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2 Survivors Describe the Terror and Tragedy of the Tahoe Avalanche

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2 Survivors Describe the Terror and Tragedy of the Tahoe Avalanche

The blizzard blew so fierce that the skier at the head of the line kept disappearing into a whiteout. The winds were gusting over 50 miles per hour. Almost four feet of fresh powder had piled up and more was falling every minute.

At the back of the line was Anton Auzans, trudging behind 12 other backcountry skiers climbing through a clearing high in California’s Sierra Nevada. He had his hood pulled low against the pelting wind.

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Then came a single word yelled by a ski guide somewhere ahead: “Avalanche!”

Mr. Auzans looked up in time to see a wall of white dotted with strange blurs of color. In the moment before it reached him, he realized that the colors were the tumbling skis and clothing of the other skiers.

He dove behind a dead tree for protection, but the snow was surging down the mountain like a raging river. It poured around the trunk, dragged him away and swallowed him in darkness.

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Hundreds of thousands of pounds of snow rushed into the clearing, slowing as it spilled over flatter ground, and settled into a dense pile and a terrible silence. The slide had buried everyone in the group. Almost.

Two men from the group had fallen behind.

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Back in the woods, Jim Hamilton was struggling with a sticky ski binding that had refused to lock onto his boot and caused him to fall behind. He was cursing his bad luck.

He was hustling to catch the group, following their ski track through the woods. With him was a ski guide. Mr. Hamilton expected to catch sight of the others at the next clearing. Instead, their track abruptly ended at a rough berm of snow debris, as if a giant plow had driven through.

Mr. Hamilton had been too far behind to hear the warning or the rush of snow. For a second he was mystified. Where was everybody?

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Then he heard Mr. Auzans yell. “Major avalanche! Major avalanche! We have people buried!” Mr. Auzans’s head had just poked out of the snow.

Anton Auzans and Jim Hamilton are two survivors of the deadliest avalanche in modern California history. This account is based on a number of interviews with the two men conducted over several hours, in which they offered the first eyewitness telling of what happened.

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Jim Hamilton Max Whittaker for The New York Times

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Anton Auzans Lauren Segal for The New York Times

The Feb. 17 avalanche killed nine skiers who were among 15 people on a guided trip high in the mountains near Lake Tahoe, including six women who were all close friends.

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The two men, both lifelong skiers who had never met before the trip, said that as the storm beat down, conditions steadily grew worse, but their guides largely stuck to an itinerary laid out long before the storm, and led the group beneath steep terrain where a massive slide buried nearly everyone. The few skiers who were free dug desperately to save the others, but were overwhelmed by the number of people trapped, and by the unrelenting blizzard that threatened to cause another deadly slide.

In the days since, many in the public, including some veteran backcountry skiers, have raised questions about why four experienced guides left a protected backcountry hut during a historic storm and led their group across avalanche terrain, while not spreading skiers out so that one avalanche would not take out the whole group.

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Those questions remain largely unanswered. The Nevada County Sheriff’s Office and California’s workplace safety agency, Cal-OSHA, are investigating whether there were safety violations or criminal negligence by the company that led the trip, Blackbird Mountain Guides. No findings have been announced.

There were four other survivors: One ski guide, two women in the group and a third man who had signed up for the trip. The surviving women declined to comment through a spokeswoman, as did the other ski client. The guide, a man, could not be reached for comment.

In a statement after the accident, Blackbird Mountain Guides, asked people not to speculate, adding, “It’s too soon to draw conclusions, but investigations are underway.”

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A Welcome Forecast of Heavy Snow

The trip started on a blue-sky day.

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Mr. Auzans and Mr. Hamilton arrived at Donner Pass, where Interstate 80 cuts through a gap in the mountains, on the morning of Sunday, Feb. 15. The weather was mild and snowy peaks were shining under a clear sky.

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Sunday: Groups skied to huts

The plan was to ski three miles over a high mountain ridge east of the highest summit in the area, Castle Peak, to a hidden subalpine basin called Frog Lake. There, at 7,600 feet, sat a cozy collection of backcountry huts that would provide the skiers with hot meals, warm beds and a launching point for human-powered climbs up remote mountains to ski untracked slopes.

A monster winter storm was set to move in that night and drop up to eight feet of snow over four days. The local avalanche forecasting office warned of possible “widespread avalanche activity” and slides large enough to bury people in the days ahead. But the skiers viewed the weather not as a concern, but as a stroke of good luck.

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For six weeks the region had gone without a significant storm, leaving the snow thin and crusty and not much fun to ski. The storm promised to bring what the skiers had hoped for, what they had each paid almost $1,500 for: bottomless fresh powder.

At the pass, the two clients were greeted by their guides from Blackbird Mountain Guides, — Andrew Alissandratos, 34, and the guide who survived — and by the third man.

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A second group had also hired Blackbird to head to the huts that day: Eight friends, all women in their 40s or early 50s, who had been taking backcountry trips together for years. Many of them also liked to surf. Most had high-powered jobs and impressive résumés. Both groups were led by Blackbird, and had signed up for the same hut trip, but each group had their own pair of guides.

