How a Long Island Nursing Home Empire Got Its Way
By Michael Amon and Ridgely Ochs
Sept. 23, 2007 p.A4 to A8
Faced with a crisis over complaints about its treatment of Filipino nurses, Long Island nursing home group SentosaCare turned for help last year to a friendly politician it had supported in the past — Sen. Charles Schumer.
The Democratic senator then wrote four letters over the course of two months to Philippine government officials, including President Gloria Macapagal-Arroyo. They asked the officials to meet with SentosaCare’s executives or to “consider reviewing” the Woodmere company’s case after the country suspended the company’s affiliated recruitment operation. Macapagal-Arroyo’s former chief of staff said the Schumer letters were unprecedented.
Shortly after two Schumer letters sent the same day, the Philippine government lifted the suspension. SentosaCare’s Filipino recruitment pipeline was back in business. Over the next two months, a national campaign fund headed by Schumer received nearly $75,000 from investors, attorneys and vendors for SentosaCare-affiliated nursing homes.
The involvement of New York’s senior senator triggered a storm of controversy 8,500 miles away in the Philippines that also has reached Long Island. Amid the dispute, Suffolk County District Attorney Thomas Spota agreed to meet in private with SentosaCare’s principals and their lawyer. They asked him to investigate the 10 nurses at a Smithtown nursing home who were among 26 who prompted the uproar when they resigned abruptly from SentosaCare facilities in New York City and Long Island.
An investigation followed immediately, and 10 months later the Smithtown nurses were charged for endangering patients when they quit without notice. The indictment is apparently the first of its kind in the state.
The results of its appeals to Schumer and Spota illustrate the ready access to power enjoyed by SentosaCare, which has quietly emerged as the largest for-profit nursing home group in the state. More than one in seven nursing home beds on Long Island are at SentosaCare facilities.
In the last decade, its executives, investors and subcontractors have donated more than $750,000 to political campaign funds for both major parties. More than $198,000 of the largesse went to Schumer’s re-election campaign and the Democratic Senatorial Campaign Committee — led by Schumer and credited with restoring Democratic control of the Senate after the 2006 mid-term elections.
Howard Fensterman, SentosaCare’s chief attorney, is Schumer’s Long Island finance chairman and a top fundraiser for the Democratic Senatorial Campaign Committee, chaired by Schumer. Fensterman, along with the SentosaCare executives he represents, said they had supported Schumer for years, well before he acted on their behalf.
The senator’s role in the Philippines episode began in April 2006, shortly after 26 Filipino nurses and a physical therapist resigned en masse from five SentosaCare facilities in New York City and Long Island. Many complained they had contracted with one nursing home only to be assigned to another, and disputes over pay, benefits and hours were routine. They filed formal complaints in Washington and the Philippines.
The Philippines suspended Sentosa Recruitment Agency — a Manila-area company that finds nurses for SentosaCare facilities — on May 24, 2006, to prevent further “exploitation,” according to the suspension order. The order was lifted without a hearing on June 8, 2006, six days after Schumer wrote to the two Filipino labor officials responsible for the action, Philippine records show. Normally, officials said, companies are suspended for months as investigations and hearings are conducted.
This month, the Philippines dismissed the nurses’ complaints for “utter lack of merit.” The nurses are appealing, but Fensterman said the decision was “vindication” for SentosaCare.
Just trying to help
Schumer said his letters were a natural product of his ongoing efforts to assist health care companies as they address the nationwide shortage of nurses. The letters had “no connection whatsoever” to political donations made by SentosaCare’s executives, he said, and they did not ask for the suspension to be lifted, only that the matter be examined closely.
“The letters simply ask for due process for a New York company,” Schumer said. “There are many times that a company will call us up and say a foreign country is treating it unfairly. I regard it as part of my job to help New York companies.”
He also said the letters were handled “on a staff level” — though Fensterman said Schumer asked detailed questions about the issue at a meeting in Washington, D.C., last year about a week before the June 27 letter to Arroyo.
Schumer’s actions struck at least one expert in campaign finance as unusual.
