As residents died, nursing homes raked in CARES Act cash
Nursing homes are heavy political spenders and not shy about flexing that political muscle. They are hiring lobbyists and cashing in on COVID-19 stimulus money despite having problems that predated the virus.
Heather Williams knew on April 28 that her mom, 63-yearold Sarita Redmond, had tested positive for COVID-19. But the Southern Oaks Care Center, which had become a petri dish of infection, would tell Williams nothing more.
Call after call to the Pensacola nursing home went unanswered, Williams said. And a state executive order intended to protect elders in long-term care barred her from visiting her mother.
Williams asked local police to make a welfare check in midMay. The Pensacola Police Department told her that COVID-19 restrictions forbid that, too.
“I didn’t know what else I could do,” Williams said.
The day before Williams learned that her mother had COVID, Southern Oaks reported that 92 residents and 15 employees at the 210-bed facility had tested positive for the virus — the most cases of any nursing home in the state at that point.
It’s one of a number of troubled Florida facilities connected to Eliezer Scheiner, a New York nursing home operator who has made headlines for the poor quality of care in his homes in other states, although the connections are obscured in records. He is also known for his fundraising for President Donald Trump.
Nursing homes, which rely almost exclusively on state and federal payments from Medicaid and Medicare, are heavy political spenders and not shy about flexing that political muscle. As COVID-19 has led to more than 150,000 cases and more than 40,000 deaths nationwide in nursing homes, owners have pushed for immunity from lawsuits stemming from their handling of the virus. That is despite the fact that problems at some homes predate the virus and that industry insiders acknowledge many nursing homes didn’t have sufficient infection controls to stop the spread of the highly contagious COVID-19.
While they’ve had mixed success in winning immunity, nursing homes have gotten nearly $10 billion in federal funds from the Centers for Medicare and Medicaid services to help offset COVID-19 costs.
Late last year, Scheiner organized a fundraiser that brought in roughly $3 million to support Trump’s re-election bid, giving $750,000 himself.
“I want to thank Eli Scheiner for doing such an incredible job,” Trump said at last year’s fundraiser.
While Scheiner’s fundraising prowess has garnered praise from the president, his nursing homes have generated reproach from regulators.
Of the the 24 Florida nursing homes tied to Scheiner and a business partner, Teddy Lichtschein, more than a third are on the state’s Watch List for troubled nursing homes, and health regulators reported 114 verified complaints at the homes between November 2016 and November 2019, state records show.
Florida facilities connected to them have also racked up more than $485,000 in fines from the federal government since 2017 and nearly $70,000 in fines from the state of Florida in the same time period.
The coronavirus pandemic has further exposed the homes’ shortcomings. More than 100 residents and employees have died from COVID-19, the illness caused by exposure to the virus, at nursing homes linked to Scheiner and Lichtschein, according to the Miami Herald’s analysis of state records. The loss of life is among the highest totals of any network of homes in the state, a Miami Herald analysis of state and federal data shows.
The Miami Herald spoke with relatives of current and former residents at several of Scheiner’s 24 facilities. Many painted a similar picture of poorly managed homes that have kept families in the dark during the COVID-19 pandemic.
Lorraine Bydalek’s 44year-old daughter, whose cerebral palsy leaves her wholly dependent on caregivers, contracted COVID-19 at the North Lake Care Center in Lake Park in early May, after the facility had been in lockdown for months. Bydalek said North Lake didn’t do enough to protect residents from contracting the virus, for example allowing residents requiring treatments at outside facilities to be in close proximity to her daughter.
“They’re constantly being exposed,” she said.
Crystal Knowles kept running into dead ends whenever she tried to learn about the status of her 61-year-old father, George Knowles, who spent nearly two weeks at the Palms Care Center in Lauderdale Lakes in March in the early stages of the COVID-19 pandemic.
“It was very hard to have a family member there and not know what’s going on exactly,” she said. “Trying to call the facility was the worst customer experience I’ve ever had. It was the complete run-around.”
Williams’ assessment of the Pensacola home where her mother contracted COVID-19 was equally blunt: “That facility, in my opinion, should be shut down.”
