My father passed away as a direct result of neglect. The real price of forprofit health care. Good evening, thanks for joining us, im joie chen. The great concern for all of us who have had to make health care statisticians for us that weve made the wrong one. Case in point, Skilled Nursing homes, most are run by for profit companies, more than 15,000 Nursing Homes but theres also increasing evidence that the priority for these types of facilities isnt always on the vulnerable patient. And as america tonights michael okwu found in his investigation the outcome can be deadly. Reporter Robert Pineda was a free spirit, an accountant by training pineda favored pickup trucks, enjoyed training and at age 50 decided to take up acting and landed a number of pictures including all the pretty horses with matt damon. Thats you in the middle. Me in the middle. Daughter lucette said uncle bob had swag before we even knew what swag was. That was my father. Reporter after falling and breaking a kneecap in 2012, the 68yearold pineda wound up at the nursing home for three or four weeks of rehabilitation. I was naive enough that if i was there every day nothing would happen to my dad. Two weeks after her father received at the facility, she received a phone call. They were transporting my father to the local emergency room. On the telephone, they sounded like this was not urgent. Reporter but it was. Pineda had a stage 4 bed sore it had penetrated through to internal tissue and became infected. What was your feeling . I was angry, disappointed, i felt internally what could i have done, could i have done something more . Reporter what lucero didnt know, others were also finding the care at casa real astoundingly indifferent. Six Nursing Homes in the state all of them owned by preferred Care Partners. The attorney generals complaint allegation Staffing Levels were kept dangerously low to maximize profits while residents suffered. This lawsuit is about better protecting the most vulnerable populations and secondly this is about bringing justice for taxpayers involving hundreds of millions of public dollars that were squandered in these facilities. Reporter among the allegations residents were left in soiled clothes or beds. Often for hours at a time. Suffered unnecessary falls. Because requests for help went unanswered. Went hungry and lost weight because not enough nurse assistants were scheduled to help them eat. One resident choked to death allegedly because his food was not pureed as required. There was an incredible amount of suffering due to inadequate care. Dr. Why did you get into this business . Tracy worked as Staff Development coordinator at one of the facilities raised in the complaint. She raised the issue and left because it wasnt addressed. Developed pressure sources over a sores over a good portion of her body. Her teeth were not brushed. People called for help, no one answered. Prizing to you. No. Ill give you another one. A registered nurse, working the 3 p. M. To midnight solicit, said there wasnt enough time the reposition the residents, doing range of motion exercises that the residents needed and falls were common. The company ceo was notified nothing was done. Surprising . No. You try the get to as much as you can on your shift and its not always possible to do everything. Its just not. Youre somebody who cares about this clearly. Its a calling for you. What do you think, when you hear these allegations . It makes me sick. It makes me sick that thats what happens to our elderly population. New mexicos suit against preferred Care Partners the Nursing Homes previous partner Cathedral Rock corporation and the seven Nursing Homes, comes as academics are concerned that the forprofit Nursing Homes are putting the bottom line first. Were these companies putting profits ahead of care . We believe they were. As you look at the care plans they didnt meet their duty to provide adequate care. We believe its a model that favors profits over people. The Kaiser Family foundation in may found for profit Nursing Homes nationally were twice as likely as nonprofits to receive only one or two stars in medicares five star rating seam. Meaning they were system meaning they were twice as likely to be below average or much below average. The way the Nursing Homes make money on the forprofit side is by understaffing. Professor emeritus at the university of california san francisco. Shes researched Nursing Homes and found for profits have lower staffing and many more serious deficiency than nonprofits. They are less likely to put in quad rn staffing. And rns are the most important part of the nursing home staffing because theyre the ones that can assess residents they provide the treatments, they do the planning and the care management. So if you dont have enough of them youre going to have all kinds of quality problems. Reporter at the seven facilities in new mexico america tonight found registered nurses, rns, spend 35 minutes per resident, per day. According to documents filed with medicare. Thats below average, also average twice as many health deficiencies. In your opinion often do profits come first and the residents come second . Of course. Its a forprofit business. Its no different than any other business. They want to make a profit. Except there is sort of a moral component to this business. Absolutely. Because you talk about care. You talk about actual human beings and care. Somebodys mother and father and uncle. They dont see the residents day to day. They dont is interact with them, they rely on other people the do that. Theyre up in their offices and thats what theyre looking at is financial statements. Theres enough profit out there, even if you staff adequately, it can be done but nobody does it though. In a statement the