The four guides from Blackbird all had extensive experience and formal training. They checked that everyone had the required safety gear — an avalanche beacon for locating people who are buried; a long, folding probe to pinpoint them under the snow; and a shovel for digging them out. Mr. Auzans and Mr. Hamilton had both taken basic avalanche safety classes, but neither had experienced an avalanche before.

When the topic of the impending storm came up, Mr. Hamilton said the guides told him not to worry, they knew how to pick safe terrain. They would have to stay on treed slopes and avoid the steep inclines that many skiers love, but he said one guide told him there would be so much powder that no one would care.

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The groups put climbing skins on the bottom of their skis to grip the snow and climbed up to a ridge on the side of Castle Peak, about 1,700 feet above the freeway.

Mr. Hamilton snapped pictures of views that spilled out seemingly forever. He was 65, a software engineer and grandfather, and had moved to California from Massachusetts a year before. He had only been backcountry skiing four times and would never have attempted a trip like this without expert guides. But he wanted to experience the renowned deep Lake Tahoe backcountry powder, so he had looked online and found the Frog Lake trip on Blackbird’s website. There was one slot left.

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“Wow,” he had said to himself, “it’s meant to be.”

On the ridge, the skiers took off their climbing skins for a long ski down an open bowl to a steep snow gully called Frog Lake Notch that cut beneath a granite summit called Perry’s Peak.

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On a big powder day, Frog Lake Notch would be a natural avalanche path, but that Sunday, the old snow was firm and safe. By early afternoon, they had reached the huts at Frog Lake.

It was just the kind of experience Mr. Auzans was hoping for.

A 37-year-old electrician in the Bay Area with a young son, he had grown up snowboarding at nearby resorts and in recent years had grown increasingly interested in the backcountry.

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He loved the serenity and beauty of the mountains. In summer he backpacked and camped. In winter, backcountry skiing offered the same solitude and grandeur, with the added bonus of primo powder.

At the same time, he knew there was added danger. On the handful of backcountry day trips he had taken, he always went with guides because he did not completely trust himself.

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A Rising Danger

Frog Lake’s main hut had a fully stocked kitchen and big leather chairs set in front of a crackling fire. After a dinner of ravioli, the men settled in by the hearth.

Mr. Auzans cracked open the book he had brought on the history of the Donner Party. He was, by his own admission, obsessed with stories of disaster and survival, and wanted to learn about the group of pioneers, who in 1846, tried to cross the Sierra Nevada and got trapped by heavy snowfall. Nearly half of them died and some, stranded for months by deep snow, resorted to cannibalism. Donner Pass still bears their name.

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The book sparked a discussion around the fire about the disaster, then other historic disasters.

As they talked, one of the men observed that most disasters aren’t caused by just one thing, but by a series of small events that led to a catastrophe.

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On Sunday night it started to snow hard. By the next morning, the huts were covered by nearly a foot of fresh powder and it was still dumping.

The three male clients and the group of women gathered in the main hut for breakfast. While they ate, the four guides met in a separate room to make a plan for the day.

Early Monday, the Sierra Avalanche Center, which forecasts backcountry snow conditions in the region, posted an update: “Avalanche danger is rising. Backcountry travelers could easily trigger large avalanches today.” The center added: “Consider avoiding avalanche terrain in areas where clues to unstable snow are present.”

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The forecast now said that the hazard, on a scale of 1 to 5, had increased to Level 3, with “considerable” danger, up from Level 2, with “moderate” danger, on Sunday. But the center continued to warn that, by Monday night, the hazard could increase to Level 4, with “high” danger.

Whether the guides checked those forecasts or conferred with Blackbird headquarters is unclear, the two men said in interviews, because the guide meeting happened behind closed doors. Mr. Hamilton said that the huts did have an internet connection. Blackbird Mountain Guides said in a statement, “Guides in the field are in communication with senior guides at our base, to discuss conditions and routing based upon conditions.”

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Most avalanches occur on slopes between 30 and 45 degrees. The guides told the group that they would climb about 800 feet through the trees on the east side of another nearby summit, called Frog Lake Peak, and ski a 25-degree slope that would be safe.

The guides did not ask for feedback or if anyone had misgivings, Mr. Hamilton and Mr. Auzans said, and no one spoke up.

Avalanche prediction has improved dramatically since the 1980s, but knowing when snow is likely to slide has not led to a drop in fatalities. Many backcountry users continue to go into dangerous terrain, even when advised of the risk.

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That has caused avalanche safety experts in recent decades to recognize that accidents have as much to do with failures in human decisions as they do with failures in snow layers. In response they have shifted education toward helping people spot human factors that push them to take dangerous risks.

Backcountry users are taught to recognize a group of human decision-making traps that can make getting caught in an avalanche more likely, said Sara Boilen, a psychologist in Montana, an avid backcountry skier and a snow safety researcher who regularly gives an avalanche safety talk.