“Members of Congress certainly write letters for constituents all the time. I think the difference here is they don’t always write letters to foreign governments, and they don’t always try to intervene in the way he did,” said Bill Allison, a senior fellow at the Sunlight Foundation, a Washington, D.C., group that pushes for open government. “It’s very difficult to say … but whenever you have a big contributor and a member working on their behalf, it does raise questions. Members are supposed to be open to everyone. The question is, is he going to these lengths for people who don’t have money?”
Schumer’s letters became front page news in the Philippines. A political furor erupted when Senate Minority Leader Aquilino Pimentel last September charged that the Philippine president’s chief of staff, Michael Defensor, had intervened on Sentosa Recruitment Agency’s behalf following Schumer’s letter.
Support for nurses
Filipino immigrant groups and lawmakers have rallied behind the 26 nurses and a physical therapist who quit with them. They have dubbed them the “Sentosa 27,” demanded investigations of Schumer’s involvement and called for the suspension’s reinstatement.
“The bottom line is, [the government] felt the pressure from the senator who wrote the letter,” said Ellene Sana, executive director of the Center for Migrant Advocacy, a Manila group that helped the nurses file their complaints. “The case was not decided on the basis of the issues.”
SentosaCare officials said Schumer’s letters had nothing to do with the $74,480 contributed in the months after Schumer’s letters by their network of nursing homes and subcontractors to the Democratic Senatorial Campaign Committee, which raised $120 million for the 2006 elections.
“To suggest that a check was given to Chuck Schumer to get him to do something is inappropriate and flies in the face of the facts,” Fensterman said. The group had given Schumer’s 2004 re-election and the Democratic Senatorial Campaign Committee a total of $123,816 before he wrote the letters, records show.
Since the lifting of the suspension, the nurses’ cause has suffered more setbacks. Last month, an office in the U.S. Justice Department declined to bring a discrimination lawsuit on their behalf before an administrative immigration court. The nurses have decided to file the action with the court themselves.
Still unresolved is the March 2007 indictment in Suffolk County. A grand jury charged 10 of them with endangering the welfare of children, saying that their mass resignation caused a staffing crisis at Avalon Gardens Rehabilitation and Health Care Center in Smithtown and put at risk the lives of chronically ill children.
James Druker, the nurses’ defense attorney in the criminal case, said SentosaCare’s political contacts will play a central role in the Suffolk trial because its owners asked for the charges in a meeting last year with District Attorney Thomas Spota, who had received $1,500 in campaign donations from Fensterman.
Robert Clifford, a Spota spokesman, said the district attorney meets personally with “all kinds of people” about investigations and pursues their concerns fairly without regard to political donations.
Having their ear
Long before it called on Schumer last year, SentosaCare had a reputation as a company that elected officials listen to, if for no other reason than sheer size, health care industry observers said. Its two owners — Benjamin Landa of Brooklyn and Bent Philipson of upstate Monsey — control 25 nursing homes in New York, 10 on Long Island. More than 22 percent of Nassau County’s 7,777 nursing home beds are in SentosaCare facilities, according to the Health Department. The group is smaller in Suffolk, accounting for 6 percent of 8,657 beds.
“You have to reckon with them because they’re so big,” said Neil Heyman, president of the Southern New York Association, a group that represents 64 downstate nursing homes, not including SentosaCare facilities.
Landa, 51, a former Pataki Administration appointee, has donated $64,500 to candidates of both major parties. Philipson, 41, is a Danish national and former garment industry executive. Several times a year, the nursing homes’ investors, attorneys and subcontractors contribute campaign money to a bipartisan group of politicians in Washington, Albany, New York City and Long Island, campaign finance records show. The checks are usually delivered on the same date, a time-honored practice that allows the recipient to easily track sources of support.
Fensterman, 54, a Lake Success attorney and an owner of a SentosaCare nursing home in Great Neck, is a leading fundraiser for Schumer and other Democrats, including Nassau County Executive Thomas Suozzi and Attorney General Andrew Cuomo. (Last week, Cuomo stopped accepting donations from Fensterman because of his ties to a Landa-owned company under state investigation.)
