For most people, the term human trafficking conjures up images of ethnic young people controlled by sleazy handlers who buy and sell them for sex or labor. We might hear about human trafficking ring leaders that have been arrested and sentenced to long prison terms for their heinous acts.
There’s another practice of human trafficking that goes largely ignored even though it happens daily, sometimes right under our noses. The traffickers don’t hide from the law because the law is either on their side, as in the case of guardianship and conservatorship abuse, or because, even when these offenders are caught, the human trafficking component is ignored by authorities. I’m talking about the use and abuse of our elderly who are sought out for their Medicare/Medicaid dollars. Their predators are doctors, nursing home corporations, hospitals, and long-term care pharmacies.
The schemes are all fairly similar. You need an unscrupulous doctor who is willing to admit patients into hospitals, order unnecessary tests, transfer them to a nursing home, and write prescriptions for as many pharmaceuticals as their poor bodies can manage. Authorities uncovered one such scheme in Chicago. The players were Dr. Roland Borrasi, Rabbi Morris and Philip Esformes, corrupt father/son nursing home corporation operators, an Illinois psychiatric hospital, and two acute care hospitals. The Chicago Tribune covered this human brokering scheme which you can read here and here.
The Esformes, Dr. Borrasi, and hospital administrators colluded to shuttle patients among their facilities for the purpose of filling their beds and maximizing Medicare reimbursements. Hospital administrators paid Borrasi to admit elderly nursing home residents into hospitals for costly, unnecessary tests and treatments. In turn, Borrasi paid Morris Esformes for the use of his nursing home residents. One of Borrasi’s associates alleged he was with Borrasi in March 2001 when Esformes called and told Borrasi to admit at least five nursing home patients to various hospitals. Borrasi did so without question. Borrasi was recorded by federal agents as he spoke to a fellow doctor in his practice, “Basically, I have a commodity; my commodity is nursing home patients.”
In 2010, Borrasi was sentenced to 6 years in a Kentucky federal prison. Today he resides in a RRM (Residential Reentry Management) facility in Chicago with a scheduled release date of June 7, 2014. According to the Illinois Dept. of Financial &Professional Regulation, Borrasi’s physician and controlled substance licenses were suspended in May, 2010 “due to convictions of conspiracy and offering and receiving bribes, related to patient referrals.” What happens if he applies for reinstatement?
The Esformes were named in the scheme, denied any involvement, and, as in the past, escaped without charges. In 2005, Rabbi Esformes played the religion card when he was facing charges of abuse and neglect for abominable conditions in his Chicago nursing homes. He said of city and state officials, “Beside the fact that they’re anti-mental health and anti-black, they’re probably anti-Jew because I’m an ordained rabbi.” Oy vey.
Last August, facing a jury trial, the Esformes agreed to pay $5 million to the Justice Department to settle charges of a pharmacy sale kickback scheme with Omnicare. Omnicare had already paid their fine. Once again, the Esformes are free to move forward with nothing more than a wrist slap and a fine that, for them, is simply the cost of doing business. They continue full participation with our Medicare/Medicaid programs. Despicable.
The Esformes own EMI Enterprises which, according to Bloomberg Business, owns and operates nursing homes, retirement centers, and assisted living facilities in Illinois and Florida. The company is based in Lincolnwood, Illinois. Their facilities have a long history of poor care and serious deficiencies.
We’ll never know how many nursing home residents were abused at the hands of these vile people. We know about an elderly woman who was sent from one of their nursing homes to a psychiatric hospital because she refused to go to the facility dining room to eat her dinner. I wonder how much Esformes got for her. We know about the elderly man with dementia who Borrasi sent to a participating hospital to undergo inappropriate brain radiation treatments. But what about all the ones who suffered that we don’t know about? How many people were left with no quality of life because they were filled with antipsychotic drugs? How many old people spent days confused and afraid as they were shifted from facility to facility, pawns in this shell game run by a group of health professionals who profited from these healthcare atrocities? How many people died from this horrific arrangement of moving and drugging and gratuitous procedures? This scheme went on for years and elderly patients were shuffled around like pieces on a chess board.
Understanding that what they did was wrong and feeling outraged is a cakewalk. The more difficult task it accepting the lack of punishment for these crimes. Why weren’t the perpetrators charged with human trafficking and elder abuse along with charges of fraud? They all deserved harsh prison sentences, monetary penalties, and suspensions from any future dealings with our Medicare system to ensure they couldn’t repeat their crimes. To this day, after years of providing shoddy care, Morris Esformes enjoys the fruits of his abuses.
This scheme wasn’t the first of its kind and it certainly will not be the last. Until our public health officials ban providers who abuse our citizens or defraud our system, our elderly and vulnerable citizens can expect much more abuse in the future and we can expect to see our public health dollars funnel into the dirty pockets of the abusers.