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People skiing familiar terrain — such as experienced guides on home turf — are more likely to assume a familiar route is safe. Skiers who see an opportunity as scarce or fleeting — such as a long-awaited trip or fresh powder — are more likely to downplay the danger. Individuals wanting to fit in with the group may be reluctant to speak out. Novices are prone to defer to someone they see as an expert, and not question their decisions.

In groups of six to 10, statistics show, the risk grows substantially, as numbers give the illusion of safety and unspoken competition pushes the tolerance for risk.

Over time, Dr. Boilen said, taking risks can become normalized.

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“It’s very hard to avoid. I’ve seen it in my friends, I’ve seen it in myself,” she said. “You can creep past a red line you would never intentionally step across.”

The ski from the Frog Lake huts on Monday turned out to be fantastic. The guides chose enjoyable runs. The snow was deep and soft. There were no signs of avalanches. Both groups returned to the huts wet, tired and happy, Mr. Hamilton said.

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“It was everything you thought it would be. Just epic. And I never once felt like we were in danger,” he said. “I remember watching the women fly by me and they are having a blast.”

Fleeing Into a Storm

By Monday night the snow was hitting harder than ever.

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At midnight, the wind started blowing steadily from the southwest, gusting over 40 m.p.h. It howled through the trees and shook the huts.

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Monday: Strong winds caused snow to drift

The wind drove snow across the bare peaks above Frog Lake, depositing tons of loose powder on northern slopes in deep, unstable piles. On Perry’s Peak, just above the huts, a pile started to accumulate on a bare slope with an angle of about 35 degrees. It was prime avalanche terrain. It was also right above the path the skiers would take to try to get back to their cars on Donner Pass.

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When the skiers woke on Tuesday, the chance of avalanches had increased from possible to likely, according to the Sierra Avalanche Center forecast.

The guides once again held a morning planning meeting in a separate room while their clients had breakfast. When they came out, they told the skiers the groups had to cancel a planned ski lap and leave before conditions got worse.

“‘We have to get out of here now,’” Mr. Auzans recalled them firmly telling the groups.

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Returning the way they came in, through Frog Lake Notch, was a no go. The steep slopes were now too dangerous. That left several alternatives, some seemingly riskier than others.

The website for the Frog Lake Huts offered an alternative path down a tree-covered slope to the southeast. There was also a one-lane road to the huts, closed in winter, that went east through safe terrain. Both routes were longer, and would have left the skiers far from their cars.

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Tuesday: Skiers returned to trail

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A third possibility was to stay in the huts, which had food and water and plenty of room. But the guides never mentioned the option, the men said. Instead, a fourth alternative was chosen by the guides. The groups would head for the cars, retracing much of their path in, but would avoid Frog Lake Notch by going around the back of Perry’s Peak.

Why the guides chose that course of action was not clear to the two men. There was no discussion with clients, Mr. Hamilton and Mr. Auzans said, and no clients openly raised concerns.

“I didn’t say anything,” Mr. Auzans recalled. “I’m not an expert and so I decided to trust the plan.”

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An Attempt to Get Out

Winds were gusting at over 50 m.p.h. when they left. At times the skiers could not see more than a few feet.

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The women’s and men’s groups combined into one party with four guides, and started zigzagging up a gentle slope to the ridge of Perry’s Peak, 500 feet above the huts.

The snow was hip deep without skis on. The guides took turns in the lead, packing a trail for the others to follow, but it was slow going. An hour later, they had covered less than a mile.

As they trudged uphill, skiers naturally bunched up behind the leader. At points on the climb the guides stopped the group and sent skiers one at a time across steeper slopes.

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At around 10 a.m. they reached the ridge, stopped in the howling wind to pull off their climbing skins, and skied down the north side.

Mr. Hamilton watched the women, all veteran powder skiers, slip along effortlessly. He was not as graceful. He fell and struggled to get up. By the time they regrouped at the bottom, it was about 10:45 a.m.

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The group now faced a mile-long climb up a gentle valley beneath Perry’s Peak. Beyond it was a long downhill glide to the cars. No part of the path crossed steep slopes. The group appeared to be home free.

The women put on their climbing skins ahead of the men and left with the lead guide to break trail. Mr. Auzans and the third client soon followed.

Mr. Hamilton tried to hurry, but could not get his boot into his binding. The guide at the rear of the group waited with him. Finally, they heard it click into place and moved up the trail.

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Tuesday: Minutes before avalanche

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A Scream, and Then Silence

At about that moment, the wind-piled mass of snow on the north side of Perry’s Peak failed. Untold tons rushed down like a tsunami, picking up speed as it tumbled the equivalent of 40 stories.

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What triggered the avalanche may never be determined. The careful investigation that might provide answers, experts say, would be difficult because the storm and efforts by rescuers to stop further avalanches likely covered signs in the snow that could have provided clues. But the impact was immediately clear.

Directly in the path of the avalanche, the other 13 skiers were climbing a gentle slope through a clearing. Nearly all of them were bunched up behind the lead guides who were breaking trail. Mr. Auzans was last in line.

