With the support of grassroots leaders, former state controller, Board of Equalization member and California budget director, Betty Yee on Wednesday officially launched her campaign for governor.

Citing her experience bringing accountability to government as an asset and her outsider mindset as a strength, Yee pledged to put the state back-on-track for all Californians.

She joins a field that so far includes Lt. Gov. Eleni Kounalakis, former State Senate leader Toni Atkins and State Superintendent of Schools Tony Thurmond.

Yee served on the Board of Equalization representing the First District — which included 21 counties, among them Lake — for several years before becoming state controller. She visited Lake County in that capacity to meet with local leaders in the spring of 2010.

As state controller, Yee said she took on big corporations, righted discrimination in the state’s tax code, giving more rights to LGBTQ+ partners, and discovered over $7 billion in improper spending, translating into real impact for California’s working families.

While traveling the state, Yee was encouraged by many to use her expertise to tackle California’s affordability crisis, to lift millions of Californians and their families into the middle class.

Yee said she could no longer ignore the need for her proven leadership and experience of knowing how to get the most out of every state budget dollar to ensure California truly adds up for everyone.

“Things in California just don’t add up anymore. Families are working harder than ever, but the cost of housing, food, college, childcare, elder care, and more is moving out of our reach,” Yee said. “Together we have the grit and the power to make California add up for all of us again.”

“I believe in Betty because she is an inclusive leader with a steady hand at the wheel. Everyday she demonstrates the drive to do the right thing –– to lift up all Californians,” said Jefferson Coombs, community leader, social justice organizer, and education advocate. “Betty's authenticity, intersectional leadership, and vision inspires and empowers ordinary people to do extraordinary things in their communities.”

Yee’s story begins with pursuing the California Dream. Yee was born in San Francisco to Chinese immigrant parents who built a laundry and dry cleaning business from scratch in the Parkside District of San Francisco.

The second oldest of six children, Yee grew up speaking no English in the home. Her family lived in a one-room apartment behind the family’s laundry, where she shared a sofa bed with her four sisters. Throughout her primary education, Yee attended the city’s public schools wearing clothes her mother sewed to save on the cost of store-bought clothes.

Like many first-generation Californians, Yee’s parents didn’t speak English, and therefore at age 8, Yee began managing the books for the family’s laundry.

Early on, Yee learned how numbers add up, but also what the numbers meant for her family — if weekly earnings came up short, that was one less carton of milk or loaf of bread for her family. She learned when things are out of balance, too many communities are left to fend for themselves, and sometimes get left behind.

With support from her family and community, Yee went on to earn a bachelor’s degree from UC Berkeley, where she returned decades later to serve on the Cal Alumni Association board to help raise funds for much-needed scholarships.

She holds a master’s degree in public administration from Golden Gate University.

She currently serves as the vice chair of the California Democratic Party.

On Wednesday, the California Department of Public Health launched the “Never a Bother” campaign, a youth suicide prevention public awareness and outreach campaign for youth, young adults, and their parents, caregivers and allies.

The campaign to address youth suicide was co-created with input from California’s youth, with oversight by CDPH’s Office of Suicide Prevention.

“Young Californians are facing a mental health crisis like never before,” said CDPH Director and State Public Health Officer, Dr. Tomás J. Aragón. “While this crisis has been growing for years, the pandemic put a spotlight on the issue, especially those in marginalized and underserved communities. This campaign directly addresses this crisis with education, tools, and resources informed and co-created by diverse young people across the state."

“The ‘Never a Bother’ campaign utilizes one of the most important tools we have to address the youth mental health crisis: the voices of young people,” said First Partner Jennifer Siebel Newsom. “The youth who partnered with us to create this campaign provided invaluable insight into the resources, knowledge, and support needed to best address their needs. As a mother, I am proud to see a campaign that resonates with youth and serves as a reminder to them that they are never alone and never a bother."

“Never a Bother” was created with input from more than 400 youth from diverse communities across the state, as well as the Youth Advisory Board and 34 youth-serving community-based organizations and tribal entities from across California.

With support from The Center at Sierra Health Foundation, all of these groups are working hand-in-hand on youth suicide prevention initiatives.

Insights from in-depth research, focus groups, and listening sessions were also incorporated into all aspects of the “Never a Bother” campaign concept and strategy.

Suicide was the second leading cause of death among youth ages 10 to 25 years in California between 2018 and 2022, with youth ages 10 to 18 experiencing a more than 20% increase in suicide rates from 2019 to 2020.

The “Never a Bother” concept was chosen by youth due to the inviting and welcoming look and feel of the campaign, which includes approachable icons and language.

The campaign resonates with youth as it validates their feelings of not wanting to be a burden to others. It speaks to their need to know that they are never a bother, that no problem is too small, and that it is important to check in with one another before, during, and after a crisis.

“As we continue to prioritize the future of our youth and their mental health, California continues to invest in a significant, multi-year overhaul of our mental health system,” added Dr. Aragón. “This campaign focuses on really listening to our young people and putting resources in the hands of those who need them most."

The multilayered “Never a Bother” campaign will use traditional advertising, social media content, and community outreach strategies to reach young people across California up to age 25.

The campaign focuses on youth populations disproportionately impacted by suicide, who may also face more systemic barriers to resources and support. An additional focus includes youth who identify as 2SLGBTQIA+, have experienced mental health and/or substance use challenges, and/or have been impacted by the foster care system.

The “Never a Bother” Campaign will:

• Increase knowledge and awareness of suicide warning signs, crisis lines, and other sources of support among youth, young adults, and their caregivers.
• Help young people ask for help, know that they deserve help, and they are not a “bother,” and communicate that they are not alone in supporting themselves or a friend before, during, and after a crisis.
• Support young people reaching out for help, for themselves or for a friend.
• Strengthen parents and caregivers’ abilities to recognize warning signs of suicide and intervene.

Suicide is a complex problem requiring collaborative solutions at multiple levels, including individuals, families, schools, and communities.

Suicide prevention can only be effective when everyone is part of the solution, including:

• Learning how you can support yourself, a friend, or a youth in your care before, during, and after a crisis.
• Telling a friend or young person in your care that they are never a bother and encourage them to reach out for help when they need it.
• If you are experiencing thoughts of suicide, you are not alone. Call or text 988 to reach the Suicide & Crisis Lifeline (24/7). Trained professionals can reconnect you with your reasons to keep going and show you ways to cope with difficult days.

The "Never a Bother" campaign is the latest endeavor of Governor Gavin Newsom’s Master Plan for Kids’ Mental Health and the California Health and Human Services Agency’s Children and Youth Behavioral Health Initiative, or CYBHI.

In line with the Master Plan and CYBHI, the campaign continues the state’s effort to increase awareness of suicide prevention and mental health resources, build life-saving intervention skills, and promote help-seeking behavior.

 

In the U.S., wildland firefighters are able to stop about 98% of all wildfires before the fires have burned even 100 acres. That may seem comforting, but decades of quickly suppressing fires has had unintended consequences.

Fires are a natural part of many landscapes globally. When forests aren’t allowed to burn, they become more dense, and dead branches, leaves and other biomass accumulate, leaving more fuel for the next fire. This buildup leads to more extreme fires that are even harder to put out. That’s why land managers set controlled burns and thin forests to clear out the undergrowth.

However, fuel accumulation isn’t the only consequence of fire suppression.

Fire suppression also disproportionately reduces certain types of fire. In a new study, my colleagues and I show how this effect, known as the suppression bias, compounds the impacts of fuel accumulation and climate change.

What happened to all the low-intensity fires?

Most wildfires are low-intensity. They ignite when conditions aren’t too dry or windy, and they can often be quickly extinguished.

