News
Firefighters Likely Had Limited View of Approaching Plane in LaGuardia Crash
The rapidly approaching plane that collided with a fire truck at New York’s LaGuardia Airport last month was most likely hard for the firefighters to see, a New York Times analysis has found.
They were navigating in the rain on a taxiway that was angled away from the oncoming plane. Because the plane had just touched down, the pilots and the firefighters were left with very little time to react.
The collision killed both pilots and was the first deadly crash at the airport in over three decades. The two firefighters, who were rushing to another emergency, survived with injuries.
The Times built a 3-D model, interviewed aviation experts and analyzed flight data, video footage of the crash and air traffic control audio — all to answer a critical question: What could the firefighters see?
The truck’s dispatch
The two firefighters were driving on Taxiway D in the lead vehicle of a convoy that had been dispatched to assist with an emergency on the other side of the airport from the fire station.
Their fire truck, a type that can weigh upward of 60,000 pounds when fully loaded, is designed with the driver’s seat in the center, in part to offer better visibility. The other firefighter typically sits to the right of the driver.
The air traffic control tower had cleared an Air Canada Express jet to land on Runway 4. About two minutes later, the tower cleared the truck to cross the same runway using Taxiway D. Eleven seconds later, the tower called back with an urgent warning to stop, but the truck kept moving. It is unclear if the firefighters in the truck heard the warnings.
Each firefighter had a disadvantage
Even in an optimal scenario in which the driver was looking directly toward the oncoming plane in the moments before collision, it’s likely that his view of the approaching plane would have been obstructed by the second firefighter.
If the driver had leaned forward slightly with his head turned about 90 degrees to the right before looking straight again, the plane would have most likely been obstructed:
The second firefighter would have had a better view, but for him, the plane would most likely not have stood out as a moving object until it grew closer to the truck. Even as the plane was approaching, it would have stayed in roughly the same position in his field of view — making the plane more difficult to track than if it had been moving across his line of sight.
This is a familiar phenomenon documented in aviation and maritime navigation, in which an object approaching on a collision course can appear to be stationary until the last moment, when it seems to suddenly grow in size.
Here is what the view for the second firefighter could have been if he had been leaning forward slightly with his head turned about 90 degrees to the right and looking toward the plane:
Crash footage shows that there was one vehicle in the convoy initially traveling alongside the fire truck, and it may also have blocked the firefighters’ view of the runway before it came to a stop about seven seconds before the crash.
Based on the available evidence, there is no way to know with certainty where the firefighters were looking in the seconds before the crash. The runway where the crash occurred is bidirectional, meaning planes can approach one at a time for landing in both directions. As a result, the firefighters would not necessarily have been able to assume the direction of oncoming planes.
The two firefighters, Sgt. Michael Orsillo and Officer Adrian Baez, who were hospitalized along with about 40 others, did not respond to requests for comment. The Port Authority of New York and New Jersey, which runs LaGuardia Airport and its fire rescue unit, declined to comment.
The taxiway was angled away from the oncoming plane
The lead fire truck had been driving along a taxiway that was angled away from the direction of the oncoming plane. This means that the plane was approaching off the right rear section of the truck — where it would have been difficult for the firefighters to see — instead of its direct right-hand side.
As a result of the angle, the driver would have had a difficult time spotting the plane, regardless of where he was looking. If he had turned to the right, toward the plane, his view might have also been obstructed by the firefighter beside him:
The plane would have appeared in the right corner of the second firefighter’s field of view, but only if he had leaned forward slightly, turned his head to the right and looked in the plane’s direction. Here is what he might have seen right before the truck entered the runway about two seconds before collision:
The analysis of the crash footage also shows that the truck turned slightly toward the left as it entered the runway. It is unclear whether it turned because the firefighters saw the plane, but the change in direction angled the firefighters farther away from the approaching plane, making it even harder to see.
Airports use these slanted taxiways because they allow planes to exit the runway more quickly, instead of having to make a sharp 90-degree turn at a slower speed.