Her mother’s care at the facility was even subject to an investigation for abuse and neglect by the Florida Department of Children & Families. The Southern Oaks Care Center said the investigation exonerated the home, but Williams said she hadn’t yet been informed of the results. The department confirmed the existence of the investigation but would not confirm its findings.
The Pensacola nursing home said that it’s currently COVID-19 free and that it had the highest early COVID-19 totals because it had tested residents and staff earlier than other nearby facilities. Amanda Waddell, the home’s community liaison, said its phones went down in April because a contractor working across the street accidentally severed the facility’s lines.
Waddell defended the care provided by the facility during the COVID-19 pandemic.
“At our facility many who tested positive were asymptomatic and thankfully our mortality rates were very much below the averages at other skilled nursing facilities, but every loss was and remains tragic,” Waddell said in an e-mail.
The North Lakes Care Center pushed back on criticism of its practices.
“It appears that you are sending us a list of questions that are applicable to all nursing homes in the State of Florida and elsewhere in the country,” the administrator, Steven Landa, said in response to questions about complaints
STATEWIDE, THE NUMBER OF NEW DEATHS AT LONG-TERM CARE FACILITIES HAS SHOT UP IN RECENT WEEKS, AFTER DECLINING FOR MUCH OF MAY AND JUNE.
by family members about the care for patients during the pandemic.
Scheiner, Lichtschein and the Palms Care Center did not return phone calls or e-mails with detailed questions.
‘BYZANTINE ARRANGEMENT’
Property records for the facilities show that they are owned by companies listing Scheiner, Lichtschein or employees at their Brooklyn company, TL Management LLC, as the officers, with the same Brooklyn shipping store listed as the business address for all of the entities.
But Scheiner and Lichtschein aren’t listed as owners of any of the homes in state or federal nursing home records. Instead, another New York man, Michael Bleich, is listed as indirect owner of each facility in federal nursing home records and as an officer in state corporation records.
Bleich appears to have become involved with many of the facilities in 2015, according to Florida state records. In a master sublease agreement obtained by the Herald from the same year, a company controlled by Bleich, Care Master Tenant Inc., leased 11 of the properties from Scheiner and Lichtschein’s TL Healthcare Holdings. The agreement shows that Bleich wasn’t just leasing the property on which the facilities are located, but the licenses and medical records, too. When the lease ended, Scheiner and Lichtstein would retain control of the licenses and other related assets.
Bleich didn’t respond to phone calls and text messages. Reached by the Herald in late April, when Southern Oaks had first reported the most COVID-19 cases in the state, he told the Herald, “Call the facility, I’m not going to talk to you.”
The complex legal structure of these homes isn’t uncommon among nursing homes and other long-term care centers. Trying to determine who actually owns a nursing home regularly involves navigating a maze of shell companies. That’s by design.
A 2012 presentation by top law firm Baker Donelson touted the advantages of a “complex corporate structure” for long-term care facilities in limiting the scope of “regulatory sanctions or penalties” and potential damages in a lawsuit.
“Many plaintiffs’ attorneys will never conduct corporate structure discovery because it’s too expensive and time consuming,” the presentation aimed at nursing home executives and attorneys said.
Ken Connors, an attorney in South Carolina who has brought numerous suits against senior care companies in Florida and across the South, said: “It’s a byzantine arrangement that is calculated to obscure the people who are making the operational decisions and by virtue of that obscurity immunize the people making them.”
In the wake of the deadly COVID-19 pandemic, which has killed nearly 3,000 residents and staff statewide, nursing home operators have sought formal immunity from negligence lawsuits related to their handling of the pandemic. The nursing home industry wrote a letter to Florida Gov. Ron DeSantis in early April requesting that he extend sovereign immunity to nursing homes, hospitals, assisted living facilities and other healthcare providers. So far, DeSantis hasn’t indicated whether he supports granting immunity to the owners.
But at the federal level, nursing home owners have found an ally in Senate Majority Leader Mitch McConnell, a Kentucky Republican, who has said he supports including liability protections in future rounds of coronavirus legislative relief.
Scheiner and Lichtschein redoubled their political efforts as COVID-19 spread this spring.