The 2% of fires that escape suppression are those that are more extreme and much harder to fight. They account for about 98% of the burned area in a typical year.

In other words, trying to put out all wildfires doesn’t reduce the total amount of fire equally – instead, it limits low-intensity fires while extreme fires still burn. This effect is worsened by climate change.

Too much suppression makes fires more severe

In our study, we used a fire modeling simulation to explore the effects of the fire suppression bias and see how they compared to the effects of global warming and fuel accumulation alone.

Fuel accumulation and global warming both inherently make fires more severe. But over thousands of simulated fires, we found that allowing forests to burn only under the very worst conditions increased fire severity by the same amount as more than a century’s worth of fuel accumulation or 21st-century climate change.

The suppression bias also changes the way plants and animals interact with fire.

By removing low-intensity fires, humans may be changing the course of evolution. Without exposure to low-intensity fires, species can lose traits crucial for surviving and recovering from such events.

After extreme fires, landscapes have fewer seed sources and less shade. New seedlings have a harder time becoming established, and for those that do, the hotter and drier conditions reduce their chance of survival.

In contrast, low-intensity fires free up space and resources for new growth, while still retaining living trees and other biological legacies that support seedlings in their vulnerable initial years.

By quickly putting out low-intensity fires and allowing only extreme fires to burn, conventional suppression reduces the opportunities for climate-adapted plants to establish and help ecosystems adjust to changes like global warming.

Suppression makes burned area increase faster

As the climate becomes hotter and drier, more area is burning in wildfires. If suppression removes fire, it should help slow this increase, right?

In fact, we found it does just the opposite.

We found that while conventional suppression led to less total area burning, the yearly burned area increased more than three times faster under conventional suppression than under less aggressive suppression efforts. The amount of area burned doubled every 14 years with conventional fire suppression under simulated climate change, instead of every 44 years when low- and moderate-intensity fires were allowed to burn. That raises concerns for how quickly people and ecosystems will have to adapt to extreme fires in the future.

The fact that the amount of area burned is increasing is undoubtedly driven by climate change. But our study shows that the rate of this increase may also be a result of conventional fire management.

The near total suppression of fires over the last century means that even a little additional fire in a more fire-prone future can create big changes. As climate change continues to fuel more fires, the relative increase in area burned will be much bigger.

This puts more stress on communities as they adapt to increased extreme wildfires, from dealing with more wildfire smoke to even changing where people can live.

A way forward

To address the wildfire crisis, fire managers can be less aggressive in suppressing low- and moderate-intensity fires when it is safe to do so. They can also increase the use of prescribed fire and cultural burning to clear away brush and other fuel for fires.

These low-intensity fires will not only reduce the risk of future extreme fires, but they also will create conditions that favor the establishment of species better suited to the changing climate, thereby helping ecosystems adapt to global warming.

Coexisting with wildfire requires developing technologies and approaches that enable the safe management of wildfires under moderate burning conditions. Our study shows that this may be just as necessary as other interventions, such as reducing the number of fires unintentionally started by human activities and mitigating climate change.

Mark Kreider, Ph.D. Candidate in Forest and Conservation Science, University of Montana

This article is republished from The Conversation under a Creative Commons license. Read the original article.

NICE, Calif. — A member of Robinson Rancheria Band of Pomo Indians who got her start at the tribe’s casino has been named the casino’s general manager, a milestone for the business.

Robinson Rancheria Resort & Casino announced that Elizabeth Anderson Nix is its new general manager, the first member of the tribe and the first woman to hold the role.

“I am extremely honored and humbled to accept the leadership role of general manager,” Nix said.

For over 30 years, Nix has been a noteworthy tribal leader in the gaming industry.

She is an enrolled tribal member of the Robinson Rancheria Band of Pomo Indians and began her career at Robinson Rancheria Resort & Casino as a blackjack dealer in 1993.

By 2005, she became the table games manager and would remain in that role for six years before taking positions at Running Creek in Lake County and Graton Resort Casino in Sonoma County.

After four years of working in other resort properties, Nix returned home to Robinson Rancheria Resort & Casino as the director of table games in 2015.

She continued her climb to the top of the leadership hierarchy and became the director of gaming operations in 2018 before being recently promoted to general manager.

In its announcement on her hire, the casino’s leadership said Nix’s table games expertise allowed Robinson Rancheria Resort & Casino to maintain its dominant position as Lake County’s premier casino in California.

Under her direction, a new smoking slot lounge has been added to the bingo room to provide another environment for players who smoke.

The smoking room is less than 10% of the total gaming space at the casino resort, which allows it to provide clean air for the nonsmokers without any interference, the casino’s announcement explained.

“As a tribal member of the Robinson Rancheria Band of Pomo Indians it’s incredibly important to me as a stakeholder, but also as a leader, to step up and help lead this organization in a direction that will provide long-term viability and sustain economic development for our tribe,” said Nix.

LAKE COUNTY, Calif. — With the official canvass of the March 5 primary election due to be completed next week, the Lake County Registrar of Voters issued an update on its progress to wrap up the final ballot count.

The elections office said that a total of 4,499 ballots remain to be counted. That’s about 600 fewer ballots than the total count given a week ago.

This latest total count includes 4,189 vote-by-mail ballots, 266 provisional/conditional ballots, and 44 vote-by-mail ballots that require further review for various reasons.

Once the 28-day canvass is completed, then the primary results will be considered final and official, the elections office reported.

A new law that went into effect this year, AB 63, requires that the elections office update vote results and unprocessed ballot counts at least once per week and post the updated information on its website.

For more information, visit the Lake County Registrar of Voters website or call 707-263-2372 OR toll-free at 888-235-6730.

On Tuesday, Rep. Mike Thompson (CA-04) and Rep. Mike Levin (CA-49) led a letter signed by 16 members of the California Congressional delegation to California Public Utilities Commission President Alice Busching Reynolds expressing their concerns over high fixed charge proposals under consideration in the CPUC’s Income Graduated Fixed Charge, or IGFC, proceedings.

As utility bills continue to rise in California, Reps. Levin and Thompson, and their colleagues asked the CPUC to avoid implementing a high fixed charge that could impede progress on our climate goals or increase electricity costs for low-and middle- income families.

A fixed charge is a fixed fee that ratepayers will have to pay every month, regardless of how much electricity they use or try to conserve.

“We are concerned that a high fixed charge could undercut investments in renewable energy and energy efficiency that Congress intended to encourage with the Inflation Reduction Act,” explained the letter. “We are further concerned that a high fixed charge could increase the electricity bills of millions of Californians, especially those who live in small homes, condos and apartments. Such setbacks could harm our progress on federal and state clean energy, climate, and equity goals.

“Congress passed the Inflation Reduction Act to make electrification, energy efficiency improvements, and distributed energy resources more affordable for Americans. These measures will help to bring down utility bills, lower greenhouse gas emissions, and combat climate change,” the letter continued. “We are concerned that imposing a high fixed charge could make it substantially more difficult for families to realize cost savings from electrifying their homes, improving their energy efficiency, or installing distributed energy resources such as rooftop solar.”

The full letter is below.


Dear Commissioner Reynolds,

We write to express concern about the Income Graduated Fixed Charge (IGFC) proceeding at the California Public Utilities Commission (CPUC). We are concerned that a high fixed charge could undercut investments in renewable energy and energy efficiency that Congress intended to encourage with the Inflation Reduction Act. We are further concerned that a high fixed charge could increase the electricity bills of millions of Californians, especially those who live in small homes, condos and apartments. Such setbacks could harm our progress on federal and state clean energy, climate, and equity goals.

