Federal and State Constitution required to protect the interests of the respondent.    

The judge is not protecting the respondent when the aforesaid judge is advising the petitioner as to what physician will be available to perjure himself.    If you read the statute that I cited you will note that the guardianship is limited – it is limited to only those disabilities that they respondent actually inhibit the respondent from enjoying the benefits of his/her citizenship.     This is consistent with ADA – not the holocaust or the gulag! 

I am not concerned as to the form the complainant wishes to use – it is important that all the salient and important facts be accurately provided the investigation.  The object is an HONEST INVESTIGATION and evaluation.   The conciseness of the fact recitation is also important.   There are literally millions of senior citizens who have been drawn into this travesty and are being denied their basic CONSTITUTIONAL  RIGHTS.     It is important that your situation receive that HONEST INVESTIGATION and all the miscreants have some sleepness nights.

Dr. Sugar’s book on Guardianship is worthwhile reading.    More information can be found on NASGA, AAAPG, Probate Sharks, MaryGSykes *****.    The October 9, NewYorker article also is suggested reading.   We are all vulnerable to this HUMAN TRAFFICKING – in fact most of us are a fall away from being prey!    The venalness of the assault on the American Constitution is clearly revealed by the document filed by Jerome Larkin, the administrator of the Illinois Attorney Registration and Disciplinary commission wherein he related the exposure of Judicial corruption in the MaryGSykes blog with “YELLING FIRE IN A CROWDED THEATER.”    That was preposterous.  The blog is a factual account of scores of abusive guardianships existing in Illinois.  It is not a work of fiction, but of fact.  These are fact the Atty Regn and Disciplinary Commission wishes to ignore and sweep under the rug inasmuch as they involve some of the most despicable actions taken against the disabled citizens of Illinois, and it is all done under color of law.
Of course the Illinois Supreme Court showed its devotion to the RULE OF LAW and the First Amendment – it issued an interium suspension followed by a three year suspension of the law license of JoAnne Denison for operating and maintaining a blog that documents the untoward and criminal actions of a wide variety of Illinois lawyers and Judges.    Rule 8.3 required Ms. Denison and other lawyers to expose the corruption!   However, most lawyers were afraid!   Joining the “cover up” the 2nd oldest profession  demonstrated why judges and lawyers are so poorly regarded by the “great unwashed!”    Now is the time for the “great unwashed” to show its metal.

Ken Ditkowsky

Lawyer and civil rights activist.

From FB: Anyone surprised? All 4 WV judges subject to impeachment for corruption

https://www.nbcnews.com/news/us-news/all-west-virginia-s-supreme-court-justices-impeached-over-spending-n900461

All of West Virginia’s Supreme Court justices impeached over spending

Lawmakers approved an article they had abused their authority and failed to control office expenses, including $1 million in renovations to offices.
by Associated Press /  / Updated 

CHARLESTON, W.Va. — West Virginia lawmakers completed the extraordinary move of impeaching all four state Supreme Court justices Monday night for spending issues, including a suspended justice facing a 23-count federal indictment.

The state House of Delegates voted to impeach Justice Allen Loughry on eight articles, setting the stage for a trial in the state Senate.

Beth Walker became the final justice to be impeached when an article was approved stating all four justices abused their authority. It said they failed to control office expenses, including more than $1 million in renovations to their individual offices, and not maintaining policies over matters such as working lunches and the use of state vehicles and office computers at home.

Walker had dodged impeachment earlier Monday night when lawmakers decided to overlook her $131,000 in spending on office renovations. A short time later, another article was withdrawn against Chief Justice Margaret Workman, who spent $111,000 in renovations.

Justice Robin Davis was impeached for $500,000 in office renovations. And lawmakers approved articles against Loughry for spending $363,000 in renovations to his office; having a $42,000 antique desk and computers, all owned by the state, at his home; lying to the House Finance Committee about taking home the desk and a $32,000 suede leather couch; and for his personal use of state vehicles.

Loughry, Workman and Davis also were impeached for their roles in allowing senior status judges to be paid higher than allowed wages. Lawmakers say the overpayments violated state law and stopped when they were challenged by the Internal Revenue Service.

Another impeachment article was withdrawn dealing with an accusation Loughry used state money to frame personal items at his office.

