From KKD: Nursing homes cashing in insurance to make money off of Covid 19

kenneth ditkowskyThu, Sep 17, 8:58 PM (7 hours ago)
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HHS and the Sheer Stupidity of Giving for-Profit Nursing Homes MORE Money -Covid

September 17, 2020LostMessiahCovid-19Healthcare, Nursing and RehabilitationNursing Home OversightUncategorizedCovid-19Nursing and RehabilitationNursing FacilitiesNursing Home Oversight

OPINION – No Amount of Money is Going Incentivize a Morally Bankrupt and Profit Centric Nursing Home Owner/Operator/ Manager to Improve Care to Patients – More Oversight is Required

Whomever thought up the idea that shelling out MORE money to nursing homes, their owners, managers, wealthy entrepreneurs and magnates to reduce Covid-19 numbers doesn’t seem to understand the dynamics of the nursing home industry. In fact, that idea represents an utter and complete disregard for the entire history of the nursing home industry, the coining of money that occurs and the harrowing lack of oversight that lead to Covid-19 deaths.

It was not about a lack of funding for appropriate care. The deaths were caused by greed. The stockpiling of PPE (and respirators) so they could be traded or sold on a secondary market, represented greed.

The obscene amounts of money that has already been given to fabulously wealthy owners, operators and magnates in the form of PPP and EIDL loans has only allowed the wealthy to get wealthier. It has improved nothing else. And, you cannot buy a conscience with that money, which would be what is required to stop improve the quality of life of every individual currently residing in nursing homes and to prevent further death when Covid-19 ravages these homes again.

To many of the owners, operators and managers in for-profit care nursing and rehabilitation centers, a patient represents an equity interest in a financial gain, whether that gain is in the form of Medicare/Medicaid or private insurance, or in the form of a life insurance policy after a patient has died. Nursing care is not about improving the lives for human beings, the vulnerable and the most in need of care and compassion. It is not about preventing a spread of a deadly virus.

For every person who died from Covid-19, the owners, operators and magnates made money on life insurance policies where they didn’t on some other death benefit or healthcare payment. The owners, operators and managers are all but printing money in the basements of some of these homes, coining it. They DO NOT need more money. What they need is oversight.

For many of these nursing home owners, operators, managers and the equity interested individuals, providing additional access to money is like giving an opiate to an addict. You cannot instill in many of these individuals a sense of moral obligation to do right by their patients, clients and families. These people are not morally challenged they are morally bankrupt and the money only feeds into an ability to obtain more equity on human life and death.As the scandal perpetuate (but are covered up by the media) it is apparent that an HONEST INVESTIGATION by a specially impaneled GRAND JURY is required.    The miscreants can and have purchased justice to the detriment of population they are supposed to service.
Our trusted public servants cannot and/or will not do the tasks that they were elected to do.     In certain situations the failure is due to incompetence, but in too many circumstances it is pure greed.    
If anyone needs a reminder of just how ‘dirty’ the HUMAN TRAFFICKING IN GRANDMA is, all they have to do is look at some of the cases.     The Sallas case 07 P 5360 is a clear example.    The public guardian certain knows all about 755 ILCS 5/11a – 22, yet he acted allegedly in concert with the ByLine Bank in a scheme to have Amelia Sallas sign loan documents that the Illinois Legislature made it a crime for the Bank to have Amelia sign them   
How will the criminal action descried in 755 ILCS 5/11a – 22 be addressed?    Given the current pattern of ‘cover up’ in the Illinois Courts – it will be swept under the rug.    If enough storm and drama is generated we will be offered more useless legislation.   The miscreants will take their booty hide it and not be bothered to pay the INCOME TAXES due.   In fact the Illinois Attorney Registration and Disciplinary commission will hurry to the aid of the miscreants and ignore their collective duties and their ethical considerations mandated by ABA Rule 8.3.     The FIX IS IN!     
Dean Sallas’ life was threatened for speaking up for himself.   What will happen to him if he is successful in seeking Justice?     The death threat to Sallas has been ignored by the authorities!     