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The skiers were not spread out to cross avalanche terrain. The clearing did not pose an obvious danger. The slope was only about 20 degrees — not steep enough for snow to slide. It remains unknown if, in the blowing snow, the guides realized that a steep slope towered just above them to the left.

“Avalanche!” was all Mr. Auzans heard.

By the time he looked up, the rest of the group had already been swallowed. The snow pushed him over and dragged him down. As he was being buried, the survival stories he loved to read flashed in his mind and he put his hands over his face to try to make an air pocket.

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Everything went black. He was packed too tightly to move. He knew from his training that he had to get out soon or he would likely die.

If people buried in an avalanche are rescued within 20 minutes, accident data shows, 90 percent live. But in the next 15 minutes, carbon dioxide from their own breathing builds up in the snow, the heat of their breath can form an ice shield that blocks all air, and the survival rate drops to 30 percent. It then drops steadily as time goes on.

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Trapped in the snow, Mr. Auzan thought about his 3-year-old son and never seeing him again. He said a rage built up inside him and gave him the strength to push his hands free. Suddenly, he was looking at daylight.

He struggled to make the hole bigger, broke through and sat up. He was expecting to see a commotion of rescue activity. There was only silence.

“This is bad,” he thought.

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Moments later, Mr. Hamilton and the guide that was at the rear came through the trees.

“We have people buried!” Mr. Auzans shouted. He pointed to the last spot he had seen anyone.

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The guide pulled his avalanche beacon from his jacket, unfolded his probe and hurried toward the signal.

Mr. Auzans was stuck — his boots were still attached to his skis, which were buried in the snow. He dug to work himself free.

Mr. Hamilton spotted a ski pole sticking up from the debris. It started to wave. He skied over and saw an arm of the third male client. He had made an airway with one arm, and was able to talk through the hole.

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Don’t worry about me, I’m OK, Mr. Hamilton remembers him saying. Go look for other people.

Minutes were ticking by. Mr. Auzans dug himself out, grabbed his shovel and went to help the guide whose probe had found a skier about four feet under the snow.

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The digging was hard. The slide had compacted the snow into something less like powder and more like cement. It took a number of minutes to get down to the skier.

They uncovered the face of a woman. As they brushed away the snow they kept asking if she was OK. She only moaned, but that meant she was breathing. The guide and Mr. Auzans immediately moved to try to find more skiers, leaving all but the area around the woman’s face still buried.

A few feet away the probe found a second skier. They dug steadily, hacking at the hard snow. As they dug, Mr. Hamilton went back to the other male client and began to dig him out, hoping he could help with the rescue.

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About four feet down, the guide and Mr. Auzans found a second woman. Brushing the snow from her face, they saw her eyes blink. She moaned. Breathing. They told her they needed to go look for more survivors.

Somewhere in the blur of digging, Mr. Auzans called 911. It was 11:30 a.m. He reported a slide with multiple people buried. Rescuers immediately went into action.

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At least 30 minutes had passed since the slide, Mr. Auzans estimated. Time was running out.

While shoveling to the second woman, they had encountered someone’s leg and another person’s backpack. The group seemed to all be buried close together.

Within minutes they had uncovered the head of a third skier. It was one of the male guides. But when they tried to revive him, they got no response.

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Without stopping, they dug down to a fourth skier. A woman. She, too, appeared lifeless.

‘We Had to Save the People We Knew Were Alive’

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Now the men above the snow faced a bleak decision.

It was about noon. About an hour had passed since the slide. There were seven people still unaccounted for, but the chances of finding them alive seemed slim.

The storm was still hitting with savage force. Another avalanche could hit at any moment. The two women who were alive were still mostly buried. They seemed to drift in and out of consciousness as snow blew in on their faces.

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The men knew if they did not rescue the women and move to safety that they all might die. They made the decision to stop the search.

“We were all in danger. We did as much as we could. We pushed until we started finding people that were deceased. Making the decision to stop the search was one of the hardest things I’ve ever had to do,” Mr. Auzans said afterward. “What are our priorities? We had to save the people we knew were alive.”

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The group turned their efforts to freeing the women. When they pulled the first one up to the surface, she slumped over and mumbled that she just needed to sleep. Mr. Auzans got her standing, but found that she could barely walk.

The guide pulled the second woman out, and she started to cough up blood.

They knew they had to move out of the avalanche path. They led the women into the woods, leaving the clearing and the people buried there.

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The decision has weighed on both men in the days since.

“I honestly tried my best. I tried my best,” Mr. Auzans said in an interview from his home on Monday, less than a week after the avalanche. “I was buried. I helped to save three people.”

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He said he wished they could have saved them all, adding, “My heart goes out to all the families of the deceased.”

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Tuesday: Waiting for rescue

At about 12:30 p.m., Mr. Auzans texted 911 that they were moving to safety. The guide dug a snow pit, then laid a tarp over the top to make a crude shelter and put the women inside in sleeping bags. They began a long wait.

Rescuers knew where the group was, but with the storm, a helicopter was not an option. Snowmobiles and snowcats could not reach them. The group thought there was a good chance they would have to spend the night.