Proponents of the IGFC rightly state that electricity bills are quickly becoming a major burden on household incomes. However, we worry that their proposed solution – to impose a high monthly fixed charge regardless of how much electricity households use – is not the best tool to keep costs down and meet our climate goals.

California has long been a leader in energy efficiency and conservation measures. Known as the Rosenfeld curve, California’s per capita electricity consumption has stayed nearly flat since the 1970s thanks to these efforts. Imposing a high fixed charge may undercut these decades of progress by forcing people to pay their utility company before they even turn on the light switch.

Congress passed the Inflation Reduction Act to make electrification, energy efficiency improvements, and distributed energy resources more affordable for Americans. These measures will help to bring down utility bills, lower greenhouse gas emissions, and combat climate change. We are concerned that imposing a high fixed charge could make it substantially more difficult for families to realize cost savings from electrifying their homes, improving their energy efficiency, or installing distributed energy resources such as rooftop solar.

Proponents of the IGFC claim that a high fixed charge will accelerate electrification. However, we are concerned that these proposals may slow, not hasten, the fight against climate change. Modeling has found that proposals before the CPUC could lead to greater adoption of high-efficiency gas appliances instead of electrification, like electric vehicles and heat pumps, that we desperately need to decarbonize our grid.

Proponents of the IGFC also claim that it will reduce the overall electric bills of lower-income families and that it will reduce the cost of each unit of electricity. However, it could also impose the highest monthly fixed charges in the United States—fees that customers would have to pay regardless of their energy usage. The current average monthly fixed charge across U.S. investor-owned utilities is $11 per month. Proposals under consideration include monthly fixed charges as high as $128 for some families. Even $33 per month would distinguish California as having a monthly fixed charge three times the national average. And there is little to stop utilities from continuing to increase electric rates once they secure the highest fixed charges in the country.

Many lower- and middle-class Californians would see their overall bills increase under a high fixed charge proposal. For example, under the Joint Investor-Owned Utilities’ proposal, a single parent with one child living in a small apartment in the expensive San Diego area earning just $40,000 per year would be forced to pay a new fixed charge of $73 each month—regardless of how much they try to reduce their energy usage. This person could be one of the millions of Californians unduly harmed by this proposal.

We believe that a policy change of this magnitude requires thorough vetting and analysis. We urge the CPUC to ensure that any proposal it ultimately pursues neither inadvertently and disproportionately increases energy costs for low- and middle-income California families, nor slows down our efforts to address climate change through energy efficiency, conservation, or distributed energy resources. We encourage the Commission to fully consider any alternatives to lower California’s unacceptably high electric bills and reduce the energy burdens of low-income families, fixed-income seniors, and those who do their part to conserve electricity, while keeping in line with our climate goals.

Thank you for your consideration of our concerns.

On Tuesday, U.S. Rep. Jared Huffman (CA-02) and Adam Schiff (CA-30) introduced the Tribal Community Protection Act, legislation to address the crisis of Missing and Murdered Indigenous People, or MMIP, on tribal lands by encouraging record sharing between tribal and state/local law enforcement.

Of the missing persons included in the National Missing and Unidentified Persons System, or NamUs, 3.5% were identified as American Indian and Alaska Native — more than three times their percentage of the U.S. population.

Complicated jurisdictional overlaps between federal, state, local and tribal law enforcement agencies exacerbate the problem.

“The tragedy of Missing and Murdered Indigenous People is an epidemic, and jurisdictional red tape and communication breakdowns fuel this crisis. Tribes in my district have been putting in the hard work to protect their people and lead on this issue — by which I am tremendously proud of and inspired — but they can’t do it alone,” said Rep. Huffman. “My bill with Rep. Schiff will help bridge the gap between tribes and local law enforcement so they can work together to keep tribal communities safe.”

“The violence facing our Indigenous communities, particularly women and girls, is a crisis we cannot ignore,” said Rep. Schiff. “With the complex nature of government-to-government relationships, sometimes this violence against women and Indigenous people can fall through the cracks, or lead to delays and inaction. Our bill aims to bridge this gap by promoting cooperation and information sharing between tribal, state, and local law enforcement agencies. This will not only save lives but also help keep our tribal communities safe and ensure that those who break the law are held to account.”

“Tribal communities continue to face the crisis of missing and murdered Indigenous people every day. Common sense reforms to support and prevent the disappearance of our people from their communities are vital to help end this crisis. Rep. Schiff’s and Rep. Huffman's bill is one of those common sense solutions which promotes information sharing between states and localities with Tribes. The National Indian Health Board is proud to support this bill which works to address the ongoing crisis of our missing and murdered Indigenous people,” said Chief William Smith, chairman of the National Indian Health Board.

The Tribal Community Protection Act would create a funding incentive through Byrne Justice Assistance Grants to states and localities that both submit written notification to tribes about restraining orders and temporary restraining orders so that they can be enforced by tribal law enforcement on tribal land, and accept and enforce tribal restraining orders and temporary restraining orders, in turn.

The Tribal Community Protection Act is supported by the National Congress of American Indians, National Council of Urban Indian Health, National Indian Health Board, National Indigenous Women’s Resource Center, and the Strong Hearted Native Women’s Coalition.

The Tribal Community Protection Act is co-sponsored by Representatives Adriano Espaillat (NY-13), Raul Ruiz (CA-25), Gwen Moore (WI-04), Andrea Salinas (OR-06), Julia Brownley (CA-26), Joyce Beatty (OH-03) and Dina Titus (NV-01).

LAKE COUNTY, Calif. — A Lake County highway improvement project has received millions of dollars, part of a nearly $1 billion allocation approved this week by the California Transportation Commission.

Caltrans will spend approximately $930 million over the next four years to improve bicycle and pedestrian infrastructure throughout the state, according to a plan the California Transportation Commission approved.

This includes 265 miles of new and improved bike lanes on state highways and the addition of more than 1,300 safety elements by mid-2028.

The latest allocations include nearly $375 million from the federal Infrastructure Investment and Jobs Act of 2021 (IIJA) and $276 million via Senate Bill 1 (SB 1), the Road Repair and Accountability Act of 2017.

The California Transportation Commission also approved a series of transportation projects totaling approximately $1 billion in continuing a historic push to improve the vital transportation infrastructure through rural and urban projects throughout the state.

Those allocations include approximately $3.9 million for the construction of a left-turn lane and other roadway improvements on Highway 29 from south of Bottle Rock Road to north of Cole Creek Road near Kelseyville.

“The future of transportation relies on offering increased options for everybody, including better paths for walking and infrastructure for biking,” Caltrans Director Tony Tavares said. “These investments will help us build a California that fits every traveler, including those on foot, on bicycles, and on other personal mobility devices.”

The bicycle and pedestrian infrastructure spending plan is part of the 2024 State Highway Operation and Protection Program, or SHOPP.

Funding over the next four years will improve access and safety for bicyclists and pedestrians using the state highway system.

Of the 265 new and improved bike lanes, 203 miles are a combination of Class 1, 2 and 4 variety, and 62 miles are designated Class 3. Safety elements featured in the plan include more visible and separated bike lanes, ADA-accessible curb ramps, better signage, and upgraded signalization.

The following projects are among those that will focus on improvements in bicycle and pedestrian infrastructure:

A $36 million project in Imperial County on State Routes 115, 111 and 86 to fix existing sidewalks and add new sidewalks, Class II bike lanes, and Class IV separated bikeways. Improvements include ADA curb ramp upgrades, lighting systems, traffic signal system upgrades, and overhead sign structure rehabilitation.

A $19.6 million project on the Pacific Coast Highway (SR-1) in Santa Cruz County to repair 8.3 miles of pavement, guardrail, crosswalks, sign panels, and Class II bike lanes. This project includes new bike guide striping and enhanced signage. The finished product will all be brought up to the standards of the Americans with Disabilities Act (ADA).

