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Inside the Last Weeks of RFK Jr.'s Campaign

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Inside the Last Weeks of RFK Jr.'s Campaign

Robert Kennedy Jr.’s presidential campaign ended as it began: with a lengthy speech that railed against the dark forces controlling politics, government and the media.

Speaking in Phoenix on Friday, Kennedy said he was suspending his independent bid for the White House and endorsed former President Donald Trump, citing their shared concerns about “the war on our children,” the war in Ukraine, and free speech. “I have the certainty that this is what I’m meant to do,” he said, calling the decision a “spiritual journey” to embrace a candidate who, until a few weeks ago, he derided as a “sociopath” and a “terrible human being.

In other circumstances, it would have been a striking scene: the scion of the most iconic family in Democratic politics, endorsing Trump to keep the Democrats out of the White House and denouncing them as “the party of war, censorship [and] corruption.” Except that this particular Kennedy is a longtime conspiracy theorist who used his famous name to prop up one of the most bizarre presidential bids in modern history.

The announcement marked the end of a chaotic campaign which over 16 months switched from Democrat to independent, cycled through campaign managers and staffers, and shifted its positions on issues from abortion to climate change. Run by Kennedy’s daughter-in-law, the operation had no headquarters, few official events, and dedicated much of its time to appearing on podcasts and fringe YouTube shows. Kennedy showed up where he was invited: a sheriffs conference in Oklahoma, the set of Dr. Phil in Houston, a Bitcoin conference event in Miami, and a discussion about pig farming in Maine.

Kennedy says all of this was by design. “I’m less interested in campaigning and I have, I would say, almost zero interest in attention,” he told me in an interview in Albuquerque, N.M., in June, where he was about to premiere his latest documentary in front of an audience of more than 200 supporters wearing “Kennedy for President” buttons. “I really am preoccupied with governing.”

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When Kennedy managed to make national headlines, it was rarely for anything related to governing. Instead, an increasingly outlandish series of revelations about his past trickled to the surface: the dead worm in his brain, the dead bear cub in his trunk, the dog (or was it a goat?) he once ate off a stick in the Andes.

Kennedy’s unlikely coalition of vaccine skeptics, New Age influencers, environmental activists, Silicon Valley pundits, and right-wing fans was held together by nostalgic vibes and cash infusions from his running mate, philanthropist Nicole Shanahan. Kennedy and Shanahan rarely saw one another. She spent her time visiting raw milk farms, talking about soil as a political issue, and musing about whether the government may be “satanically possessed.” (Kennedy did not even mention her in his speech suspending his campaign.)

Kennedy commutes to the premiere of the documentary “Recovering America” in Albuquerque on June 15.David Williams for TIME

Despite all this, Kennedy polled in double digits for more than a year. The candidate cast himself as a third choice during an election cycle that should have presented the biggest opportunity for an independent candidate in decades. In polls, roughly 2 in 3 Americans said they dreaded a rematch between the 78-year-old Trump and 81-year-old Joe Biden. In a campaign season ripe for a third-party spoiler, Kennedy’s bid had the potential to capture enough support to swing a tight race. Three major forces in U.S. politics—the Democratic National Committee, the Trump campaign, and Kennedy’s own prominent family—all feared that he could draw enough voters to affect the outcome in November.

Read More: Inside the Very Online Campaign of RFK Jr. 

But Kennedy’s haphazard operation was unable to capitalize on broad public dissatisfaction with Trump and Biden. Like the candidate himself, it operated without a clear goal or coherent ideology, according to interviews with half a dozen current and former campaign staffers and advisers. One month, it would veer left, casting the candidate as “the original liberal” and “old school Kennedy Democrat.” The next, it would pull sharply to the right, flying Kennedy to Arizona to “formulate policies that will seal the border permanently” and promoting COVID-19 conspiracy theories.

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The 70-year-old candidate was more or less cosplaying the process of running for President, according to current and former staffers. “He hates making binary, black-and-white choices, and he hates deadlines,” says one former adviser. Staffers described a chaotic campaign rife with screaming matches on Zoom calls. Longtime associates from Kennedy’s days in environmental and anti-vaccine activism collected six-figure salaries without showing up to a single meeting, they said, describing a constant clash between right and left-wing factions as the campaign struggled to define their candidate’s platform.