Minority Democrats on the House Judiciary Committee that approved the articles last week had tried to speed up the impeachment process in the hopes of beating an Aug. 14 deadline for arranging a special election in November if any justice is removed from office or leaves office. Instead, the committee took its time, even conducting a tour of the state Supreme Court offices earlier this month.

Republican Gov. Jim Justice will be allowed to appoint new justices to replace any who are impeached — with no requirement that they be from the same party as the incumbent.

Democrats have accused Republicans of attempting to wrest the court away from voters, who elected the current justices in nonpartisan elections.

Delegate Barbara Evans Fleischauer of Monongalia County said Democrats agreed all along there was enough to recommend Loughry’s impeachment. But she said going after the other justices “was a power grab, was a takeover of the court and using the impeachment process to take over another branch of government.”

“We’re taking away from the people,” she said

Some legislators said they didn’t support impeaching any justice for wasteful spending, only for articles pertaining to lying, cheating or stealing.

But John Shott, a Mercer County Republican who chaired the House Judiciary Committee hearings that drew up the impeachment articles, asked whether there is public confidence in the court, and if not, “we need to take action to try to rebuild that trust.”

Several lawmakers noted the Supreme Court has a separate budget and is currently allowed to spend as it sees fit. But Shott said the court should spend that money wisely “and for the benefit of its citizens.”

A proposed constitutional amendment this fall would bring the state courts’ budget partly under legislative control.

Image: Allen Loughry
Allen Loughry. Craig Cunningham / AP

Loughry, who wrote a 2006 book chronicling West Virginia political corruption, was indicted in June on 23 counts of mail fraud, wire fraud, lying to federal law enforcement, witness tampering and obstruction of justice. Justice and legislative leaders have asked him to resign. Loughry has not responded and did not testify at the committee hearings.

One impeachment article accused Loughry of lying to the House Finance Committee in January about his involvement in his office renovations, including a custom-designed wooden-inlay map showing all 55 West Virginia counties embedded in the floor.

Loughry was suspended earlier this year. Justice Menis Ketchum retired and agreed to plead guilty to a federal wire fraud count involving the personal use of state-owned vehicles and fuel cards.

A special election already is set in November to fill the remainder of Ketchum’s term.

Circuit judge Paul T. Farrell has been sworn in to act as the court’s chief justice for the Senate trial, whose timeline is uncertain. The court’s fall term starts in early September. In the event that one or more justices is on trial in the Senate, the court said last week it would hear all cases on the docket as scheduled.

The last time the Legislature was involved in similar proceedings was 1989, when state Treasurer A. James Manchin was impeached by the House of Delegates after the state lost $279 million invested in the bond market. Manchin resigned before the state Senate took up the impeachment measure. He was never charged and the state recovered $55 million from lawsuits against nine New York brokerage firms involved in the losses.

From MG: On the Bradley Amendment and child support obligations: is it all fair?

 Bradley Amendment (Federal Law:  Public Act 99-509 (42 U.S.C. § 666 – yes, I appreciate the irony of the number 666 as the sign of the Beast/Devil), and its effect on Child Support.

Quickly, here is what the Devil’s Law (okay, I’m pushing the irony envelope here), I mean Bradley Amendment does:

-Automatically triggers a lien each time child support is due.  That means, if you miss 3 payments, you have three separate liens against you.  Each occurring on the date that the child support is due.  The obligee does not have to do ANYTHING to initiate the lien.  It’s an automatic judgement against the obligor, as if you got sued 3 times and lost 3 times.

-Since it is non-expiring, it never ends.  It does not matter if you are 95 on Social Security eating dog food; it survives.  There is no Statute of Limitation.  I guess that the government puts this on par with murder.

-But unlike murder, it survives death.  That is, if you die, you cannot be charged with murder.  But for child support purposes, if you die (or the obligee dies, or the child dies) the lien still exists.  It ends up in probate court for them to find anything of value to satisfy the lien.  It does not matter if you are 95 and your child is now 75.  Or if your child died before you and you inherited from your child’s estate, and then you died; the obligee gets the money.