In addition to Lake County’s project, the latest CTC-approved projects include:

Approximately $1.1 million in SB1 funding in support of allocations toward pavement repair, guardrail and ADA curb ramp upgrades and other roadway improvements on U.S. 101 from Route 1 to the Humboldt County Line at various locations near Leggett, Piercy and Cooks Valley in Mendocino County.

Approximately $10.4 million in emergency allocations toward the removal of slide material and hazardous trees, roadway repairs and the construction of rockfall barriers on U.S. 199 from Hiouchi to the Oregon State Line in Del Norte County following a series of wildfires that started on Aug. 15, 2023.

Approximately $3.2 million in emergency allocations toward debris removal, slide repair and rockfall mitigation and erosion control on U.S. 101 from north of Wilson Creek Road to south of Crescent City in Del Norte County.

Approximately $1.7 million including more than $1.5 million in federal IIJA funding in support allocations toward roadway safety improvements on U.S. 199 from the Middle Fork Smith River Bridge to near Gasquet in Del Norte County.

Approximately $1.4 million in support of allocations toward the construction of ADA curb ramps and sidewalks, retaining walls and roadway and culvert improvements on Route 1 in Fort Bragg from the Pudding Creek Bridge to Route 20 in Mendocino County.

Approximately $1.3 million in support of allocations toward the construction of a left-turn lane, install lighting and other roadway improvements on U.S. 101 from the Rowdy Creek Bridge to north of Fred Haight Drive near Smith River in Del Norte County.

IIJA, known as the “Bipartisan Infrastructure Law,” is a once-in-a-generation investment in our nation's infrastructure to improve the sustainability and resiliency of our energy, water, broadband and transportation systems. Since 2021, California has received nearly $38 billion in IIJA funds, including more than $27.6 billion for transportation-related projects.

In addition, SB 1 provides $5 billion in transportation funding each year that is shared between state and local agencies. Road projects progress through construction phases more quickly based on the availability of SB 1 funds, including those partially funded by SB 1.

Visit this website for more information about California transportation projects funded by IIJA and SB 1.

NORTHERN CALIFORNIA — Cal Fire helicopter pilots and crews will be conducting training exercises using night vision goggles, enhancing their ability to protect communities during any hour.

Residents near Lake Berryessa and Indian Valley Reservoir can expect to see low-flying Cal Fire helicopters operating from dusk until midnight Monday, March 25, through Friday, March 29.

These flights are crucial for ensuring Cal Fire crews are prepared and proficient, especially during critical nighttime hours when visibility is reduced.

Pilots will practice maneuvers like water drops, while crews will sharpen their navigation and communication skills.

What to expect:

• Residents may see and hear low-flying Cal Fire helicopters during the training periods.
• The aircraft will be operating with Federal Aviation Administration approval and will adhere to all safety regulations.
• While there is potential for increased noise levels, Cal Fire is committed to minimizing disruption to the community.

Why night training matters:

• Wildfires can occur at any time of day, and CAL FIRE helicopter crews need to respond effectively regardless of lighting conditions.
• Night training allows pilots and crews to practice in conditions that closely resemble real-world emergencies.
• Regular training exercises ensure the safety of both firefighters and the communities they serve.

Cal Fire appreciates the understanding and cooperation of the community as they conduct this important training exercise.

Learn more about the Cal Fire Aviation Program here.

Redwood Region Resilient Inclusive Sustainable Economy, or RISE, has officially been awarded $14 million in Catalyst pre-development funding.

As one of the 13 “California Jobs First” regions — and especially as a rural region comprising Tribal Lands and Del Norte, Humboldt, Lake and Mendocino counties — the Catalyst funding will help bridge the gap between planning and implementing regional economic development strategies and investments.

RISE said these funds will enable the Redwood Region to develop ready-to-go projects that can compete for funding opportunities from federal, state, and private sources.

The news came earlier this month when Gov. Gavin Newsom announced the $182 million Catalyst Funds awards to jumpstart the Regional Investment Initiative, or RII, and the creation of a California Jobs First Council and operational plan focused on streamlining the state’s economic and workforce development programs “to create more quality jobs, faster.”

The council and operational plan intend to guide the state’s investments in economic and workforce development to create more family-supporting jobs and prioritize industry sectors for future growth.

“For rural and under-capitalized regions like ours, getting projects ready for implementation is often held up by the expense and workload of the pre-development phase. After a year of figuring out our planning and governance structure for Redwood Region RISE, this next phase will be where the rubber hits the road and we start to move some funding to those projects that will have the best chance to receive implementation funds from the state, or that will be attractive to other funding agencies,” said Susan Seaman, program director for the Arcata Economic Development Corp., RISE’s fiscal agent.

The awarded $14 million Catalyst funds include up to $2 million for Collaborative’s operations, up to $1.5 million towards sector investment coordinators, up to $1.5 million towards grant administration and compliance, and — arguably most importantly — up to $9 million for project pre-development activities.

It is important to note that Redwood Region RISE still needs to contract with the state before these funds are available. The Employment Development Department expects these contracts to be executed around May, after which these funds will be available to reach communities in the Redwood Region.

A 10-year grassroots vision

California Jobs First’s Regional Investment Initiative is a $600 million state-wide program designed to promote a sustainable and equitable recovery from the economic distress of COVID-19.

Redwood Region RISE is one of the 13 Regional Collaboratives in the state working together to bring good, quality jobs to the region — tribal lands and Del Norte, Humboldt, Lake and Mendocino counties.

In its efforts, RISE said it is actively centering the experiences and empowering voices of the priority communities that don't always participate in or benefit from economic development planning processes.

The collaborative — a broad coalition of close to a thousand community members and organizations — is working together to surface local and regional needs and opportunities through dedicated tribal, local, and sector planning tables, an equity council and a community-endorsed voting member block.

RISE currently is midway through its planning phase, at the end of which, in September, they will present a 10-year strategic vision that identifies regional investments to make a positive impact on and create good job opportunities for communities, ensure sustainable economic growth (diversifying economies), and get us closer to California’s goals for a carbon-neutral future.

How can you get involved?

The public is invited to join the public collaborative Zoom meetings every last Thursday of the month between 11 a.m. and 12:30 p.m. These gatherings are a great way to stay informed on Redwood Region RISE's progress, dive into key research findings for our region through its Data Walks, and share your knowledge and feedback with the group. To learn more and join these meetings, visit the RISE website.

If you have a project idea you think will make a difference for communities in our region, make sure to log it in the Project Inventory Form.

For more information, email ccrp@humboldt.edu.

The California Center for Rural Policy at Cal Poly Humboldt serves as Redwood Region RISE’s Regional Convener, North Coast Opportunities and True North Organizing Network are community engagement and outreach partners, and the Arcata Economic Development Corp. is the fiscal agent.

For more information, visit the Redwood RISE website.

 

The care at Landmark of Louisville Rehabilitation and Nursing was abysmal when state inspectors filed their survey report of the Kentucky facility on July 3, 2021.

Residents wandered the halls in a facility that can house up to 250 people, yelling at each other and stealing blankets. One resident beat a roommate with a stick, causing bruising and skin tears. Another was found in bed with a broken finger and a bloody forehead gash. That person was allowed to roam and enter the beds of other residents. In another case, there was sexual touching in the dayroom between residents, according to the report.

Meals were served from filthy meal carts on plastic foam trays, and residents struggled to cut their food with dull plastic cutlery. Broken tiles lined showers, and a mysterious black gunk marred the floors. The director of housekeeping reported that the dining room was unsanitary. Overall, there was a critical lack of training, staff and supervision.