That said, the Federal Aviation Administration urges airports to use intersections configured at 90-degree angles because they give pilots and drivers the best visual perspectives to see other aircraft and vehicles, said Michael O’Donnell, a retired F.A.A. official and a former airport firefighter.
The truck did not slow down or stop before entering the runway
The Times analysis of the crash footage indicates that the truck did not stop or slow down before entering the runway and that it was traveling at a relatively steady speed of about 30 miles per hour from the moment the air traffic controller first gave the warning to stop until the collision.
Slowing down or stopping entirely may have given the firefighters more time to look and assess any oncoming traffic on the runway.
Seconds after the controller first warned the truck to stop, about seven seconds before the crash, the convoy of vehicles that was following the lead truck slowed down and stopped while the lead truck continued.
Once the tower clears an emergency response vehicle to cross a runway, the vehicle’s drivers are not expected to obey the stop marks on the pavement, Mr. O’Donnell said. But they are expected to look for aircraft before crossing and proceed with caution, he said.
Other distractions
It’s also likely that there were other visual distractions. The airport runway and taxiways are lined with lights. The night of the crash was rainy and misty, and the rain-slicked surface of the runway could have given it the appearance of a glaring light show.
“At night, it’s basically like driving through a lit-up Christmas tree,” said Bobby Egbert, a spokesman for the Port Authority Police Benevolent Association, the officer’s union. “You have so many lights and the crew has to know exactly what those lights mean.”
What the firefighters could have seen or not seen “with that equipment, at that time of night, with that illumination,” is one of the many components of the National Transportation Safety Board’s investigation, said Peter Knudson, a spokesman for the board, who said the preliminary report would be released later this month. He declined to answer questions about the crash, citing the ongoing investigation.
According to safety board officials, the airport’s runway status lights, set in the pavement at taxiways and runway crossings to warn of planes on or approaching the runway, were functional that night. Video analysis of the crash shows that the truck may have entered the runway around the same time as the lights went from red to dark, which they are designed to do a couple seconds before a plane passes.
What the jet’s pilots may have seen
For the pilots, Captain Antoine Forest and First Officer Mackenzie Gunther, the truck was most likely in their field of vision from the cockpit, if they were looking down the runway:
About the same time that the fire truck entered the runway, the Air Canada jet dropped its speed sharply below what is typical after touchdown, according to a Times analysis that compared the jet’s flight data with hundreds of other landings on Runway 4 by the same aircraft model. The plane reduced its speed to about 100 miles per hour from about 140 miles per hour in about three seconds.
The firefighters’ limited visibility is only one factor among many that the authorities are investigating as possibly contributing to the crash. They are also looking into any potential problems with air traffic controller staffing, radio miscommunications and vehicle tracking technology.
How we analyzed the crash footage
The Times estimated the position and speed of the lead fire truck by analyzing video of the crash, flight path data from Flightradar24, satellite imagery and the manufacturer’s dimensions of the vehicle.
First, we geolocated the camera in the crash video by matching landmarks in the footage (buildings, runway markings and lights) to their real-world positions in satellite imagery. From that fixed vantage point, we measured the span of the truck in each video frame. Those measurements — combined with the truck’s physical dimensions, its path along the taxiway and its position relative to the runway lights — allowed us to estimate its position frame by frame. From those positions and the video’s timestamps, we then calculated the truck’s speed. Our estimates of the truck’s position are within three feet, and its speed is within five miles per hour.
We placed the positional data of the truck into a georeferenced 3-D model of the airport, where we programmatically animated the vehicles along their paths. We tested our analysis by overlaying the video frames on the 3-D model rendered from the camera’s position, as seen in the video below.
The Times also obtained flight data showing landings at LaGuardia Airport from several hundred aircraft — the same model as the Air Canada Express jet. The data helped us understand how the plane’s speed on the runway compared with that of other planes slowing down after a typical touchdown.
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.
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, 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.
“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.
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.”
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 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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Taylor Glascock for KFF Health News
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.
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.”
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.
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 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.
Ric Tapia
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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.
“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.
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.
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.
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.
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.”
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.”
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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