-It cannot be discharged in Bankruptcy.  Here is where the corruption of family court makes it worse.  Judges often tell attorneys (or attorneys do on their own) to list attorney fees as “in the nature of child support” (whether true or not) so that attorney fees are treated as non-dischargeable.

-It cannot be discharged, even if it was based on lies/fraud/mistake (mother named wrong dad).

-It does not matter if the Child died.  If the State does not enter in the computer that the child died, child support continues without discharge.

AND NONE OF THIS CAN BE CORRECTED RETROACTIVELY.  That is, once the date the support is due, it is written in stone.  In other words, it cannot be corrected, despite lies, fraud, mistake, stupidity, unconstitutionality, you name it.

AND THE BIGGIE IN STUPIDITY:  There is no judicial discretion.  Zero.  Ziltch.  No matter how warped, stupid, or unconstitutional the results.  Here are some of my favorites of stupid (and unconstitutional) results.  There are cases where the obligor was:

-In a coma (and failed to go into court to reduce their child support, not that a judge would even reduce it.).  I heard of a case where a judge ordered a obligor in Australia who was in a long-term coma be placed in custody for contempt until he started paying.

-A captive of Saddam Hussein during the Gulf War.  I guess Dictator Saddam Hussein would not give the guy time to file for a modification to child support.

Here are some actual cases (with the State’s response):

-Bobby Sherrill, a Lockheed employee in Kuwait from North Carolina, was captured by Iraqis and spent nearly five months as an Iraqi hostage. Sherrill was arrested the night after his release for not paying $1,425 in child support while he was a hostage.

Clarence Brandley, a Texas high school janitor, was wrongly convicted in 1980 of murder.  After spending many years in prison and on death row, he was released in 1990 and he then sued the state of Texas for wrongful imprisonment in 1993. The state then responded with a bill for nearly $50,000 in child support that had not been paid while in prison.

Taron James, a U.S. Navy veteran from California, was forced to continue to pay child support until 2006, even after the child was demonstrated by DNA test in 2001 to be not his; James paid $12,000 in such payments.  There are lots of cases similar to this one.

-Larry Souter was wrongly convicted of murder in 1992 and spent 13 years in prison before being exonerated and released in 2005. Upon release, he was ordered by the court to explain why he shouldn’t be held in contempt for failing to pay $38,000 in combined back child support, interest, and penalties (damn, interest and penalties too).  Notice a State pattern – we wrongly convicted you, you could not pay (because we wrongly locked you up), so now we’re going to punish you more.

Link this with the perverse incentives of Title IV-D, and a obligor has no chance.

And that my kids, is today’s lesson on the Bradley Amendment and Due Process in America.  Sleep well.

MG–advocate for fair child support payments

From KKD: we have to clean up the probate messes, from the court to the nursing homes that abuse the elderly and disabled

Dr. Sugar’s book is a primer.   
 
It is is must read to understand the problem of ELDER CLEANSING and corruption in the Courts that has lead to the guardianship problem and just what a cancer and assault on our Constitution it has become.   
 
I was drawn into this situation when the attorney for the guardian and the guardian ad litem in the Mary Sykes case -09 P 4585 (Cook County) each individually called me to threaten me that Judge Maureen Connors would “sanction” me if I looked into the Mary Sykes case.    Of course I told them to go to hell.  Truth to their word, they appeared before Judge Connors and demanded that I be sanctioned.    First she tried to scare me; however, I did not attorn.    Finally I was sanctioned almost 5,000 dollars for my attempting to look into a guardianship case pending in Cook County, Illinois.  
 
Naturally I took an appeal and won.   
 
That did not end the case, the Attorney Registration and Disciplinary Commission first tried to silence me, and then when it became obvious that I was now interested and not going away INTIMIDATION was the next step.    When it came out that the presiding judge in the case was ‘wired’ (fixed) and I was still demanding an HONEST INVESTIGATION I was the subject of a full bore soviet style disciplinary hearing.    (As I had practiced law for over fifty years, I was not and still am not intimidated – I hope to live long enough to see the DEPARTMENT OF THE TREASURY arrive on the doorstep of each of the criminals – public and private – and collect the interest, taxes, and penalties that each 18 USCA 371 co conspirator owes.
 