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They put their water in their jackets to keep it from freezing. They built a larger snow pit where everyone could stay warm.

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After the avalanche, the group made a shelter for the two women who survived. Jim Hamilton

For hours they waited in the storm. Some kept their emotions at bay by keeping busy, others broke down, overwhelmed by the enormous loss and the thought of the devastation ahead for the many loved ones of the dead.

At about 5:30 p.m., just as it was getting dark, about a dozen rescuers arrived on skis.

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With avalanche conditions still high and daylight fading, the rescuers decided the priority was to get the survivors out.

The only way was on skis. The women had regained enough strength to move on their own. The rescuers found skis for them in the pile of debris.

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In the dark, using headlamps, the rescuers led the five survivors back over to the ridge on Perry’s Peak, and down to the huts, where snowcats and an army of other rescuers were waiting.

Left behind on the dark mountain were the six friends who traveled together: Carrie Atkin, Liz Clabaugh, Danielle Keatley, Kate Morse, Caroline Sekar and Kate Vitt. And the three veteran guides: Andrew Alissandratos, Nicole Choo and Michael Henry.

It would be days before the storm relented and rescuers could return to retrieve them.

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A view from the shelter to the avalanche area, which was behind the trees. Jim Hamilton

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Methodology

The positions of the skiers and the extent of the avalanche path are approximate based on survivor accounts, an avalanche report from the Sierra Avalanche Center and avalanche experts. New York Times journalists built the 3-D model of the area using a 2021-2022 laser scan from the United States Geological Survey.

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Real estate investors are buying up long-term care facilities. Residents can suffer

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Real estate investors are buying up long-term care facilities. Residents can suffer

Leslie Adams holds a photo of his mother, Shirley, who died after developing infected bedsores at a rehabilitation center, according to a lawsuit he filed. A court awarded the family $17 million, but they are still trying to collect it.

Taylor Glascock for KFF Health News


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Taylor Glascock for KFF Health News

By the time she was hospitalized in 2020, Pearlene Darby, a retired teacher, had suffered open sores on both legs, both hips, and both heels, as well as a five-inch-long gash on her tailbone. She died two weeks later at age 81 from infections and bedsores, according to her death certificate. Her daughter sued the nursing home, alleging it had left Darby sitting in her own feces and urine time and again.

The lawsuit, settled on confidential terms last year, blamed not only the managers of City Creek Post-Acute and Assisted Living but also the building’s owner, a real estate investment trust, or REIT. In the year Darby died, City Creek paid CareTrust REIT more than $1 million in rent, while the Sacramento, California, nursing home ran a deficit, court records show.

Federal tax rules ban REITs from running health care facilities, but CareTrust was not an absentee landlord either, according to internal records filed in the case. It chose the nursing home’s management company and required through the lease that the home keep at least 80% of beds occupied. CareTrust granularly tracked how well the home kept to its financial plan, down to the money spent monthly on nurses and food, the records said. And the documents showed that the real estate company kept tabs on government safety inspection findings and Medicare quality ratings.

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Both CareTrust and the nursing home operator denied liability for Darby’s death. CareTrust officials said in court papers that it is not involved in day-to-day nursing home decisions or patient care, and that it monitors facilities to ensure nothing jeopardizes rent payments.

In a written statement, CareTrust Corporate Counsel Joseph Layne told KFF Health News: “We are the property owners, not the operators.”

Pearlene Darby is shown in a family photo with her grandson Caleb Darby. She has a big smile and they are both doing a dance move, with an outstretched arm.

Pearlene Darby, pictured here with her grandson Caleb Darby, was a resident of a Sacramento, California, nursing home. She died two weeks after being hospitalized for bedsores and an infection. The home denied liability and the case was settled out of court.

Shirlene Darby


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Shirlene Darby

Landlords with influence

Over the past decade, real estate investment trusts have bought thousands of buildings that house nursing homes, hospitals, assisted living facilities, and medical offices. A KFF Health News examination of court filings and corporate records shows that these landlords have more influence than the health care facilities publicly acknowledge.

The documents reveal REITs often select the management who oversee the operations and leave them in place even when they are aware of threadbare staffing, floundering governance, repeated safety violations, or other problems that hamper quality of care. A California jury in March awarded $92 million in punitive damages against a former REIT over the death of a 100-year-old resident with dementia who froze to death outside her assisted living facility.

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“The REITs are in charge,” said Laraclay Parker, one of the lawyers who represent Darby’s daughter.

Absence of oversight

Despite their ubiquity, REITs remain invisible to state and federal health regulators. Hospitals and nursing homes are not required to disclose rent payments or landlord identities in the annual reports they submit to Medicare.

Under President Donald Trump, the Centers for Medicare & Medicaid Services indefinitely suspended a Biden-era requirement that nursing homes disclose REIT involvement. Catherine Howden, a CMS spokesperson, said in a statement that the agency does not regulate facilities based on their tax status or corporate form and instead focuses on the quality of the care they provide.