The inspectors tagged Landmark as deficient in 29 areas, including six that put residents in immediate jeopardy of serious harm and three where actual harm was found. The issues were so severe that the government slapped Landmark with a fine of over US$319,000 − more than 29 times the average for a nursing home in 2021 − and suspended payments to the home from federal Medicaid and Medicare funds.

Persistent problems

But problems persisted. Five months later, inspectors levied six additional deficiencies of immediate jeopardy − the highest level − including more sexual abuse among residents and a certified nursing assistant pushing someone down, bruising the person’s back and hip.

Landmark is just one of the 58 facilities run by parent company Infinity Healthcare Management across five states. The government issued penalties to the company almost 4½ times the national average, according to bimonthly data that the Centers for Medicare & Medicaid Services first started to make available in late 2022. All told, Infinity paid nearly $10 million in fines since 2021, the highest among nursing home chains with fewer than 100 facilities.

Infinity Healthcare Management and its executives did not respond to multiple requests for comment.

Such sanctions are nothing new for Infinity or other for-profit nursing home chains that have dominated an industry long known for cutting corners in pursuit of profits for private owners. But this race to the bottom to extract profits is accelerating despite demands by government officials, health care experts and advocacy groups to protect the nation’s most vulnerable citizens.

To uncover the reasons why, The Conversation’s investigative unit Inquiry delved into the nursing home industry, where for-profit facilities make up more than 72% of the nation’s nearly 14,900 facilities. The probe, which paired an academic expert with an investigative reporter, used the most recent government data on ownership, facility information and penalties, combined with CMS data on affiliated entities for nursing homes.

The investigation revealed an industry that places a premium on cost cutting and big profits, with low staffing and poor quality, often to the detriment of patient well-being. Operating under weak and poorly enforced regulations with financially insignificant penalties, the for-profit sector fosters an environment where corners are frequently cut, compromising the quality of care and endangering patient health. Meanwhile, owners make the facilities look less profitable by siphoning money from the homes through byzantine networks of interconnected corporations. Federal regulators have neglected the problem as each year likely billions of dollars are funneled out of nursing homes through related parties and into owners’ pockets.

More trouble at midsize

Analyzing newly released government data, our investigation found that these problems are most pronounced in nursing homes like Infinity − midsize chains that operate between 11 and 100 facilities. This subsection of the industry has higher average fines per home, lower overall quality ratings, and are more likely to be tagged with resident abuse compared with both the larger and smaller networks. Indeed, while such chains account for about 39% of all facilities, they operate 11 of the 15 most-fined facilities.

With few impediments, private investors who own the midsize chains have quietly swooped in to purchase underperforming homes, expanding their holdings even further as larger chains divest and close facilities. As a result of the industry’s churn of facility ownership, over one fifth of the country’s nursing facilities changed ownership between 2016 and 2021, four times more changes than hospitals.

A 2023 report by Good Jobs First, a nonprofit watchdog, noted that a dozen of these chains in the midsize range have doubled or tripled in size while racking up fines averaging over $100,000 per facility since 2018. But unlike the large, multistate chains with easily recognizable names, the midsize networks slip through without the same level of public scrutiny, The Conversation’s investigations unit found.

“They are really bad, but the names − we don’t know these names,” said Toby Edelman, senior policy attorney with the Center for Medicare Advocacy, a nonprofit law organization.

“When we used to have those multistate chains, the facilities all had the same name, so you know what the quality is you’re getting,” she said. “It’s not that good − but at least you know what you’re getting.”

In response to The Conversation’s findings on nursing homes and request for an interview, a CMS spokesperson emailed a statement that said the CMS is “unwavering in its commitment to improve safety and quality of care for the more than 1.2 million residents receiving care in Medicare- and Medicaid-certified nursing homes.”

The statement pointed to data released by the oversight body on mergers, acquisitions, consolidations and changes of ownership in April 2023 along with additional ownership data released the following September. CMS also proposed a rule change that aims to increase transparency in nursing home ownership by collecting more information on facility owners and their affiliations.

“Our focus is on advancing implementable solutions that promote safe, high-quality care for residents and consider the challenging circumstances some long-term care facilities face,” the statement reads. “We believe the proposed requirements are achievable and necessary.”

CMS is slated to implement the disclosure rules in the fall and release the new data to the public later this year.

“We support transparency and accountability,” the American Health Care Association/National Center for Assisted Living, a trade organization representing the nursing home industry, wrote in response to The Conversation‘s request for comment. “But neither ownership nor line items on a budget sheet prove whether a nursing home is committed to its residents. Over the decades, we’ve found that strong organizations tend to have supportive and trusted leadership as well as a staff culture that empowers frontline caregivers to think critically and solve problems. These characteristics are not unique to a specific type or size of provider.”

It often takes years to improve a poor nursing home − or run one into the ground. The analysis of midsize chains shows that most owners have been associated with their current facilities for less than eight years, making it difficult to separate operators who have taken long-term investments in resident care from those who are looking to quickly extract money and resources before closing them down or moving on. These chains control roughly 41% of nursing home beds in the U.S., according to CMS’s provider data, making the lack of transparency especially ripe for abuse.

A churn of nursing home purchases even during the COVID-19 pandemic shows that investors view the sector as highly profitable, especially when staffing costs are kept low and fines for poor care can easily be covered by the money extracted from residents, their families and taxpayers.

“This is the model of their care: They come in, they understaff and they make their money,” said Sam Brooks, director of public policy at the Consumer Voice, a national resident advocacy organization. “Then they multiply it over a series of different facilities.”

Investor race

The explosion of a billion-dollar private marketplace found its beginnings in government spending.

The adoption of Medicare and Medicaid in 1965 set loose a race among investors to load up on nursing homes, with a surge in for-profit homes gaining momentum because of a reliable stream of government payouts. By 1972, a mere seven years after the inception of the programs, a whopping 106 companies had rushed to Wall Street to sell shares in nursing home companies. And little wonder: They pulled in profits through their ownership of 18% of the industry’s beds, securing about a third of the hefty $3.2 billion of government cash.

The 1990s saw substantial expansion in for-profit nursing home chains, marked by a wave of acquisitions and mergers. At the same time, increasing difficulties emerged in the model for publicly traded chains. Shareholders increasingly demanded rapid growth, and researchers have found that the publicly traded chains tried to appease that hunger by reducing nursing staff and cutting corners on other measures meant to improve quality and safety.

“I began to suspect a possibly inherent contradiction between publicly traded and other large investor-operated nursing home companies and the prerequisites for quality care,” Paul R. Willging, former chief lobbyist for the industry, wrote in a 2007 letter to the editor of The New York Times. “For many investors … earnings growth, quarter after quarter, is often paramount. Long-term investments in quality can work at cross purposes with a mandate for an unending progression of favorable earnings reports.”

One example of that clash can be found at the Ensign Group, founded in 1999 as a private chain of five facilities. Using a strategy of acquiring struggling nursing homes, the company went public in 2007 with more than 60 facilities. What followed was a year-after-year acquisition binge and a track record of growing profits almost every year. Yet the company kept staffing levels below the national average and levels recommended by experts. Its facilities had higher than average inspection deficiencies and higher COVID infection rates. Since 2021, it has racked up more than $6.5 million in penalties.

Ensign did not respond to requests for comment.

Even with that kind of expense cutting, not all publicly traded nursing homes survived as the costs of providing poor care added up. Residents sued over mistreatment. Legal fees and settlements ate into profits, shareholders grumbled, and executives searched for a way out of this Catch-22.