It was interesting to note that so arrogant are these criminals that when the IARDC discovered that Seth Gillman ( a hospice fraudster stealing from medicare) was co-operating with the FBI, Jerome Larkin the and Illinois Attorney Disciplinary Commission sought to intimidate him by applying for an interium suspension of his law license.
 
Tonight I plan to appear on Bev Cooper’s public access Television program and discuss this corruption.    I’ve tried to encapulate the issues that we have previously discuss on the program – for your information – I typed up the following note for myself.     I hope that you find it interesting, to wit:
 

August 8, 2018.

Official Corruption that has been discussed, to wit:

1.       Guardianship.    Centered around the Mary Sykes case 09 P 4585 and the October 9, 2017 New York article.      Dr. Sugar’s Book is an expose of the central aspects of the criminal enterprise.     It should be noted that there are good and necessary guardianships, but they are overshadowed by those designed to fit into the grand scheme of HUMAN TRAFFICKING IN THE ELDERLY.

a.       Guardianship fraud like the Sykes case is designed to PUT THE VICTIM on ice until they can be denuded of all property, property, and value.     The vast majorities of these guardianships involve:

                                                               i.      Isolation of the victim

                                                             ii.      Obtaining control over the victims’ property

                                                           iii.      Rendering the victim helpless and solely in the control of the traffickers – usually the guardian, but in the case of Alice Gore, the guardian ad litem

                                                           iv.      “spreading the wealth” this can be accomplished by outright theft – assets, like Mary Sykes’ gold coins just disappear and are not inventoried.    Any mention of the stolen goods is brought before a corrupt judge who listens carefully to every word of complaint and then finds that the complainer is a liar and interfering with the due administration of the estate.

                                                             v.      Elimination of the victim.    Use of Opioids (supplied by health care providers – such as the government) keep the victim alive for as long as insurance company or government health care money, such as Medicare can be garnered.     After the last practical dollar is extracted the victim is put to death.   Cremation covers up a wealth of questions.

b.       Guardianship fraud derived from legitimate attempts to help a disabled person.    In this situation, a co-operate Judge, corrupt lawyers and Guardian ad litem get together to rape and estate.    They set up the family individual who is a legitimate guardian and accuse the guardian of acting improperly.    An irate judge threats doom and gloom but relents and does not send the family member appointed guardian to jail – a judge is rendered that is enough to put the fear of God into the family member and a pawn is appointed guardian.    The pawn is manipulated into bit by bit transferring all the value assets of the Estate into the pockets of the co-operate judge, the guardian ad litem et al.   The Alice Gore case is a classic example of this fraud.

c.       Variations on the theme.     Including PURPOSE DIRECTED GUARDIANSHIP.    The Jaycox case is an illustration.    Jaycox recognized that something was wrong and refused to authorize further payment.     The nursing home then petitioned the Court for a guardian.    When Jaycox engaged counsel (yours truly) and thwarted the attempt to obtain a guardianship, Jaycox died and was cremated.    Carol Wyman was subjected to ELDER CLEANSING because her husband had the clout and could use guardianship to obtain control wherein a divorce would be against his best interests.

2.       Frauds associated with the CARE OF THE ELDERLY.   (It should be noted that several of the large health care providers have referred to the elderly as a commodity!)

a.       Outright criminal activity such as Medicare Fraud.      The key example is the Philip Esformes criminal trial – a billion dollars in Medicare money was stolen.     Trial is set for October 2018.       This case involved all the elements, to wit:

                                                               i.      Payment of money to public officials – in the Esformes case a government health care person assigned to make certain the nursing homes are run in a sanitary and proper contradiction was bribed – she pleaded guilty got five years in prison.

                                                             ii.      Kickbacks.     See Omnicare case, Larkin Hospital, etc.     This is standard practice and involves a portion of the fees derived from the victim are spread to those individuals – doctors, lawyers, hospital administrators, and other who delivered the victim to the criminal conspiracy.