company said preferred Care Partners stands by the care it provides to new mexicos frail earlly and the compassionate staff who consider Long Term Care an honorable profession. Robert pineda never returned home from the hospital, he died of renal failure caused by infection. After four more surgeries, tracheotomy, colostomy bag, kidney dialysis, intubation, you name it, we were given the talk by the doctors, now his breathing is 100 supported by the ventilator. What was your fathers health before this episode with casa real . My father was a type 2 diabetic. My father passed away as a direct result of the bed sore that was received from the neglect at casa real for the 14 days that he was there. That is why my fathers death. Suzette says her mission now is to keep his memory alive. America tonights michael okwu joins us now. Michael, such a heartbreaking story about mr. Pineda, nothing going to bring him back but if this lawsuit does find these Nursing Homes liable, whats the penalty . Well, joie, the government paid for these residents through medicare and medicaid, up to 250 a day with the understanding that these residents would actually receive care. You heard it. The new Mexico Attorney general says that these Nursing Homes did not provide that care. So hes essentially arguing that they repay the money and that damages and penalties be assessed. This case is just getting started. Were still very early but all told we could be looking at millions of dollars at least. So michael we know that medicare does penalize hospitals if they are found at substandard care, that is if theyve been committing some flaws and faults theres a penalty in that they get reimbursed at a lower rate. Does the same apply to these Nursing Homes . Reporter oh thats a great question and the answer might be surprising to people. The fact is that right now there is absolutely no financial incentive oprovide the best care. Thats because to provide the best care thats because the government essentially pays each one of these Nursing Homes the same amount of money whether youre a onestar facility or a fivestar facility. That is just appalling. America tonights michael okwu for us thanks. Next, a health risk in the community, new evidence and old fears about the industry in their midst. Later an oregon ranchers last stand. Personally im not for sale im not for sale. Chances are youre going to lose this battle. No question about it. Why keep fighting it. Live on my knees or die on my feet. America tonights adam may on the pipelines path. And is it highway robbery . How Law Enforcement can seize cars cash and tonight we fastforward to one towns struggle with its own riches and the Energy Industrys plans to cash in. Pennsylvania sits amid a gusher of wealth but one that has driven the traditional residents away. We found one of the last holdouts in green county. Scottish highland cattle graze on grasses and leafy greens. In green county in the very southwestern corner of pennsylvania. Brown says its a great time to be selling organic beef. Theres much more demand than i can supply. You might wonder why shes put her farm up on the market. How much is it on sale for . 449. 3800 square foot house that is also a b and b and 45 acres, a pond, a wood barn, i mean so its a beautiful place. But brown is selling. Because she worries it wont stay a beautiful place. Her farm is sandwiched between a proposed coal operation and natural gas drilling. Green countys lush hills conceal a wealth of energy riches below. A confluence of appalachian coal and the marcellu srveg lus shale. Youre getting it from both sides. Oh yes, down there and up there. Here is a long wall mine outside waynesburg, the county seat, natural gas inaugurations installations dot the hill tops. Growing enough of patients that have cardiovascular studies. Does not confirm a direct link but a possible connection between machines used to extract natural gas and oil. Next in the path of trouble. A ranchers fight to save his land as the community aims to saver its economy. And another attempt to rebuild thursday on america tonight. Correspondent lori jane gliha, returns to ferguson. Theres a line of police advancing toward the crowd here. Ferguson city under siege. It isnt easy to talk openly on this base. And americas war workers. Its human trafficking. Watch these and other episodes online now at aljazeera. Com faultlines. Judge before the break we spoke of Health Worries in communities dominated by the Energy Industry and thats just one face off. Increasingly, Natural Gas Industry for one expects to build 450,000 miles of pipeline in the united states, over the next 20 years. To do that, it will need land. And lots of it. America tonights adam may in oregon now on the communities in the way. After decades of grew igrueling hard work, bill gows work came true. On an Oregon Mountain top he raised his family here and hes ready to hand the reins over to his son. But the gow and is in dictate of a takeover by a company that wants to build a 35 inch pipeline. If i cut a scar across your cheek how much would that change you . There will be a 100 foot swath right through there. Can you imagine what a scar that will be . No trees . No buildings no nothing. Reporter gow proudly took us on a tour of his beef ranch. All i wanted to be was a beef rancher that was my dream. When i came here i didnt have two pieces bleep put together. I added more ground more ground more ground. Reporter today he has 2300 acres, from his ridge you can see where the pacific connector pipeline would cut through peaks and valleys. Okay its going to go down this road right here down this ridge. Reporter along the pipelines 230 mile route a 100 foot corridor of trees along the entire length of the pipeline will be torn out. Nothing not