Recognizing the long-term potential for profit growth, private investors snapped up publicly traded for-profit chains, reducing the previous levels of public transparency and oversight. Between 2000 and 2017, 1,674 nursing homes were acquired by private-equity firms in 128 unique deals out of 18,485 facilities. But the same poor-quality problems persisted. Research shows that after snagging a big chain, private investors tended to follow the same playbook: They rebrand the company, increase corporate control and dump unprofitable homes to other investment groups willing to take shortcuts for profit.

Multiple academic studies show the results, highlighting the lower staffing and quality in for-profit homes compared with nonprofits and government-run facilities. Elderly residents staying long term in nursing homes owned by private investment groups experienced a significant uptick in trips to the emergency department and hospitalizations between 2013 and 2017, translating into higher costs for Medicare.

Overall, private-equity investors wreak havoc on nursing homes, slashing registered nurse hours per resident day by 12%, outpacing other for-profit facilities. The aftermath is grim, with a daunting 14% surge in the deficiency score index, a standardized metric for determining issues with facilities, according to a U.S. Department of Health and Human Services report.

The human toll comes in death and suffering. A study updated in 2023 by the National Bureau of Economic Research calculated that 22,500 additional deaths over a 12-year span were attributable to private-equity ownership, equating to about 172,400 lost life years. The calculations also showed that private-equity ownership was responsible for a 6.2% reduction in mobility, an 8.5% increase in ulcer development and a 10.5% uptick in pain intensity.

Hiding in complexity

Exposing the identities of who should be held responsible for such anguish poses a formidable task. Private investors in nursing home chains often employ a convoluted system of limited liability corporations, related companies and family relationships to obscure who controls the nursing homes.

These adjustments are crafted to minimize liability, capitalize on favorable tax policies, diminish regulatory scrutiny and disguise nursing home profitability. In this investigation, entities at every level of involvement with a nursing home denied ownership, even though the same people controlled each organization.

A rule put in place in 2023 by the Centers for Medicare & Medicaid Services requires the identification of all private-equity and real estate investment trust investors in a facility and the release of all related party names. But this hasn’t been enough to surface the players and relationships. More than half of ownership data provided to CMS is incomplete across all facilities, according to a March 2024 analysis of the newly released data.

Even the land under the nursing home is often owned by someone else. In 2021, publicly traded or private real estate investment trusts held a sizable chunk of the approximately $120 billion of nursing home real estate. As with homes owned by private-equity investors, quality measures collapse after REITs get involved, with facilities witnessing a 7% decline in registered nurses’ hours per resident day and an alarming 14% ascent in the deficiency score index. It’s a blatant pattern of disruption, leaving facilities and care standards in a dire state.

Part of that quality collapse comes from the way these investment entities make their money. REITs and their owners can drain cash out of the nursing homes in a number of different ways. The standard tactic for grabbing the money is known as a triple-net lease, where the REIT buys the property then leases it back to the nursing home, often at exorbitant rates. Although the nursing home then lacks possession of the property, it still gets slammed with costs typically shouldered by an owner − real estate taxes, insurance, maintenance and more. Topping it off, the facilities then must typically pay annual rent hikes.

A second tactic that REITs use involves a contracting façade that serves no purpose other than enriching the owners of the trusts. Since triple-net lease agreements prohibit REITs from taking profits from operating the facilities, the investors create a subsidiary to get past that hurdle. The subsidiary then contracts with a nursing home operator − often owned or controlled by another related party − and then demands a fee for providing operational guidance. The use of REITs for near-risk-free profits from nursing homes has proven to be an ever-growing technique, and the midsize chains, which our investigation found generally provided the worst care, grew in their reliance on REITs during the pandemic.

“When these REITs start coming in … nursing homes are saddled with these enormous rents, and then they wind up going out of business,” said Richard Mollot, executive director of the Long-Term Care Community Coalition, a nonprofit organization that advocates for better care at nursing homes. “It’s no longer a viable facility.”

The churn of nursing home purchases by midsize chains underscores investors’ perception of the sector’s profitability, particularly when staffing expenses are minimized and penalties for subpar care can be offset by money extracted through related transactions and payments from residents, their families and taxpayers. Lawsuits can drag out over years, and in the worst case, if a facility is forced to close, its land and other assets can be sold to minimize the financial loss.

Take Brius Healthcare, a name that resonates with a disturbing cadence in the world of nursing home ownership. A search of the federal database for nursing home ownership and penalties shows that Brius was responsible for 32 facilities as of the start of 2024, but the true number is closer to 80, according to BriusWatch.org, which tracks violations. At the helm of this still midsize network stands Shlomo Rechnitz, who became a billionaire in part by siphoning from government payments to his facilities scattered across California, according to a federal and state lawsuit.

In lawsuits and regulators’ criticisms, Rechnitz’s homes have been associated with tales of abuse, as well as several lawsuits alleging terrible care. The track record was so bad that, in the summer of 2014, then-California Attorney General Kamala Harris filed an emergency motion to block Rechnitz from acquiring 19 facilities, writing that he was “a serial violator of rules within the skilled nursing industry” and was “not qualified to assume such an important role.”

Yet, Rechnitz’s empire in California surged forward, scooping up more facilities that drained hundreds of millions of federal and state funds as they racked up pain and profit. The narrative played out at Windsor Redding Care Center in Redding, California. Rechnitz bought it from a competing nursing home chain and attempted to obtain a license to operate the facility. But in 2016, the California Department of Public Health refused the application, citing a staggering 265 federal regulatory violations across his other nursing homes over just three years.

According to court filings, Rechnitz formed a joint venture with other investors who in turn held the license. Rechnitz, through the Brius joint venture, became the unlicensed owner and operator of Windsor Redding.

Brius carved away at expenses, slashing staff and other care necessities, according to a 2022 California lawsuit. One resident was left to sit in her urine and feces for hours at a time. Overwhelmed staff often did not respond to her call light, so once she instead climbed out of bed unassisted, fell and fractured her hip. Other negligence led to pressure ulcers, and when she was finally transferred to a hospital, she was suffering from sepsis. She was not alone in her suffering. Numerous other residents experienced an unrelenting litany of injuries and illnesses, including pressure ulcers, urinary tract infections from poor hygiene, falls, and skin damage from excess moisture, according to the lawsuit.

In 2023, California moved forward with licensing two dozen of Rechnitz’s facilities with an agreement that included a two-year monitoring period, right before statewide reforms were set to take effect. The reforms don’t prevent existing owners like Rechnitz from continuing to run a nursing home without a license, but they do prevent new operators from doing so.

“We’re seeing more of that, I think, where you have a proliferation of really bad operators that keep being provided homes,” said Brooks, the director of public policy at the Consumer Voice. “There’s just so much money to be made here for unscrupulous people, and it just happens all the time.”

Rechnitz did not respond to multiple requests for comment. Bruis also did not respond.

Perhaps no other chain showcases the havoc that can be caused by one individual’s acquisition of multiple nursing homes than Skyline Health Care. The company’s owner, Joseph Schwartz, parlayed the sale of his insurance business into ownership of 90 facilities between mid-2016 and December 2017, according to a federal indictment. He ran the company out of an office above a New Jersey pizzeria and at its peak managed facilities in 11 states.

Schwartz went all-in on cost cutting, and by early 2018, residents were suffering from the shortage of staff. The company wasn’t paying its bills or its workers. More than a dozen lawsuits piled up. Last year, Schwartz was arrested and faced charges in federal district court in New Jersey for his role in a $38 million payroll tax scheme. In 2024, Schwartz pleaded guilty to his role in the fraud scheme. He is awaiting sentencing, where he faces a year in prison along with paying at least $5 million in restitution.

Skyline collapsed and disrupted thousands of lives. Some states took over facilities; others closed, forcing residents to relocate and throwing families into chaos. The case also highlights the ease with which some bad operators can snap up nursing homes with little difficulty, with federal and state governments allowing ownership changes with little or no review.