b.       Hospice fraud.    The Seth Gillman plea of guilty illustrates this fraud.     No one does this encompass placing people in hospice who are not dying but extending the life of a dying person to collect as much money as possible.   With cremation available a dead victim can have administered thousands of dollars of medications and service by the simple entry on a chart.    Controlled doctors sign death certificates, and with Cook County, Dade County, et al so ripe with fraud and corrupt public officials ******

c.       Opioid and drug fraud.     A doped up human trafficking victim requires little care and is pure profit.    An average of $3000 a month pays for the care of a nursing home patient in the ELDER CLEANSING program, however the billing can be $12,000 to over $15,000 a month for the care.     No one knows the difference; the victim has a drug induced sleep.   It is much easier to administer a patient dead to the world.    As an example, Physical Therapy can be administered to sleeping patient by merely pushing his/her wheel chair out of the room and into the hall.    Insurance and the Government pay without question for not only the opioids, but the PT.

d.       General targeting:       After last year’s hurricane a LARKIN hospital related nursing home (also apparently related to Esformes had a problem – their air conditioning went out.     Removing the patients to another facility would cut off the Federal Health Care payments, so they made do with fans.     14 people died.    The issue was money over health care.

e.       Service fraud:      With the advent of breaking up the monopoly owned by large utilities the nursing home moguls have set up their own service companies such as electric, and gas.    The costs and profits now go into the “pot” and can be adjusted so as to justify the large month charges made from government health care programs.     It should be noted that the “facility” owned by the moguls usually do not employ many on staff people.   They employ services to furnish them nurses, doctors, techs etc.     The employment costs thus also can be manipulated.

3.       Cover-up of fraud

a.       Official cover up.     This occurs in guardianship cases when the criminal enterprise has one or more objectors.      Family members are motivated by Love of the victim, the anticipation of an inheritance, or just being good person.    These people ask questions.    For instance, a common question is:  Why does mother sleep so much of the time?     Another is what is wrong – mother is getting worse – not better!     These questions can be stalled only for so long.    In the Sykes case, the Gore case etc.    The cover-up usually takes the form of a stall.    When that does not work, it evolves into pure intimidation.      If the “loved one” (i.e. the person motivated to address the criminal enterprise) is too insistent personal threats are directed to the “loved one” The threat seizes on some real or imagined offense and the fraudsters threaten civil or criminal action against the “loved one.”     In the guardianship scenario the Judge is called into the matter.    The judge listens to all the evidence and then rules that the offending “love one” is doing serious harm to the designated victim by the inquiry – she is being agitated/      From that point on asking if mother can visit with x is agitation and results in a RULE TO SHOW CAUSE.     Again, the Judge sternly listens to all the evidence and rules that the family member (et al) has violated an order of court and contempt of court (and possibly jail) is on the docket.      It this does not work then:

                                                               i.      Disciplinary proceedings in the Courtroom.     a stern judge again listens to all the evidence and issues just enough penalty that intimidation sets in.      This process can be multiple hearings and can even result in jail.   The fact that there is no criminal conduct or even wrongful conduct is irrelevant.     The object is to silence the victim and her family.   The most officious strategy is to actually render a judgement against the loud mouth objector.     (in the case where the objector actually has some status – such as being appointed the actual guardian in the case – the judgment can be enforced by attaching the bond)

                                                             ii.      Referral of the matter to “law enforcement”, the Attorney Disciplinary Commission.     This is trickier because law enforcement employs too many honest people and too many people must be clued in and compensated.      Because of legitimate Court procedures the appeal process is impotent, and the justice system is even more impotent.   Nowhere is this more evident that in the JoAnne Denison disciplinary case.    JoAnne exposed every event cited supra in her blog tying it to Judges sitting in the Probate Division of the Circuit Court of Cook County.    When JoAnne would not “shut up” her cry for an HONEST INVESTIGATION was deemed to be ETHICALLLY CHALLENGED by the jurists who were openly and notoriously engaged in HUMAN TRAFFICKING of the elderly, she and (me too) were charged with DISCIPLINARY OFFENSES and suspension of law licenses was sought.      When after Denison ignored one threat after another to SHUT UP and continued a Petition for an interim suspension of her license was filed by the IARDC.    Mr. Larkin, the administrator argued that public was harmed by the exposure of Judicial corruption AND her exposure of judicial corruption was akin to YELLING FIRE IN A CROWDED theater.   She was suspended.