REITs now own a fifth of the nation’s senior housing, which includes assisted living, memory care, and independent living, according to an industry analysis. REITs also hold investments in 1 in 6 nursing homes. Publicly traded REITs that focus on health care are now worth nearly a quarter of a trillion dollars, according to Nareit, an industry association.

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While one research study found REIT investments were associated with higher spending on nursing wages, another concluded that after being bought by REITs, nursing homes frequently replaced registered nurses with less skilled nurses and aides. A third analysis concluded that health inspection results were worse after REIT investment.

Researchers also found that investor-owned hospital chains that sold buildings to REITs were more likely to close or go bankrupt, as happened in 2024 with Steward Health Care. Often, private equity investors kept the sale proceeds as profits while the hospitals were burdened with new rent costs. “There were no improvements in clinical outcomes,” said Thomas Tsai, an associate professor at the Harvard T.H. Chan School of Public Health.

REITs are required to distribute most of their income and don’t have to pay the 21% federal corporate income tax on it. There is a catch: A REIT that “directly or indirectly operates or manages” a health care facility loses the tax break for five years. Typically, a REIT leases the property to another company that runs the nursing home or assisted living facility and maintains its tax break. Nareit said health care REITs distributed more than $7 billion in dividends in 2024.

Michael Stroyeck, head of health care analysis at Green Street, a real estate research company, said “there’s definitely a symbiotic relationship” between REITs and facility managers because they have the same goals. He said he has seen REITs replace operators that are having difficulties or go bankrupt.

John Kane, a senior vice president at the American Health Care Association and the National Center for Assisted Living, an industry group that represents nursing homes, said in a statement: “Given government funding often falls short, REITs have been valuable partners in helping to invest in long term care without influencing daily operations.”

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Low staffing at a chain

Strawberry Fields REIT, which like CareTrust trades on the New York Stock Exchange, owns or controls the buildings of 131 nursing home facilities. The nursing home operations inside 66 of those facilities are owned by Moishe Gubin, Strawberry Fields’ chief executive, and Michael Blisko, one of its directors, according to Strawberry Fields’ annual report for last year.

Gubin and Blisko also jointly own Infinity Healthcare Management, which manages their nursing homes; Blisko is Infinity’s CEO. On average, Infinity-affiliated nursing homes provided an hour and a quarter less nursing care per resident per day than the national average of four hours, a KFF Health News analysis of federal records found.

Infinity and several of its nursing homes have recently settled 30 death and injury lawsuits in Cook County, Illinois, totaling more than $4 million, said Margaret Battersby Black, a Chicago lawyer. A jury last year awarded $12 million in a lawsuit brought against Infinity and one of its Chicago nursing homes over the 2023 death of Shirley Adams. A retired candy factory worker, Adams died after developing infected bedsores at Lakeview Rehabilitation and Nursing Center, according to the lawsuit.

“She had wounds that no one could explain,” one of her adult children, Leslie Adams, testified at trial. Medicare gives Lakeview its lowest quality rating, one star out of five.

Leslie Adams is shown sitting on a staircase outside a brick building.

Leslie Adams lost his mother, Shirley, who died after developing infected bedsores at Lakeview Rehabilitation and Nursing Center, according to a lawsuit he filed. “She had wounds that no one could explain,” he testified. (Taylor Glascock for KFF Health News)

Taylor Glascock for KFF Health News

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Paul Connery, a lawyer for Adams’ family, said they are still trying to collect on the judgment against the nursing home and management company, which now totals $17 million with interest and attorney fees.

“If I get caught speeding and I went to court, they issue me a ticket and I’ve got a fine to pay,” Adams said in an interview. “How are they able to still continue to move on with business like nothing has happened?”

In a phone interview and an email, Gubin said Strawberry Fields, Infinity, and the nursing homes are all legally distinct and that he has not played an active role in Infinity in more than a decade. He said nursing homes get sued all the time but that the verdict against Lakeview is so large that it will force the home to declare bankruptcy or shut down.

A multistory brick building on a city street is show. Two bare trees are visible. The word "Lakeview" appears on an awning, and a large sign says, "Thank you, Staff."

The owners and operators of Lakeview Rehabilitation and Nursing Center in Chicago also are directors of the real estate investment trust that owns the building, a securities filing shows.

Taylor Glascock for KFF Health News


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Taylor Glascock for KFF Health News

“The whole thing is unfortunate,” Gubin said by phone. “For 15 years they were a perfectly good guardian” and “a well-run building,” he said. “You wouldn’t think it was fair to be judged on your worst day.”

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Blisko and an Infinity lawyer did not respond to requests for comment.

Strawberry Fields, which owns 10 assisted living facilities and two long-term care hospitals in addition to the nursing homes, earned net income last year of $33 million from $155 million in rent, a 21% profit margin, securities filings show. Gubin said those weren’t excessive returns.

A $110 million verdict

Traditionally, REIT leases make the operating companies responsible for paying property taxes, insurance premiums, and maintenance costs. In 2008, Congress gave health care REITs a new option to make money: On top of collecting rents, they could set up subsidiaries and take profits directly from health care businesses. They still must have independent management overseeing care decisions. Many REITs have embraced the role even though the subsidiaries must pay corporate taxes and risk losing money if the businesses do poorly.