Ken Ditkowsky

www.ditkowskylawoffice.com

On Thursday, September 17, 2020, 02:52:50 PM CDT, kenneth ditkowsky <kenditkowsky@yahoo.com> wrote:

Nursing home mogul Philip Esformes sentenced to 20 years for $1.3 billion Medicaid fraud

By DAVID JACKSON and MARIO ARIZASOUTH FLORIDA SUN SENTINEL |SEP 12, 2019 AT 7:57 PMChicago Tribune reporter David Jackson explains how wealthy nursing home operator Philip Esformes allegedly became the orchestrator of a $1 billion Medicaid and Medicare bribery and kickback scheme. Oct. 4, 2016.

Former Illinois and Florida nursing home mogul Philip Esformes wept and pleaded for mercy Thursday before being sentenced to 20 years in prison for what the U.S. Justice Department called the largest single health care bribery and kickback scheme in American history.

A separate hearing will be held in November to determine the amount of money and property Esformes may be required to forfeit.

Esformes, who once controlled a network of more than two dozen health care facilities that stretched from Chicago to Miami, garnered $1.3 billion Medicaid revenues by bribing medical professionals who referred patients to his Florida facilities then paid off government regulators as vulnerable residents were injured by their peers, prosecutors said.

Philip Esformes, shown in 2015, once controlled a network of more than two dozen health care facilities that stretched from Chicago to Miami,

Philip Esformes, shown in 2015, once controlled a network of more than two dozen health care facilities that stretched from Chicago to Miami, (Rob Latour / Rob Latour/Invision/AP)

He housed elderly patients alongside younger adults who suffered from mental illness and drug addiction — sometimes with fatal results. In Esformes’ Oceanside Extended Care Center in Miami Beach, “an elderly patient was attacked and beaten to death by a younger mental health patient who never should have been at (a nursing facility) in the first place,” prosecutors wrote in a pre-sentencing memo.

As he handed down the sentence, Judge Robert N. Scola Jr. said the length and scope of Esformes’ criminal conduct were “unmatched in our community. … Mr. Esformes violated the trust of Medicare and Medicaid in epic proportions.”

But Scola meted out a punishment significantly less than the 30 years prosecutors requested, saying Esformes also had an extraordinary history of helping people in need. Attorneys for Esformes had described him as a selfless philanthropist who had donated more than $15 million to synagogues, schools and needy individuals, often anonymously.Said Scola: “I think he should get some consideration for his philanthropy, although it’s dangerous to say because he was stealing money from Medicare, so people might say he was giving that money to charity. But the vast majority of the money he made, he made legitimately. More importantly he was a true friend to people known and unknown to him, and that is worthy of mitigation.”  (comment – pure BS!    It has been suggested that when money was given to a charity the charity had to kick back under the table.     The Omnicare scandal also is an interesting situation.)

In arguing for a 30-year sentence, prosecutors said his yearslong bribes-for-patients schemes involved the corruption of medical professionals and government regulators, and entailed grievous injuries to a massive number of elderly patients.

“Miami is the epicenter of health care fraud, there was no one like Philip Esformes, he was king,” prosecutor Allan J. Medina told the judge in court Thursday.

Many of his younger, drug-addicted patients spent the daylight hours wandering the streets of Miami while he collected government payments for services that were never delivered, prosecutors said.

“Phillip Esformes used deceptive and calculated means to orchestrate a fraud of the magnitude that we have not seen before,” Medina said. “People who needed to get better, who wanted to get better, they had no shot.”

“His fraud involved thousands of patients, 16 nursing homes, the systematic payment of bribes, a complex web of bank accounts, and brazen obstruction of justice to try to prevent it all from coming to light,” prosecutor Elizabeth Young wrote in a sentencing memo filed with the court this week.