The case of Goodman out of Arizona is the most obnoxious that can be imagined.     Goodman informed me that he found serious fraud in several cases.      He attempted to address them in the Probate Court, but was thwarted.     He then filed Civil Rights suits.    The miscreants went after him hammer and tong.    The obtained Rule 11 (and Rule 11 like) sanctions against him and as well as suspension of his law license.   When he continued to fight – challenging the violation of his personal civil rights more sanctions were levied against him and they literally bankrupted him.      Janet Phelan had her entire inheritance stolen from her and lives in exile in Mexico.

This is the swamp that we are asking the President to drain!

 

From FB/PBS: US nursing homes are chronically understaffed and dangerous

https://pbs.org/newshour/health/most-nursing-homes-are-not-adequately-staffed-new-federal-data-says

Most nursing homes are not adequately staffed, new federal data says

 

ITHACA, N.Y. — Most nursing homes had fewer nurses and caretaking staff than they had reported to the government, according to new federal data, bolstering the long-held suspicions of many families that staffing levels were often inadequate.

The records for the first time reveal frequent and significant fluctuations in day-to-day staffing, with particularly large shortfalls on weekends. On the worst-staffed days at an average facility, the new data show, on-duty personnel cared for nearly twice as many residents as they did when the staffing roster was fullest.

The data, analyzed by Kaiser Health News, come from daily payroll records Medicare only recently began gathering and publishing from more than 14,000 nursing homes, as required by the Affordable Care Act of 2010. Medicare previously had been rating each facility’s staffing levels based on the homes’ own unverified reports, making it possible to game the system.

The payroll records provide the strongest evidence that, over the past decade, the government’s five-star rating system for nursing homes often exaggerated staffing levels and rarely identified the periods of thin staffing that were common. Medicare is now relying on the new data to evaluate staffing, but the revamped star ratings still mask the erratic levels of people working from day to day.

At the Beechtree Center for Rehabilitation & Nursing here, Jay Vandemark, 47, who had a stroke last year, said he often roams the halls looking for an aide not already swamped with work when he needs help putting on his shirt.

Especially on weekends, he said, “it’s almost like a ghost town.”

Nearly 1.4 million people are cared for in skilled nursing facilities in the United States. When nursing homes are short-staffed, nurses and aides scramble to deliver meals, ferry bedbound residents to the bathroom and answer calls for pain medication. Essential medical tasks such as repositioning a patient to avert bedsores can be overlooked when workers are overburdened, sometimes leading to avoidable hospitalizations.

“Volatility means there are gaps in care,” said David Stevenson, an associate professor of health policy at Vanderbilt University School of Medicine in Nashville, Tenn. “It’s not like the day-to-day life of nursing home residents and their needs vary substantially on a weekend and a weekday. They need to get dressed, to bathe and to eat every single day.”

Dr. David Gifford, a senior vice president at the American Health Care Association, a nursing home trade group, disagreed, saying there are legitimate reasons staffing varies. On weekends, for instance, there are fewer activities for residents and more family members around, he said.

“While staffing is important, what really matters is what the overall outcomes are,” he said.

While Medicare does not set a minimum resident-to-staff ratio, it does require the presence of a registered nurse for eight hours a day and a licensed nurse at all times.

The payroll records show that even facilities that Medicare rated positively for staffing levels on its Nursing Home Compare website, including Beechtree, were short nurses and aides on some days. On its best-staffed days, Beechtree had one aide for every eight residents, while on its lowest-staffed days the ratio was 1-to-18. Nursing levels also varied.

The Centers for Medicare & Medicaid Services, the federal agency that oversees nursing home inspections, said in a statement that it “is concerned and taking steps to address fluctuations in staffing levels” that have emerged from the new data. This month, it said it would lower ratings for nursing homes that had gone seven or more days without a registered nurse.

Beechtree’s payroll records showed similar staffing levels to those it had reported before. David Camerota, chief operating officer of Upstate Services Group, the for-profit chain that owns Beechtree, said in a statement that the facility has enough nurses and aides to properly care for its 120 residents. But, he said, like other nursing homes, Beechtree is in “a constant battle” to recruit and retain employees even as it has increased pay to be more competitive.

Camerota wrote that weekend staffing is a special challenge as employees are guaranteed every other weekend off. “This impacts our ability to have as many staff as we would really like to have,” he wrote.