Supporters attend a screening for
Supporters attend a screening for “Recovering America”, a documentary that features Kennedy, at the Kiva Auditorium in Albuquerque on June 15.David Williams for TIME

Staffers who believed in Kennedy’s stated mission of “healing the divide” tried to propose a more strategic approach. “I can’t be the only one saying let’s go to Michigan, Wisconsin, Arizona, Nevada,” recalls one former staffer. “Why are we going swimming with sharks in Hawaii from an electoral standpoint? Why are we posting videos of him sailing and skiing?” Surrogates found themselves having to guess Kennedy’s stance on issues. “I’m going on TV in front of millions of people,” says a former staffer, “and if they ask me about this guy’s policies, I have no f—ing clue where he stands day to day.”

Kennedy’s campaign said they were not asking supporters to agree with all his policy positions. His own vice president didn’t. Shanahan, the 39-year-old ex-wife of Google co-founder Sergey Brin, only met Kennedy twice before deciding to become his running mate and often seemed surprised by the ticket’s positions. In May, she was visibly taken aback when a podcast host told her that Kennedy supported a woman’s right to an abortion up until birth.

She also often appeared blind-sided by revelations about his past. Responding to allegations that he had been accused of sexually assaulting a babysitter, she told TIME on July 5: “Maybe he didn’t know that this was the babysitter and thought it was his wife, and came over and affectionately, like, touched her and was like, ‘Whoa, that was a mistake!’” When a photo was published that allegedly showed Kennedy eating a dog in Patagonia, Shanahan asked her fiancé to call him for answers. “I was incredibly alarmed,” she told TIME, “I was like, this is not okay. You can’t eat dogs!” (Kennedy told her it was not a dog, but a goat.)

Advisers complained about the hefty salaries paid to Kennedy allies, many with scant political experience, who struck colleagues as doing little actual campaign work. “It felt like I was the only one on the campaign who didn’t have another organization or nonprofit or Substack or podcast they were promoting,” says another former staffer. One of Kennedy’s senior advisers, Charles Eisenstein, was paid up to $21,000 per month, according to federal election filings, despite taking extended sabbaticals in Costa Rica, calling some of Kennedy’s views “repugnant” on a podcast, and telling his 80,000 Substack subscribers that “winning the campaign is not the end goal.” (Eisenstein did not return TIME’s request for comment.)

Kennedy for President buttoms at an event in Albuquerque on June 15.
Kennedy for President buttoms at an event in Albuquerque on June 15.David Williams for TIME
Lawn signs for the Kennedy Shanahan campaign at an event in Albuquerque on June 15.
Lawn signs for the Kennedy Shanahan campaign at an event in Albuquerque on June 15.David Williams for TIME

Much of the campaign’s time and money was spent on a fight to appear on state ballots across the country. But a significant amount was spent on efforts to position Kennedy as a scion of his famous father and uncle. A super PAC spent $7 million to air a 30-second ad during the Super Bowl in February, which channeled President John F. Kennedy’s famous 1960 spot. It also paid for a half-hour documentary, titled “Who is Bobby?”, produced by former Hillary Clinton aide Jay Carson and narrated by Woody Harrelson. These campaign videos, which were promoted on X and YouTube, cast Kennedy as the heir of his father’s political legacy.

Read More: The Podcast Campaigners.

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Even a flailing Kennedy campaign spooked national Democrats and Republicans, who feared polls could not account for what might happen when Americans fed up with their choices saw a Kennedy on the ballot—no matter what he stood for.

The DNC ran an aggressive, organized, and unusually public effort to draw attention to Kennedy’s history of conspiracies and paint him as a Republican-backed stalking horse for Trump. It focused on Kennedy’s ballot-access efforts, retaining lawyers to file legal challenges against the campaign and his super PAC for any violation of federal coordination laws. They were especially worried about swing states, where even a small number of votes could potentially sway the election. “What he seems to be mad at is that the DNC is engaged in politics,” says Lis Smith, who runs the DNC “war room” targeting third-party candidates, “and that his campaign is completely unprepared to wage an effective political campaign.

Kennedy’s famously private family also came out in force. His sister Kerry has called his candidacy “dangerous to our country,” and other siblings have called the situation “heart-wrenching” and characterized his policies as “fringe thinking, crackpot ideas and unsound judgment.” Some younger family members were less subtle, with one calling him an “embarrassment” and depicting him as a Russian stooge. “Our brother Bobby’s decision to endorse Trump today is a betrayal of the values that our father and our family hold most dear,” five of Kennedy’s siblings said in a statement. “It is a sad ending to a sad story.”