Schwartz’s lawyer did not respond to requests for comment.

Not that nursing homes have much to fear in the public perception of their reputation for quality. CMS uses what is known as the Five-Star Quality Rating System, designed to help consumers compare nursing homes to find one that provides good care. Theoretically, nursing homes with five-star ratings are supposed to be exceptional, while those with one-star ratings are deemed the worst. But research shows that nursing homes can game the system, with the result that a top star rating might reflect little more than a facility’s willingness to cheat.

A star rating is composed of three parts: The score from a government inspection and the facility’s self-reports of staffing and quality. This means that what the nursing homes say about themselves can boost the star rating of facilities even if they have poor inspection results.

Multiple studies have highlighted a concerning trend: Some nursing homes, especially for-profit ones, inflate their self-reported measures, resulting in a disconnect from actual inspection findings. Notably, research suggests that for-profit nursing homes, driven by significant financial motives, are more likely to engage in this practice of inflating their self-reported assessments.

At bottom, the elderly and their families seeking quality care unknowingly find themselves in an impossible situation with for-profit nursing homes: Those facilities tend to provide the worst quality, and the only measure available for consumers to determine where they will be treated well can be rigged. The result is the transformation of an industry meant to care for the most vulnerable into a profit-driven circus.

The pandemic

Nothing more clearly exposed the problems rampant in nursing homes than the pandemic. Throughout that time, nursing homes reported that almost 2 million residents had infections and 170,000 died.

No one should have been surprised by the mass death in nursing homes − the warning signs of what was to come had been visible for years. Between 2013 and 2017, infection control was the most frequently cited deficiency in nursing homes, with 40% of facilities cited each year and 82% cited at least once in the five-year period. Almost half were cited over multiple consecutive years for these deficiencies − if fixed, one of the big causes of the widespread transmission of COVID in these facilities would have been eliminated.

But shortly after coming into office in 2017, the Trump administration weakened what was already a deteriorating system to regulate nursing homes. The administration directed regulators to issue one-time fines against nursing homes for violations of federal rules rather than for the full time they were out of compliance. This shift meant that even nursing homes with severe infractions lasting weeks were exempted from fines surpassing the maximum per-instance penalty of $20,965.

Even that near-worthless level of regulation was not feeble enough for the industry, so lobbyists pressed for less. In response, just a few months before COVID emerged in China, the Trump administration implemented new regulations that effectively abolished a mandate for each to hire a full-time infection control expert, instead recommending outside consultants for the job.

The perfect storm had been reached, with no experts required to be on site, prepared to combat any infection outbreaks. On Jan. 20, 2020 − just 186 days after the change in rules on infection control − the CDC reported that the first laboratory-confirmed case of COVID had been found at a nursing home in Washington state.

The least prepared in this explosion of disease were the for-profit nursing homes, compared with nonprofit and government facilities. Research from the University of California at San Francisco found those facilities were linked to higher numbers of COVID cases. For-profits not only had fewer nurses on staff but also high numbers of infection-control deficiencies and lower compliance with health regulations.

Even as the United States went through the crisis, some owners of midsize chains continued snapping up nursing homes. For example, two Brooklyn businessmen named Simcha Hyman and Naftali Zanziper were going on a nursing home buying spree through their private-equity company, the Portopiccolo Group. Despite poor ratings in their previously owned facilities, nothing blocked the acquisitions.

One such facility was a struggling nursing home in North Carolina now known as The Citadel Salisbury. Following the traditional pattern forged by private investors in the industry, the new owners set up a convoluted network of business entities and then used them to charge the nursing home for services and property. A 2021 federal lawsuit of many plaintiffs claimed that they deliberately kept the facility understaffed and undersupplied to maximize profit.

Within months of the first case of COVID reported in America, The Citadel Salisbury experienced the largest nursing home outbreak in the state. The situation was so dire that on April 20, 2020, the local medical director of the emergency room took to the local newspaper to express his distress, revealing that he had pressed the facility’s leadership and the local health department to address the known shortcomings.

The situation was “a blueprint for exactly what not to do in a crisis,” medical director John Bream wrote. “Patients died at the Citadel without family members being notified. Families were denied the ability to have one last meaningful interaction with their family. Employees were wrongly denied personal protective equipment. There has been no transparency.”

After a series of scathing inspection reports, the facility finally closed in the spring of 2022. As for the federal lawsuit, court documents show that a tentative agreement was reached in 2023. But the case dragged out for nearly three years, and one of the plaintiffs, Sybil Rummage, died while seeking accountability through the court.

Still, the pandemic had been a time of great success for Hyman and Zanziper. At the end of 2020, they owned more than 70 facilities. By 2021, their portfolio had exploded to more than 120. Now, according to data from the Centers for Medicare & Medicaid Services, Hyman and Zanziper are associated with at least 131 facilities and have the highest amount of total fines recorded by the agency for affiliated entities, totaling nearly $12 million since 2021. And their average fine per facility, as calculated by CMS, is more than twice the national average at almost $90,000.

In a written statement, Portopiccolo Group spokesperson John Collins disputed that the facilities had skimped on care and argued that they were not managed by the firm. “We hire experienced, local health care teams who are in charge of making all on-the-ground decisions and are committed to putting residents first.” He added that the number of facilities given by CMS was inaccurate but declined to say how many are connected to its network of affiliates or owned by Hyman and Zanziper.

With the nearly 170,000 resident deaths from COVID and many related fatalities from isolation and neglect in nursing homes, in February 2022 President Biden announced an initiative aimed at improving the industry. In addition to promising to set a minimum staffing standard, the initiative is focused on improving ownership and financial transparency.

“As Wall Street firms take over more nursing homes, quality in those homes has gone down and costs have gone up. That ends on my watch,” Biden said during his 2022 State of the Union address. “Medicare is going to set higher standards for nursing homes and make sure your loved ones get the care they deserve and expect.”

Still, the current trajectory of actions appears to fall short of what’s needed. While penalties against facilities have sharply increased under Biden, some of the Trump administration’s weak regulations have not been replaced.

A rule proposed by CMS in September 2023 and released for review in March 2024 would require states to report what percentage of Medicaid funding is used to pay direct care workers and support staff and would require an RN on duty 24/7. It would also require a minimum of three hours of skilled staffing care per patient per day. But the three-hour minimum is substantially lower than the 4.1 hours of skilled staffing for nursing home residents suggested by CMS over two decades ago.

The requirements are also lower than the 3.8 average nursing staff hours already employed by U.S. facilities.

The current administration has also let stand the Trump administration reversal of an Obama rule that banned binding arbitration agreements in nursing homes.

It breaks a village

The Villages of Orleans Health and Rehabilitation Center in Albion, New York, was, by any reasonable measure, broken. Court records show that on some days there was no nurse and no medication for the more than 100 elderly residents. Underpaid staff spent their own cash for soap to keep residents clean. At times, the home didn’t feed its frail occupants.

Meanwhile, according to a 2022 lawsuit filed by the New York attorney general, riches were siphoned out of the nursing home and into the pockets of the official owner, Bernard Fuchs, as well as assorted friends, business associates and family. The lawsuit says $18.7 million flowed from the facility to entities owned by a group of men who controlled the Village’s operations.

Although these men own various nursing homes, Medicare records show few connections between them, despite them all being investors in Comprehensive Healthcare Management, which provided administrative services to the Villages. Either they or their families were also owners of Telegraph Realty, which leased what was once the Villages’ own property back to the facility at rates the New York attorney general deemed exorbitant, predatory and a sham.

So it goes in the world of nursing home ownership, where overlapping entities and investors obscure the interrelationships between them to such a degree that Medicare itself is never quite sure who owns what.