New rating method is still flawed

In April, the government started using daily payroll reports to calculate average staffing ratings, replacing the old method, which relied on homes to report staffing for the two weeks before an inspection. The homes sometimes anticipated when an inspection would happen and could staff up before it.

The new records show that on at least one day during the last three months of 2017 — the most recent period for which data were available — a quarter of facilities reported no registered nurses at work.

Medicare discouraged comparison of staffing under the two methods and said no one should expect them to “exactly match.” The agency said the methods measure different time periods and have different criteria for how to record hours that nurses worked. The nursing home industry also objected, with Gifford saying it was like comparing Fahrenheit and Celsius temperatures.

But several prominent researchers said the contrast was not only fair but also warranted, since Medicare is using the new data for the same purpose as the old: to rate nursing homes on its website. “It’s a worthwhile comparison,” said David Grabowski, a professor of health care policy at Harvard Medical School.

Of the more than 14,000 nursing homes submitting payroll records, 7 in 10 had lower staffing using the new method, with a 12 percent average decrease, the data show. And as numerous studies have found, homes with lower staffing tended to have more health code violations — another crucial measure of quality.

Even with more reliable data, Medicare’s five-star rating system still has shortcomings. Medicare still assigns stars by comparing a home to other facilities, essentially grading on a curve. As a result, many homes have kept their rating even though their payroll records showed lower staffing than before. Also, Medicare did not rate more than 1,000 facilities, either because of data anomalies or because they were too new to have a staffing history.

There is no consensus on optimal staffing levels. Medicare has rebuffed requests to set specific minimums, declaring in 2016 that it preferred that facilities “make thoughtful, informed staffing plans” based on the needs of residents.

Still, since 2014, health inspectors have cited 1 in 8 nursing homes for having too few nurses, federal records show.

With nurse assistants earning an average of $13.23 an hour in 2017, nursing homes compete for workers not only with better-paying employers like hospitals, but also with retailers. Understaffing leads predictably to higher turnover.

“They get burned out and they quit,” said Adam Chandler, whose mother lived at Beechtree until her death earlier this year. “It’s been constant turmoil, and it never ends.”

Medicare’s payroll records for the nursing homes showed that there were, on average, 11 percent fewer nurses providing direct care on weekends and 8 percent fewer aides. Staffing levels fluctuated substantially during the week as well, when an aide at a typical home might have to care for as few as nine residents or as many as 14.

A family council forms

Beechtree actually gets its best Medicare rating in the category of staffing, with four stars. (Its inspection citations and the frequency of declines in residents’ health dragged its overall star rating down to two of five.)

To Stan Hugo, a retired math teacher whose wife, Donna, 80, lives at Beechtree, staffing levels have long seemed inadequate. In 2017, he and a handful of other residents and family members became so dissatisfied that they formed a council to scrutinize the home’s operation. Medicare requires nursing home administrators to listen to such councils’ grievances and recommendations.

Sandy Ferreira, who makes health care decisions for Effie Hamilton, a blind resident, said Hamilton broke her arm falling out of bed and has been hospitalized for dehydration and septic shock.

“Almost every problem we’ve had on the floor is one that could have been alleviated with enough and well-trained staff,” Ferreira said.

Beechtree declined to discuss individual residents but said it had investigated these complaints and did not find inadequate staffing on those days. Camerota also said that Medicare does not count assistants it hires to handle the simplest duties like making beds.

In recent months, Camerota said, Beechtree “has made major strides in listening to and addressing concerns related to staffing at the facility.”

Hugo agreed that Beechtree has increased daytime staffing during the week under the prodding of his council. On nights and weekends, he said, it still remained too low.

His wife has Alzheimer’s, uses a wheelchair and no longer talks. She enjoys music, and Hugo placed earphones on her head so she could listen to her favorite singers as he spoon-fed her lunch in the dining room on a recent Sunday.

As he does each day he visits, he counted each nursing assistant he saw tending residents, took a photograph of the official staffing log in the lobby and compared it to what he had observed. While he fed his wife, he noted two aides for the 40 residents on the floor — half what Medicare says is average at Beechtree.

“Weekends are terrible,” he said. While he’s regularly there overseeing his wife’s care, he wondered: “What about all these other residents? They don’t have people who come in.”