Esformes, who has been in maximum security detention for 37 months since his 2016 arrest, called himself a shattered, repentant man when he stood before the judge. His shoulders drooped beneath his baggy khaki prison shirt as he began rocking back and forth.

“I want to apologize to, your honor, the United States. Sorry. And my community.” As Esformes began to recite the names of his children, he briefly became incoherent. Groans and cries of “Oh God!” escaped from his family and supporters in the gallery.

“I’ve lost everything I love and cared about with the utmost intensity,” he said. “There is no one to blame but myself, me.”

While preparing his defense, Esformes told the judge, he had listened repeatedly to wiretapped conversations that revealed him arranging bribes. “I am disgusted by what I heard,” he said, at one point pounding a courtroom podium with his fist. “The Phil Esformes you heard was reckless … an arrogant man.”

Esformes said he was studying the Torah and praying for redemption. “I won’t miss that opportunity,” he said.

Prosecutors said Esformes should be forced to pay $207 million in restitution to Medicaid and Medicare; attorneys for Esformes sharply questioned that amount in court Thursday.

Judge Scola closely questioned prosecutors about how they calculated the value of the Medicaid proceeds Esformes stole over the years, ultimately finding the loss to be between $4.8 million and $8.3 million.In this 2011 court deposition, lawyers from Chicago’s Goldberg Kohn firm questioned Philip Esformes about how he and his father worked together.

Federal authorities arrested Esformes at one of his $2 million estates on the Miami Beach waterfront in 2016 and immediately placed him in the Miami Federal Detention Center.

At the time, he had a net worth of $78.9 million in bank accounts and investments, and hardly any debts, according to court papers filed by prosecutors. He maintained a Chicago Water Tower penthouse and a mansion in Los Angeles.

Esformes was deemed an extraordinary flight risk in part because he had been caught on a wiretap offering to help his business partner Guillermo Delgado flee from the U.S. to avoid prosecution as the federal investigators closed in on them.

Delgado, who helped Esformes defraud Medicare for mental health and prescription drug services, instead helped federal investigators bring Esformes to justice. He and his brother Gabriel Delgado are now serving prison time.

In one of Esformes’ crimes, prosecutors said, he used some $300,000 in stolen Medicare and Medicaid proceeds to bribe the head men’s basketball coach at the University of Pennsylvania to admit Esformes’ son to the school.

That coach, Jerome Allen, pleaded guilty in October to a money-laundering charge related to the Esformes bribes. He testified as a government witness against Esformes at the Miami trial. Allen received a probationary sentence and is now in his third season as an assistant coach with the Boston Celtics.

The dozens of nursing facilities Esformes ran with his father and business partner Morris Esformes for decades earned millions of Medicaid and Medicare dollars annually despite repeated federal law enforcement probes and Chicago Tribune investigations alleging substandard care and incidents when disabled patients were assaulted by fellow residents.

“Instead of changing his ways or expressing remorse after these settlements, Esformes simply altered his criminal scheme to avoid detection,” prosecutor Young wrote in the court filing.

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Esformes sold his Illinois nursing facilities in about 2012 but kept offices in the Chicago suburbs as he continued to operate homes in Florida with his father, government records and Tribune interviews show.

The latest case wasn’t the first time that Esformes faced fraud accusations.

In 2006, Philip Esformes was among the current and former owners of Larkin Community Hospital in Miami who were required to pay $15.4 million to settle federal and Florida civil health care fraud claims.

In that matter, one of the other defendants was Dr. Jack Michel, CEO of Larkin Community Hospital, who made his own headlines in 2017 after the 12 heat-related deaths of patients at the Rehabilitation Center at Hollywood Hills. Michel isn’t affiliated with Esformes in the latest Medicaid fraud legal battle that is sending Esformes to prison.

dyjackson@chicagotribune.com

Ken Ditkowsky

Nursing homes are becoming (or have been) nothing but illegal unconstitutional detention centers for the elderly

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