Glenn Jones, a lawyer representing Comprehensive Healthcare Management, declined to comment on the pending litigation, but he forwarded a court document his law firm filed that labels the allegations brought by the New York attorney general “unfounded” and reliant on “a mere fraction” of its residents.

The shadowy structure of ownership and related party transactions plays an enormous role in how investors enrich themselves, even as the nursing homes they control struggle financially. Compounding the issue, the figures reported by nursing homes regarding payments to related parties frequently diverge from the disclosures made by the related parties themselves.

As an illustration of the problems, consider Pruitt Health, a midsize chain with 87 nursing homes spread across Georgia, South Carolina, North Carolina and Florida that had low overall federal quality ratings and about $2 million in penalties. A report by The National Consumer Voice For Quality Long-Term Care, a consumer advocacy group, shows that Pruitt disclosed general related party costs nearing $482 million from 2018 to 2020. Yet in that same time frame, Pruitt reported payments to specific related parties amounting to about $570 million, indicating a $90 million excess. Its federal disclosures offer no explanation for the discrepancy. Meanwhile, the company reported $77 million in overall losses on its homes.

The same pattern holds in the major chains such as the Cleveland, Tennessee-based Life Care Centers of America, which operates roughly 200 nursing homes across 27 states, according to the report. Life Care’s financial disbursements are fed into a diverse spectrum of related entities, including management, staffing, insurance and therapy companies, all firmly under the umbrella of the organization’s ownership. In fiscal year 2018, the financial commitment to these affiliated entities reached $386,449,502; over the three-year period from 2018 to 2020, Life Care’s documented payments to such parties hit an eye-popping $1.25 billion.

Pruitt Health and Life Care Centers did not respond to requests for comment.

Overall, 77% of US nursing homes reported $11 billion in related-party transactions in 2019 − nearly 10% of total net revenues − but the data is unaudited and unverified. The facilities are not required to provide any details of what specific services were provided by the related parties, or what were the specific profits and administrative costs, creating a lack of transparency regarding expenses that are ambiguously categorized under generic labels such as “maintenance.” Significantly, there is no mandate to disclose whether any of these costs exceed fair market value.

What that means is that nursing home owners can profit handsomely through related parties even if their facilities are being hit with repeated fines for providing substandard care.

“What we would consider to be a big penalty really doesn’t matter because there’s so much money coming in,” said Mollot of the Long-Term Care Community Coalition. “If the facility fails, so what? It doesn’t matter. They pulled out the resources.’’

Hiding profit

Ultimately, experts say, this ability to drain cash out of nursing homes makes it almost impossible for anyone to assess the profitability of these facilities based on their public financial filings, known as cost reports.

"The profit margins (for nursing homes) also should be taken with a grain of salt in the cost reports,” said Dr. R. Tamara Konetzka, a University of Chicago professor of public health sciences, at a recent meeting of the Medicare Payment Advisory Commission. “If you sell the real estate to a REIT or to some other entity, and you pay sort of inflated rent back to make your profit margins look lower, and then you recoup that profit because it’s a related party, we’re not going to find that in the cost reports.”

That ability to hide profits is key to nursing homes’ ability to block regulations to improve quality of care and to demand greater government payments. For decades, the industry’s refrain has been that cuts in reimbursements or requirements to increase staffing will drive facilities into bankruptcy; already, they claim, half of all nursing homes are teetering on the edge of collapse, the result, they say, of inadequate Medicaid rates. All in all, the industry reports that less than 3% of their revenue goes to earnings.

But that does not include any of the revenue pulled out of the homes to boost profits of related parties controlled by the same owners pleading poverty. And this tactic is only one of several ways that the nursing home industry disguises its true profits, giving it the power to plead poverty to an unknowing government.

Under the regulations, only certain nursing home expenses are reimbursable, such as money spent for care. Many others − unreasonable payments to the headquarters of chains, luxury items, and fees for lobbyists and lawyers − are disallowed after Medicare reviews the cost reports. But by that time, the government has already reimbursed the nursing homes for those expenses − and none of those revenues have to be returned.

Data indicates that owners also profit by overcharging nursing homes for services and leases provided by related entities. A March 2024 study from Lehigh University and the University of California, Los Angeles shows that costs were inflated when nursing home owners changed from independent contractors to businesses owned or controlled directly or indirectly by the same people. Overall, spending on real estate increased 20.4%, and spending on management increased 24.6% when the businesses were affiliated, the research showed.

Nursing homes also claim that noncash depreciation cuts into their profits. Those expenses, which show up only in accounting ledgers, assume that assets such as equipment and facilities are gradually decreasing in value and ultimately will need to be replaced.

That might be reasonable if the chains purchased new items once their value depreciated to zero, but that is not always true. A 2004 report by the Medicare Payment Advisory Commission found that the depreciation claimed by health care companies, including nursing homes, may not reflect actual capital expenditures or the actual market value.

If disallowed expenses and noncash depreciation were not included, profit margins for the nursing home industry would jump to 8.8%, far more than the 3% it claims. And given that these numbers all come from nursing home cost reports submitted to the government, they may underestimate the profits even more. Audited cost reports are not required, and the Government Accountability Office has found that CMS does little to ensure the numbers are correct and complete.

This lack of basic oversight essentially gives dishonest nursing home owners the power to grab more money from Medicare and Medicaid while being empowered to claim that their financials prove they need more.

“They face no repercussions,” Brooks of Consumer Voice said, commenting on the current state of nursing home operations and their unscrupulous owners. “That’s why these people are here. It’s a bonanza to them.”

Ultimately, experts say, finding ways to force nursing homes to provide quality care has remained elusive. Michael Gelder, former senior health policy adviser to then-Gov. Pat Quinn of Illinois, learned that brutal lesson in 2010 as head of a task force formed by Quinn to investigate nursing home quality. That group successfully pushed a new law, but Gelder now says his success failed to protect this country’s most vulnerable citizens.

“I was perhaps naively convinced that someone like myself being in the right place at the right time with enough resources could really fix this problem,” he said. “I think we did the absolute best we could, and the best that had ever been done in modern history up to that point. But it wasn’t enough. It’s a battle every generation has to fight.”

Click to learn more about how some existing tools can address problems with for-profit nursing homes.

Sean Campbell, Investigative journalist, The Conversation and Charlene Harrington, Professor Emeritus of Social Behavioral Sciences, University of California, San Francisco

This article is republished from The Conversation under a Creative Commons license. Read the original article.

KELSEYVILLE, Calif. — The California Highway Patrol’s Clear Lake Area office has welcomed another new officer.

Officer Adilene Sanchez joined the Clear Lake Area office earlier this month following her graduation from the CHP Academy in West Sacramento on Friday, March 8.

Sanchez was part of a 108-member class whose members graduated and were sworn in following 26 weeks of intensive training.

“Officer Sanchez will receive extensive in-field training with experienced officers for approximately four months,” the CHP’s Clear Lake Area office reported. “Lake County is a unique area, different than larger metropolitan areas, with its unique landscape and rural roadways that will test this officer’s skills. Our ultimate goal is to get all newly promoted officers ready to face the challenges they will encounter on a day-to-day basis so they can provide the highest level of Safety, Service, and Security to the people of California.”

Sanchez, who comes from Salinas, is the Clear Lake Area office’s second female officer currently in its ranks.

She joins Officer Jessica Lee, who started here last November, said Sgt. Joel Skeen.

The CHP is hiring. More information can be found at www.chpmadeformore.com.

Email Elizabeth Larson at elarson@lakeconews.com. Follow her on Twitter, @ERLarson, or Lake County News, @LakeCoNews.