RFK Jr. For Time Magazine
Kennedy poses with supporters while surrounded by security at an event in Albuquerque, NM on June 15, 2024.David Williams for TIME

The turn toward Trump may have been driven in part by his running mate. In an interview with TIME on July 5, Shanahan, a former major donor to Democratic candidates including Biden, laid out her disgust at the Democrats. Their victory would be “more problematic for democracy than four years of a Trump presidency,” she said. “When you actually get to know those people around Trump, you realize that they’re not as evil as they’re made out to be.”

Shanahan also expounded on a series of right-wing conspiracies, referring to the false notion that Vice President Kamala Harris allowing hundreds of children to be “abducted at the border” and suggesting 9/11 conspiracies merited closer examination. (Shanahan said she had only recently Googled QAnon after being told some of these theories overlapped). “People throw around words like paranoid, fringe, conspiracy, or anti-science,” she says. “I would redefine what fringe and conspiracy theory is. There are millions of Americans questioning if the government is satanic…wondering if there’s some awful evil that has overtaken this country.”

The Trump team’s approach to Kennedy shifted as the campaign progressed. When Kennedy first announced he would run as a Democrat, in April 2023, Trump allies amplified the campaign, believing it would hurt Biden. Kennedy was a frequent guest on right-wing shows, and Fox News aired dozens of segments about his campaign, including a full-length documentary. Kennedy “was making some inroads” with voters, former Trump adviser Steve Bannon told TIME in June, calling Kennedy an “instrument” to help Trump.

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Read More: QAnon Candidates Are Running For Local Elections.

Yet over time, polls indicated that Kennedy was increasingly drawing voters away from Trump, and that Republicans largely viewed Kennedy more favorably than Democrats. Trump began to bash Kennedy as a “Democrat Plant” and “radical left liberal” and insulted his family as a “bunch of lunatics.” He warned Republicans that a vote for Kennedy was a “wasted protest vote.”  

As his poll numbers sagged— in a recent CBS News poll, Kennedy drew 2%—and his campaign ran out of cash, Kennedy blamed his lack of momentum on a multi-front war against his campaign. But he particularly blamed Democrats, saying his campaign was under siege by shadowy DNC operatives. “Some of the stuff they’ve done is just crazy,” he told TIME on June 15, somberly thumbing the beads of a white rosary in a dingy side room of the Albuquerque convention center. Kennedy said his campaign had been infiltrated and sabotaged by undercover Democratic operatives trying to “gut it from within.” At every level, he said, “we’re seeing a lot of dirty tricks being used against the campaign.”

RFK Jr. For Time Magazine
Robert F. Kennedy Jr. in Albuquerque, NM on June 15, 2024.David Williams for TIME

At that time, Kennedy was withering in his appraisal of Trump. “I don’t think President Trump has a high interest in actually governing,” Kennedy told TIME. “I think he had a very high interest in campaigning.” He sharply criticized the former President’s “really weak” handling of the COVID-19 pandemic. “He let Anthony Fauci do whatever he wanted,” Kennedy said. “He gave us lockdowns, closed 3.3 million businesses, he bankrupted the country, ran up an 8 trillion dollar debt.”

Shanahan was equally disparaging. “I don’t like his style,” she said of Trump in her separate interview with TIME. “It’s very brutish.” A Democrat or Republican win would be “different flavors of awful” for the country, she said.

Yet behind the scenes, Kennedy and his inner circle had long pondered a Trump endorsement. In January, a proposal had made the rounds laying out the case for joining forces with the Trump campaign while Kennedy had leverage.

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“A convergence of these two campaigns would change the landscape of American politics, ushering in a new era,” Link Lauren, a 25-year-old senior adviser, wrote in a memo, which TIME obtained, to Kennedy and his senior staff. “Trump is not running as a Republican. He’s running an America First agenda. He’s running outside the lines of the two-party system, just like you.”

The proposal, which campaign manager Amaryllis Fox had workshopped, was enthusiastically backed by much of the senior campaign team at the time, according to Lauren. “I thought it would be better to have a seat at the table to impact policy than go home empty-handed,” he said. But key advisers, some of whom were being paid huge monthly sums to work remotely, cooled on the idea when they realized that if Kennedy suspended his campaign they would stop receiving their salaries, according to a former staffer.