He is chairman of the Nassau Industrial Development Agency, which awards millions each year in tax breaks, leases and bond issues to local businesses. No SentosaCare projects have received Nassau IDA assistance. He also sits on a committee that chooses Democratic judicial candidates. Schumer named Fensterman as his Long Island finance chairman in 2001.
After that appointment, Schumer began to stage press conferences on elder care issues at Fensterman’s nursing home, Grace Plaza Rehabilitation and Health Care Center. In 2003, the senator spoke to Fensterman’s nursing home clients about regulatory issues at a private seminar.
“His involvement in the political process has resulted in Mr. Fensterman’s having forged special relationships with several U.S. senators, congresspersons, state senators and assembly persons,” read his official biography on the Web site of his law firm, Abrams, Fensterman, Fensterman, Eisman, Greenberg, Formato and Einiger. The paragraph was removed this summer.
Mark Zafrin, a lawyer at Fensterman’s firm who worked on SentosaCare issues, has suggested privately that those “special relationships” have tangible benefits.
Court records show that in June 2004, Zafrin responded by e-mail to a question from Helen Webster, a business partner of Landa’s who wanted “creative advice” on how to obtain an expedited Medicaid provider ID number for a clinic she and Landa were starting in Queens. Such ID numbers are necessary for businesses to be reimbursed by the government.
“You can also accelerate the Medicaid process by paying us to use our contacts with the Senators to do so,” Zafrin wrote in the e-mail. The e-mail is disclosed in a lawsuit over business disputes between Webster and Landa, who are no longer friendly.
Zafrin did not return phone calls. It wasn’t clear which “senators” he was referring to or whether they were state or U.S. senators. Such numbers are given out by the state Department of Health. SentosaCare’s owners have donated to a number of state senators, all of whom denied helping with provider numbers. Jeffrey Hammond, Health Department spokesman, said every applicant for a Medicaid ID number must go through the same process.
Asked about the e-mail, Fensterman said: “I don’t know what Mark was alluding to by saying that.”
As Landa and Philipson’s nursing home business grew, they ran into a problem facing the entire industry: how to staff the wards during a chronic nursing shortage. United States’ nursing schools do not graduate enough nurses to fulfill the demand nationwide.
“We needed to find another source for nurses before we were enveloped in a crisis of coverage,” said Landa, who would respond only in writing to interview questions.
They turned to the Philippines, where nurses are educated in English and renowned for their skills.
From start to struggle
In May 2002, Sentosa Recruitment Agency was founded in Manila by a Filipino nurse at one of Landa’s nursing homes. It has since recruited 364 Filipino nurses for SentosaCare facilities, helping them obtain green cards, pass New York state exams and flying them to New York, all at no charge.
But its operations — and those of all recruiters — hit a snag in late 2004 and early 2005, when the Philippines found it had exhausted its quota for EB-3 visas, which the U.S. awards to foreign, skilled workers to work here. Several groups of nurses bound for New York suddenly found their future in limbo.
With Sens. Edward Kennedy (D-Mass.) and Kay Bailey Hutchison (R-Texas), Schumer inserted language into the 2005 Emergency Supplemental Appropriations Act for Defense, the Global War on Terror, and Tsunami Relief allowing the Philippines, China and India to use up to 50,000 visas unused by other countries.
The next year, the nurses issue took center stage. Complaining about working conditions and what they regarded as discriminatory treatment, 26 Filipino nurses and a physical therapist resigned from five SentosaCare nursing homes on April 6, 7 and 8 of 2006.
They held a press conference in front of the office of Philippine Consul General Cecilia Rebong in Manhattan and said they were not paid overtime, did not get medical benefits and were not working at the nursing homes with which they had signed contracts. SentosaCare said the allegations were untrue.
Fensterman, who said the Philippine consul general was wrongly taking sides, then asked a Schumer staff member if the senator would write a letter on SentosaCare’s behalf. He said that he called upon Schumer just as the nurses sought help from their government officials, including the consul general in New York.
“He was someone of sufficient stature who if he wrote a letter, it would be viewed with seriousness,” Fensterman said.