Colony Capital was a REIT that through layers of shell corporations owned both the building and the operation of Greenhaven Estates, a Sacramento assisted living and memory care facility. In 2018 Greenhaven paid Colony $1.4 million in rent, nearly a third of its $4.5 million in revenue that year, according to financial records filed in court.

Greenhaven also was on the verge of losing its license, according to a revocation notice filed in November 2018 by the California Department of Social Services. Greenhaven had racked up years of health violations, including from letting untrained workers administer medications, lacking enough employees to care for people with dementia, and neglecting a resident who smeared feces over his body, bed, floor, and bathroom, the notice said.

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In February 2019, a few weeks after celebrating her 100th birthday, Mildred Hernandez, a resident with Alzheimer’s, wandered out of Greenhaven in the middle of the night. Her assisted living wing had no exit door alarms even though it housed several residents with dementia, court records showed. Berta Lepe, one of Greenhaven’s caregivers, found Hernandez under a bush, wearing only a shirt and underwear. The temperature was in the 30s.

Mildred Hernandez is pictured in a midrange photograph. She is smiling broadly and has curly gray hair.

Mildred Hernandez was 100 when she died of hypothermia after wandering out of her assisted living facility in the middle of the night. A jury awarded $92 million in punitive damages against the owner of the home.

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Ric Tapia

“She was talking, but I couldn’t understand what she was saying,” Lepe testified at trial over a lawsuit from Hernandez’s family. Hernandez died of hypothermia a few hours later, according to her death certificate.
Frontier Management, the company that Colony had hired to manage Greenhaven, denied liability and settled the lawsuit on undisclosed terms.

Since the lawsuit, Colony has changed its name to DigitalBridge, which no longer owns Greenhaven and gave up its REIT status. At trial earlier this year, DigitalBridge said resident care was the responsibility of Frontier and that Colony “encouraged” Frontier to address problems. Richard Welch, a former Colony executive, testified that replacing management is disruptive. “I viewed it as a last resort,” he said.

In March, a jury awarded Hernandez’s family a total of $110 million: $10 million in compensatory damages, $92 million in punitive damages against DigitalBridge, and $8 million in punitive damages against Formation Capital, an asset management company.

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“REIT money is very detached from knowing about or caring about patient or resident outcomes, because it’s not in their business model,” Ed Dudensing, a lawyer for the family, said in an interview. “Their allegiance is to their investors.”

DigitalBridge has asked the judge to delay finalizing the judgment while its legal challenges to the lawsuit and the verdict are evaluated. A DigitalBridge attorney and a corporate spokesperson did not respond to requests for comment, a Formation attorney declined comment, and a Frontier attorney and a spokesman did not respond to a request for comment.

‘Wet from head to toe’

When CareTrust bought City Creek Post-Acute and Assisted Living in 2019, the Sacramento nursing home where Pearlene Darby lived had a one-star Medicare rating and was losing money. CareTrust leased the building to a management company called Kalesta Healthcare Group based on the business plan Kalesta submitted.

While CareTrust was not the operator, it held periodic phone calls with Kalesta, which provided “a full update of what’s happening at the facility,” including changes in leadership, financial progress, and health inspection survey results, according to deposition testimony by Ryan Williams, a Kalesta co-founder.

According to a state inspection report, in 2020, the year Darby died, City Creek left a resident in soiled linens “wet from head to toe lying in bed” for more than eight hours. During a different visit, a health inspector cited the home after watching a nurse put a dirty diaper back onto a resident after caring for a wound. “It was just a small stool and it is far from where the wound is,” the nurse told the inspector, according to the report.

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James Callister, CareTrust’s chief investment officer, said in his deposition that CareTrust officials “review results of regulatory surveys provided to us by the tenant. We review the five-star rating.” He said, “We evaluate results of care, but we do not evaluate types of care given or how or when, no.”

Darby had been living in City Creek since 2011 after a stroke left her in a wheelchair. She needed help getting in and out of bed. From September through November 2020, Darby lost 30 pounds, her family’s lawsuit alleged. During those months, employees dropped her three times as one worker rather than the required two operated the mechanical lift, the lawsuit said.

The suit alleged City Creek failed to reposition her every two hours in bed or her wheelchair, which is the clinical standard for people at risk of bedsores, and to promptly order devices to protect her skin.

In November, the nursing home sent Darby to the hospital. A blood test found bacteria had entered her bloodstream from her feces’ touching open skin wounds, according to the lawsuit. The hospital diagnosed her with sepsis. A surgeon said she needed an operation to redirect fecal waste from her intestines but concluded she wasn’t medically stable enough for surgery, the suit said.

Darby began receiving comfort care measures and was sent back to City Creek. She died two weeks later. In court filings, CareTrust and Kalesta denied the allegations.