Scheiner wrote a $50,000 check to another pro-Trump committee in May and TL Management hired several federal lobbyists in April and May. The roster included Brian Ballard, the Floridian Politico called the “most powerful lobbyist in Trump’s Washington”; a former top aide to Texas Republican Sen. Ted Cruz, Nick Muzin; and Emily Hargan, the wife of the deputy secretary of the U.S. Department of Health and Human Services, among others.
Filings show that they were hired to lobby on a range of topics including “Federal civil liability protection in regards to coronavirus for skilled nursing homes” and “obtaining federal and state assistance for nursing homes dealing with COVID-19.”
The efforts appear to have already paid off. The Florida facilities have received between $29.5 and $47 million in competitive federal coronavirus relief funds as part of the federal CARES Act, on top of increased federal reimbursements for testing and up to $8.6 million in additional federal funds distributed to nursing homes, according to a set formula. Nursing homes tied to Scheiner and Lichtschein in New York and Texas took in an additional $18.5 to $31.5 million in the competitive funds. All told, nursing homes tied to Scheiner and Lichtschein reaped between $48 million and $78 million in CARES Act funds.
Each Florida facility was awarded money from the HHS Federal Provider Relief Fund, which comes with no strings attached. Meanwhile, 21 of the 24 nursing homes tied to
Scheiner and Lichtschein obtained between $14.5 and $32 million combined in paycheck protection program loans in late April and May, which is the most of any nursing home operator in the state, according to the Herald’s analysis of loan data and nursing home records. The loans are forgiven if they are used for payroll and other approved expenses. Recipients are supposed to indicate how many jobs were saved thanks to the money, but in data released by the U.S. Small Business Administration the number of jobs retained is listed as zero for 20 of the 21 loans.
‘TROUBLED FACILITIES’
Interviews and records suggest problems at the homes connected to Scheiner and Lichtschein long predate the virus’ spread.
The state of Florida denied two nursing home license applications submitted by Bleich in 2019, noting that 24 homes associated with Bleich had garnered 114 substantiated complaints between 2016 and 2019 — far more than other applicants for the same licenses.
Bleich wrote in one application that he “acquired several troubled facilities in or facing bankruptcy in 2018” and had “also acquired other facilities, many with physical plants that are ending their useful lives.”
The Williston Care Center near Gainesville was fined $60,000 by the federal Centers for Medicare and Medicaid Services in July 2019 after staff at the home waited too long to perform CPR on a resident who was choking on her lunch, federal inspectors found. The resident was discovered slumped over in her wheelchair in the dining room, her lips blue and with no pulse. But instead of performing CPR immediately in the dining room, the staff wheeled the resident to her room, and transferred her to her bed before starting CPR. She was taken to the hospital 15 minutes later and pronounced dead two hours after that.
In January, Florida’s Agency for Health Care Administration fined the Cypress Care Center in Wildwood, an hour outside of Orlando, $20,000 after a resident with diabetes and a related neurological disorder died in May 2019 after being left outside, unattended for three hours, according to the agency’s findings. He was discovered unresponsive by a kitchen manager, and when local emergency medical workers were called to the nursing home, they determined that his temperature was 107 degrees. He was pronounced dead at the Leesburg Regional Medical Center of, among other things, respiratory failure, cardiac arrest and hyperthermia, which is a temperature greatly above normal.
Williams said that her mother nearly died during a previous stay at the Southern Oaks Care Center last fall, when Redmond had to be hospitalized after the facility gave her an accidental overdose of morphine. Her mother’s condition at the time was so poor that she was placed in hospice care, where she was expected to die.
Though Redmond was able to recover, her family had seen enough of Southern Oaks, Williams said. Williams wanted her mother to go elsewhere, but she was unable to find a home nearby with open beds.
During the COVID-19 pandemic, some of the facilities connected to Scheiner and Lichtschein have been among the deadliest in the state. That includes the Gulf Shore Care Center in Pinellas Park, which has reported 22 resident deaths and one staff death, and the Sands at South Beach Care Center in Miami Beach, which has reported 16 resident deaths. The Southern Oaks Care Center has reported 10 deaths.