On April 25, 2006, Schumer wrote to Rebong and asked her to meet with Landa and Philipson about the nurses. The meeting took place May 3 in New York but little was resolved, Fensterman said.
Then, on May 24, 2006, the Philippine Overseas Employment Administration suspended Sentosa Recruitment Agency’s license and opened an investigation into the nurses’ complaints.
“We have reasonable ground to believe that their continued operations will lead to further violation or exploitation of the Filipino workers being recruited,” the suspension states.
Again, SentosaCare turned to Schumer. Fensterman said calls were made to the senator’s office, asking for another letter to be written.
The senator soon signed his name to two letters addressed to Patricia Tomas, secretary of the Philippine Department of Labor and Employment, and Rosalinda Dimapilis-Baldoz, the administrator of the Philippine Overseas Employment Administration.
“I respectfully request that you consider reviewing the situation between SentosaCare and those employees who have come through the Sentosa Recruitment Agency, and to take any actions that you consider appropriate,” Schumer wrote on June 2, 2006.
An unusual occurrence
The letters worked their way through bureaucratic channels all the way to the office of Philippine President Gloria Macapagal-Arroyo, said Michael Defensor, then the president’s chief of staff.
“That was the first time I got a letter like that,” said Defensor, who is now out of government.
In response, Defensor said, he called Dimapilis-Baldoz.
“It was not a hi-hello-how-are-you phone call,” Dimapilis-Baldoz said.
She said Defensor told her that there were many Filipino nurses awaiting visas with SentosaCare and, if the company’s recruitment agency was suspended, they could not go to the United States. He also said she needed to conduct a more thorough investigation before suspending a company.
“If she’s going to suspend them, she has to say, on the basis of what?” Defensor said. “I was just giving her guidance.”
On June 8, Dimapilis-Baldoz — in a move she said was rare — lifted the suspension against Sentosa Recruitment Agency after the company filed a brief outlining its position that it treated the nurses fairly.
She said she did not consider Schumer’s letter in her decision. However, she said she probably would not have acted so quickly had Defensor not called her. She said she lifted the suspension based on “the records of the case. To do otherwise, that would make a mockery of the process.”
Even after their apparent victory, Fensterman said, “There was a tremendous amount of political activity and media activity in the Philippines, and it was very negative.” Philipson hired a public relations firm there, and the company tried unsuccessfully to set up a meeting with President Macapagal-Arroyo.
Fensterman then arranged in late June for Philipson and Landa to meet with Schumer in Washington.
Schumer said the nursing home owners met with his staff, and he only chatted with them briefly. “I poked my head in, and [Fensterman] may have said, ‘Thanks for sending the letters. I hope your staff will follow up.'” He described the encounter as “very, very short.”
Fensterman has a different recollection.
He said he offered a detailed review to Schumer of the situation involving the nurses and expressed the concern that “all we had built and worked so hard to achieve over the years … was being placed in jeopardy unfairly,” Fensterman said. He said Schumer asked several questions and agreed to write a fourth letter.
On June 27, 2006, a letter from Schumer’s office went to the Philippines’ president.
“I respectfully request that you schedule the meeting with Messrs. Philipson, Landa and Fensterman and to take any actions that you consider appropriate,” Schumer wrote. “Thank you for your kind consideration.”
The meeting never occurred.
Meanwhile, Fensterman said he was fundraising for Schumer, though he said his efforts had nothing to do with the letters.
SentosaCare’s investors, lawyers and business partners had given generously in the past, starting with a modest $3,500 in 2001 and going up to $51,916 in 2005 to the Senate campaign committee in the month after Schumer was named chairman. In the first half of 2006, the company’s owners, investors and attorneys had contributed $14,000 to that campaign committee.
After the letters, they wrote more and bigger checks. On July 25, 2006, as the mid-term election campaigns heated up for Democratic senate candidates across the nation, another round of checks began rolling in to the committee.
On four separate days over the next three weeks, the SentosaCare group would write to the campaign committee 26 checks totalling $74,480.
Daniel Massey contributed to this report.