even a barn or shed can be built along the path. The Pipeline Company williams has been after this land for about a decade. How would you describe these past years dealing with the pipeline. What it really reminds me of a girl being stalked. A guy bothering her, all the time, she told him shes not interested but he wont take no for an answer. What have they done . They offered me 14,000 to go through two miles of my property. Thats an insult to my intelligence. Its a take it or leave it deal. Not like i have a choice. This is a deal when you deal with these appliance, they have a power of Eminent Domain. Reporter Eminent Domain has been controversial ever since the founding of america. Despite protections for Property Rights guaranteed in the fifth and 14th amendments, Numerous Supreme Court rulings have upheld the governments right to take private property if theres a benefit to the public. And the compensation is just. But many Property Owners here fail to see how anyone but williams pipeline and its canadian partner will benefit. Eminent domain was set out for a good reason. It was to, for the betterment of everybody. It was for public need and necessity. Theres no public need and necessity for this project. Foreign investors are going to make a ton of money and nothing for american people. Sending our gas overseas to the pacific rim countries instead of keeping it here to use for our own economy. Williams pipeline declined to speak to america tonight on camera but on a statement said the potential bfs benefit is the abilities to protect Large Manufacturing companies and other businesses to the area. The company also said our goal is to treat all land owners fairly compensating them for adverse impacts. But this card carrying republican says his land is priceless. He wants Eminent Domain laws changed and feels deserted by both Political Parties which have come out in support of pipeline. My party is actually speaking out of both sides of their mouth. All they talk about is private Property Rights, Less Government and the democrats is just as bad or worse. This whole thing has created some really strange bedfellows because of the people who helped me fight for American Dream arent the people i thought would come out. Reporter people like environmental activist robin janson. This area right here is the area where the proposed pipeline would cross the rogue river. What were looking at across the river here is all stream side vegetation for roughly 100 feet of that at first would be completely taken out. Reporter janson is with the rogue river keepers organization. The rogue has been called the wildest river in the west. The Pacific Pipeline will cross this waterway and hundreds in the region. My biggest concern in the rogue basin, all tourist based economies because of this river. And its very its the beloved place. Beloved place. When it comes to the rogue, the Pipeline Company williams tells america tonight it will tunnel under the riefer river to avoid complications. But the concept is against the fossil fuel companies. We cant fight against these boom and bust economies and leave us to clean it up and deal with the aftermath. This controversial pipeline will end right here in coos bay. , they will build a liquefied natural gas facility. And most likely the lng will be exported to asia. Todd morgan is a local businessman and booster for lng project called jordan cove. What do you say of opponents who claim Eminent Domain theres no public good in this project . Id say theres definitely public good. Twurcht weat one time we had 160 ships call on this port now were lucky to have 60. This would maintain ship calls to this port and help us to be competitive. Until the 1960s coos bay was a major port for exporting lumber to other parts of the world. But jordan cove would amount to more than 150 new permanent positions. Ive lost lifelong friends orelocating because of lack of opportunity. On this summer day, downtown coos bay, the largest city on the oregon coast was bustling with tourists but signs of trouble, unemployment is above the state average, income well below. How would an lng export facility affect downtown . Downtown would be impacted because of the influx of workers employed there during the construction phase but afterwards. 1200 locals have expressed support of jordan cove but the project has been delayed again and again, awaiting various federal and state permits. Investors have gotten nervous. If this project does not go through how big of a loss would it be for coos bay . It couldnt be a loss because were already down in the toilet as far as economy goes. We have nowhere to go but up. Personally im not for sale. Im not for sale and you know what if there are so many people that think its a good deal, move around me and go on with the thing. The chance he are youre going to lose this battle. No question about it. No question about it. So why keep fighting it . Because do i want to live on my knees or die on my feet . [ dog barking ] one mans fight to protect his American Dream. Adam may, al jazeera, oregon. What happens now, approval if a fertile Regulatory Panel is from a federal Regulatory Panel is pending. Well let you know what happens. Tell us what you think at aljazeera. Com americatonight. Talk to us on twitter or facebook, come back well have more of america tonight, tomorrow. It creates a huge opportunity for the Small Business owners. These are all different strains. This confirmation, however tragic and painful will at least bring certainty. Malaysias Prime Minister confirms that debris belongs to mh 370 which went missing last year. You are watching al jazeera live from doha. Also coming up, grief and tragedy in iraq. We meet the victims of war in the city of fallujah caught in the cross fire