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In a phone interview, Williams, the Kalesta co-founder, said Darby’s death occurred during the most challenging point of the covid pandemic, when California rules required any nurses testing positive for the virus to be sent home and nurses were quitting out of fear for their health. “It was the most herculean of professional efforts to secure enough staff,” he said.
While expressing sympathy for Darby and her family, he said it was “unconscionable” that personal injury lawyers sued nursing homes over care failures during “the worst of times.”

In court, CareTrust petitioned Judge Richard Miadich to dismiss it from the lawsuit before trial. “This case does not concern a property condition,” CareTrust’s lawyers wrote. “CareTrust is simply a landlord.” But the judge ruled last year a jury should decide whether CareTrust “exercised actual control over City Creek.”

The case was settled out of court a few months later. All parties declined to reveal the settlement terms.

A 67% Profit

As recently as November 2023 — four years after its acquisition — City Creek earned one star from Medicare. It was cited for failing to have the minimum nursing home staffing required by California law during five of 24 randomly selected days in 2022, according to an inspection report. Williams said in the interview that Kalesta had increased spending on nursing over the course of its ownership, including boosting wages, but that it takes a year or two to turn around a troubled nursing home. He said the home’s star rating in 2023 was dragged down by its poor inspection history from before Kalesta took over.

City Creek’s rating has climbed in the past two years, and it now has the top overall rating of five, according to Medicare. Medicare rates City Creek’s current staffing levels as average. That’s better than most nursing homes in more than 200 buildings CareTrust bought before 2025, according to a KFF Health News analysis of federal data. On average, CareTrust nursing homes provided a half hour less nursing care per resident per day than the national average of four hours.

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In its statement to KFF Health News, CareTrust’s counsel Layne said the REIT worked to “identify quality operators as tenants,” and that the homes the REIT rents out have more nurses and aides than the minimum required for nursing homes by their state governments. “The operators are licensed by state regulators and retain sole responsibility for operations,” the statement said.

CareTrust, which now owns more than 500 senior housing and nursing home buildings, reported net income last year of $320 million from $476 million in rents and other revenue — a 67% profit margin. As one point of comparison, HCA Healthcare, one of the nation’s largest for-profit hospital and health care chains, reported a 10% profit margin for last year.  

Lesley Ann Clement, one of Darby’s lawyers, said cases like hers show the nursing home industry is wrong to complain it lacks financial resources for more staffing.

“There’s plenty of money,” Clement said. “They’re just not spending it on patient care.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism.

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US planning to seize Iran-linked ships in coming days, WSJ says | The Jerusalem Post

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US planning to seize Iran-linked ships in coming days, WSJ says | The Jerusalem Post

The US is planning to board and seize Iran-linked oil tankers and commercial ships in the coming days, according to a Saturday report by The Wall Street Journal.

The report noted that these actions would take place in international waters, potentially outside of the Middle East.

The US “will actively pursue any Iranian-flagged vessel or any vessel attempting to provide material support to Iran,” US Chairman of the Joint Chiefs of Staff Gen. Dan Caine said. “This includes dark fleet vessels carrying Iranian oil.”

“As most of you know, dark fleet vessels are those illicit or illegal ships evading international regulations, sanctions, or insurance requirements,” Caine continued.

Caine was further quoted as saying that the new campaign, which would be operated in part by the US Indo-Pacific Command, would be part of a broader US President Donald Trump-led campaign against Iran, known as “Economic Fury.”

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 White House spokeswoman Anna Kelly told the WSJ that Trump was “optimistic” that the new measures would lead to a peace deal.

The potential US military action comes as Iran tightens its grip on the Strait of Hormuz, including attacking several ships earlier on Saturday, the WSJ reported.

The report cited CENTCOM as saying that the US has already turned back 23 ships trying to leave Iranian ports since the start of its blockade on the Strait.

The expansion of naval action beyond the Middle East will provide the US with further leverage against Iran by allowing it to take control of a greater number of ships loaded with oil or weapons bound for Iran, the report noted.

“It’s a maximalist approach,” said associate professor of law at Emory University Law School Mark Nevitt. “If you want to put the screws down on Iran, you want to use every single legal authority you have to do that.”

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Iran claimed earlier on Saturday that it had regained military control over the Strait, intending to hold it until the US guarantees full freedom of movement for ships traveling to and from Iran.

“As long as the United States does not ensure full freedom of navigation for vessels traveling to and from Iran, the situation in the Strait of Hormuz will remain tightly controlled,” the Iranian military stated.

In addition, Iranian Supreme Leader Mojtaba Khamenei declared on Saturday in an apparent message on his Telegram channel that the Iranian navy is prepared to inflict “new bitter defeats” on its enemies.

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Video: The Origins of the Supreme Court’s Shadow Docket

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Video: The Origins of the Supreme Court’s Shadow Docket

new video loaded: The Origins of the Supreme Court’s Shadow Docket

Secret memos obtained by The New York Times illuminate the origins of the Supreme Court’s shadow docket. Our reporter Jodi Kantor explains what these documents reveal about the court.

By Jodi Kantor, Alexandra Ostasiewicz, June Kim and Luke Piotrowski

April 18, 2026

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