By mid-summer, Kennedy appeared to be openly shopping around for the best offer, to the panic and disgust of some of his most fervent supporters. Trump changed his tune on Kennedy, describing him as “a little different, but very smart” and saying he would be “honored” to receive his endorsement.

Trump and Kennedy met in Milwaukee during the Republican National Convention, and a leaked video of a phone call between the two candidates showed Trump appearing to appeal for an endorsement. “I would love you to do something,” Trump said in the video of the call, which was leaked by Kennedy’s son. “And I think it’ll be so good for you and so big for you. And we’re going to win.” In the weeks that followed, Donald Trump Jr. and investor Omeed Malik were among those working to persuade Kennedy to jump on board, according to a source familiar with the discussions.

In the wake of a successful convention, Democrats dismissed the move. “Donald Trump isn’t earning an endorsement that’s going to help build support, he’s inheriting the baggage of a failed fringe candidate,” DNC senior advisor Mary Beth Cahill said in a statement on Friday. “Good riddance.”

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With reporting by Eric Cortellessa

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Video: 8 Children Killed in Louisiana Shooting, Police Say

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Video: 8 Children Killed in Louisiana Shooting, Police Say

new video loaded: 8 Children Killed in Louisiana Shooting, Police Say

A gunman shot 10 people, killing eight children, in a domestic violence shooting at multiple locations in Shreveport, La., the police said. The victims ranged in age from 1 to 14. The gunman was later fatally shot by officers.

By Christina Kelso

April 19, 2026

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Communities launch cleanup after severe weather and tornadoes churn across Midwest

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Communities launch cleanup after severe weather and tornadoes churn across Midwest

An aerial view shows damage from a tornado, on Saturday in Lena, Ill.

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Communities across the Upper Midwest are cleaning up after tornadoes and severe weather impacted the region over the weekend, damaging and destroying dozens of homes and knocking out power for tens of thousands.

“Numerous” severe storms were tracked across parts of Iowa, Illinois and Missouri on Friday, according to the National Weather Service. At least 66 tornado reports were submitted in multiple states including Oklahoma, Illinois, Missouri, Wisconsin and Iowa, the NWS Quad Cities IA/IL office said Sunday.

No deaths have been reported from the severe weather and tornado outbreak.

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In Marion Township in Minnesota, about 30 homes were damaged and a dozen have significant damage because of a tornado, according to the Olmsted County Sheriff’s Office. The tornado also damaged at least 20 homes in Stewartville and there is a temporary shelter in Rochester for people displaced by the storms, according to MPR News.

“Tornado disaster recovery continues to occur at full speed,” the Olmsted County Sheriff’s Office said on Saturday.

In Illinois, McClean County officials declared a disaster emergency because of severe storms in Bloomington. “At this time, no injuries have been reported, and emergency response agencies remain actively engaged to ensure public safety and continuity of essential services,” officials said in a statement.

But further north in the village of Lena, an EF-2 tornado caused the “most significant damage” where “many homes and outbuildings were damaged, trees uprooted, and power lines downed,” the NWS said. Numerous roads have also been blocked by debris, the Stephenson County Sheriff’s Office also said.

People continue to clean up following tornado on April 18, 2026 in Lena, Illinois.

People continue to clean up following a tornado, on Saturday in Lena, Ill.

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There have been no fatalities and no reports of serious injuries associated with the storm, Chief Deputy Andy Schroeder from the Stephenson County Sheriff’s Office told NPR on Sunday.

More than 43,000 customers lost power in Illinois but power was restored to almost all of them by Saturday night, according to electric utility ComEd.

Several tornadoes also occurred across Wisconsin, according to the NWS office in La Crosse. Twenty-six tornado warnings were issued by the office on Friday, the most in one day since the weather service office was built in 1995.

In one Marathon County town, 75 homes were destroyed by a tornado, according to Ringle Fire Chief Chris Kielman.

“It took out a whole residential area,” Kielman said, according to Wisconsin Public Radio.

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The American Red Cross of Wisconsin said volunteers are helping those impacted by the storm with meals, shelter and support.

Parts of the state are still dealing with multiple rounds of severe weather and tornadoes from earlier in the week that brought flooding to some communities.

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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.

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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.

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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)

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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.

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“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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“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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