Statewide, the number of new deaths at long-term care facilities has shot up in recent weeks, after declining for much of May and June.
Before the pandemic, the homes tied to Scheiner and Lichtschein had lower staffing levels than the state average, federal nursing home data show. The disparity was particularly wide for registered nurses, who have the most training of the caregiving staff at nursing homes and, as a result, tend to be highest paid. Residents at the homes connected to Scheiner and Lichtschein received only three-quarters the amount of daily care from registered nurses as the average at nursing homes in the state.
Advocates say those differences can be crucial for residents in need of intensive medical care.
“Every minute is an eternity when it comes to care in a nursing home,” said Brian Lee, Florida’s former long-term care ombudsman and the executive director of Families for Better care. “Every minute may be the difference between life and death.”
‘ALL SHE KNEW IS THAT SHE WAS IN PAIN’
Bydalek said she believes that seemingly endless cutbacks at the North Lake Care Center in Lake Park have put her 44-year-old daughter Jennifer Soderlund and other residents at risk.
“They’re down to bare bones on things,” Bydalek said.
Soderlund, who has the neurological condition cerebral palsy, first tested positive for COVID-19 in early May and was moved into a room with another infected resident, Bydalek said. Soderlund was moved again recently after testing negative for the virus twice.
Soderlund’s positive test came well after nursing homes banned visitors, and Bydalek thinks the nursing home hasn’t done enough to ensure that residents don’t get infected from staff or other residents who require treatment outside the facility.
She said that her daughter, who has physical but not cognitive impairments, begs to be moved in their communications. Bydalek would like her daughter to be closer to her Melbourne home but can’t find another facility with an opening for a long-term resident.
“I just want my daughter in a safer environment,” Bydalek said.
Knowles didn’t want her 61-year-old father George to be placed in the Palms Care Center in Lauderdale Lakes, either, but Palms Care was the only place equipped to take her father when he needed specialized care, including a con
DURING THE COVID-19 PANDEMIC, SOME OF THE FACILITIES CONNECTED TO SCHEINER AND LICHTSCHEIN HAVE BEEN AMONG THE DEADLIEST IN THE STATE.
stant supply of oxygen, after open heart surgery in early March.
Knowles’ father was disoriented and would call them in the middle of the night, panicked about his condition.
“It was really scary,” she said.
Despite repeated calls to Palms Care, she and her family found it nearly impossible to get any information about her father’s status, Knowles said. Each time they called, they would be passed from one staff member to another, none of whom could provide information.
Finally, Knowles’ cousin drove there in an effort to get more information. Employees brought Knowles’ father to a window where Knowles’ cousin could see him, and what the cousin saw was troubling: “He didn’t have oxygen on, he didn’t have a mask on,” Knowles said.
What’s more, her cousin saw numerous people in street clothes going in and out, and passing by Knowles’ father without masks or any protective gear.
Knowles said she was furious.
“You lock down those facilities for a reason, she said. “My dad still had staples down his chest.”
Her father left Palms Care in mid-March and died of a heart attack on April 3. There’s no indication that his death was related to COVID-19.
For Williams, in Pensacola, the first sight of her mother after months of lockdown was even more horrifying.
Williams had been trying desperately to learn more about the status of her mother, Redmond, at Southern Oaks after the COVID diagnosis in late April.
“There was a period of time where the phones were just busy, for days,” she said.
Her efforts included imploring the Pensacola Police Department to pay her mother a welfare visit. The department declined.
And in the ensuing weeks Redmond’s health declined rapidly.
After she learned that an investigation was being opened into her mother’s care, Williams demanded that her mother be taken to the hospital, which is where she and her family saw Redmond for the first time since she had contracted the virus.
Williams described her mother as a gorgeous woman with a beautiful heart who was devoted to her children, grandchildren and great-grandchildren.
The woman they saw at the hospital that day was unrecognizable.
She was emaciated and suffering from severe malnutrition. Her body was covered in bedsores and she was moaning in pain.
“She never looked like that before,” Williams said.
Her mother didn’t recognize Williams or the rest of her family.
“All she knew is that she was in pain,” Williams said.
Four days later she was dead.