Best Place to Die (12 page)

‘You lost me,' Jamie had said. And Mattie had been grateful as she was on the verge of losing the train herself.

‘Cut-off points.' Fitzhugh had explained. ‘If you're one of the top billers for a particular service, a cursory review is automatically triggered. If there's even a hint of impropriety, the Office of the Inspector General begins an investigation. If in the course of that investigation it appears that something was being done deliberately it gets shifted to Department of Justice and that's where we come in. The Nillewaug scam is unlike anything we've seen, and certainly never on this scale.'

Connor had then explained: ‘From the time this facility was created someone had this in mind. From the three cases we've started in on it boils down to this, although there seem some variations throughout. Essentially someone buys into Nillewaug at considerable cost, and pays a monthly fee. These are people of means – not impoverished Medicaid recipients.'

‘I thought all old people get Medicaid,' Jamie interjected.

Mattie shot her a look. ‘No, that's Medicare. Medicaid is for the poor.'

‘Yes,' Fitzhugh said, and to Jamie: ‘Most people don't know the difference, until they actually try to access one of the programs. But with Nillewaug the Medicaid benefit they were billing was for nursing-home care. You can only be eligible for it if you fall below the poverty line for at least three years. Which, considering the buy-in for an apartment at Nillewaug is a quarter million on up, and then you have monthly fees of about three grand . . .'

For Mattie this was familiar territory. Her own mother, with early Alzheimer's and advanced diabetes, had been in a nursing home outside of Bridgeport for the past three years. And yes, Medicaid picked up the tab for her mother whose only remaining material asset was a modest burial plan. ‘How could they possibly qualify for Medicaid?' she asked. ‘Anybody who can afford a quarter million dollars is way too wealthy.'

‘Yes,' Connor said, ‘but in the cases we've started to drill down through what appears to happen is at the point someone enters Nillewaug they begin a financial reconfiguring. Essentially, they are stripped of any recordable asset, through a combination of divestment and trusts. And five years after their balance sheet dips below the critical mark, an application is filed with Medicaid. So not only does Nillewaug rake in on the front end, by selling expensive units that aren't really owned by the tenant, they receive their monthly fees through very clever end-of-life estate planning. On paper the resident has nothing, but their families are still paying the monthly fees. And after five years Nillewaug then begins double-billing the government for those same fees.'

‘But,' Mattie said, recalling a long-ago conversation with Preston, ‘Nillewaug is an assisted-care facility, only a small portion is a nursing home.'

‘Yes and no, and that's part of the beauty of this scam,' Connor had said. ‘When licenses were filed with the state, the entire facility was given nursing home designation. So while in fact maybe one hundred beds are truly nursing home, all seven hundred residents could theoretically be counted – and billed – as extended care. Now, nationwide the average nursing home will have between seventy-five and ninety percent of their patients on Medicaid. It's by far the number-one payment source for that level of care. Nillewaug, as a licensed nursing home with seven hundred beds is staying way below those percentages.'

‘And never triggered an audit,' Mattie had said, following the logic.

‘Clever, huh?' Connor had said, just as Jim Warren was being led into the interrogation room.

Now, watching through the glass, pieces of heretofore random information clicked for Mattie. And with it her anxiety ratcheted up. Connor and Fitzhugh had pretty much admitted their hand was too weak to hold Warren on the fraud charges; they needed more time to trace the money. Warren's attorney knew this, and had his client on a tight leash. And now her gaze was riveted on the scene unfolding before her. Agent Connor was holding up a black leather gym bag wrapped in a see-through evidence bag. He raised it and then placed it on the table in front of Warren. He proceeded to put on a pair of disposable gloves. ‘Do you recognize this bag, Mr Warren?' he said as he unzipped it, revealing a change of clothing, each piece in its own evidence bag.

Jim Warren seemed frozen in his metal chair. His eyes fixed on the items as they emerged.

‘Mr Warren?'

‘We observed and filmed you depositing it and its contents early yesterday morning into a donations bin, before proceeding to the airport.'

‘So?' Warren said, his eyes darting to his attorney and then back to the agent. ‘So what, I'm giving clothes to charity?'

‘Yes,' Connor said, ‘the very clothes we filmed you in on Saturday night when you “probably” visited Nillewaug Village at eight oh-two p.m. . . . What were you doing there, Mr Warren?'

Jim looked to his attorney, and shook his head.

‘My client has answered all he intends to. I suggest we leave things in the judge's hands at his arraignment this afternoon. But, gentlemen, based on what's been presented so far, unless you pull a rabbit, Mr Warren will not be with you much longer.'

Mattie pulled out her cell and punched in the number Fitzhugh had given her. She sensed the two agents' frustration as they glared across at Warren and his slick attorney. Through the speakers she heard the phone ring and Fitzhugh pulled out his cell. ‘Yes?'

‘The M.E. said Preston had had sex within hours of her murder. Maybe that's why he was there.' And then, thinking it through further: ‘And that's why he wanted to ditch the clothes. He knew she was dead. He's scared of what physical evidence we'll find on his clothes.'

Fitzhugh nodded slightly and put his phone away. ‘Earlier,' he said to Warren, ‘you said that your only knowledge of Delia Preston was as an employee of Nillewaug. Is that accurate?'

‘Yes,' Warren answered, his eyes narrowed.

‘And you hired her when the facility first opened?'

‘Yes.'

‘So she'd be your employee.'

‘Yes.'

Attorney Windham interjected, ‘I don't see the point of this. We've already discussed Mr Warren's employer/employee relationship with Ms Preston.'

Keeping his gaze fixed on Jim Warren, Fitzhugh didn't even acknowledge the attorney. ‘Do you sleep with all your subordinates, Mr Warren, or just Ms Preston?'

‘Oh my God,' Jamie blurted, her eyes riveted on Warren's face.

Mattie held her breath.

‘Don't answer,' Attorney Windham quickly warned.

‘Why not?' Fitzhugh's expression blank. ‘Here, let me make it simpler. Were you having a sexual relationship with Delia Preston?'

Silence filled the room.

Fitzhugh persisted: ‘A yes or no, Mr Warren.'

Jim Warren turned to his attorney.

‘Don't answer, Jim.'

‘I see,' Fitzhugh said, looking at his partner, and then at Warren. ‘Will you answer the question, Mr Warren?'

‘No.'

‘For the record,' Fitzhugh said, with a slightly theatric flare, ‘Mr Warren has refused to answer the question as to whether or not he was having a sexual relationship with Delia Preston, the administrative director of Nillewaug Village and one of the two signers on Betty Grasso's treatment plan.'

From behind the mirror Jamie turned to Mattie. ‘He was sleeping with her?'

‘Appears that way,' she said.

‘Betty Grasso is the woman who died up on the roof,' Jamie added. ‘Don't you think it's strange that it's her treatment plan? Was that deliberate?'

‘I don't know. But it's an excellent pick up. What I do know –' watching and listening as Fitzhugh and Connor continued to question the tight-lipped Warren – ‘they don't have enough to hold him.' She empathized with the two agents' frustration, a major case being carefully built and now possibly destroyed by prematurely bringing in their major suspect. All hopes of catching Jim Warren with a smoking gun evaporated as the man lawyered up and clammed up.

‘They're going to let him walk?' Jamie was incredulous.

‘Yes,' Mattie said, realizing several things. ‘At least for now. They'll keep a close eye on him. He's obviously guilty of something. But is it just millions of dollars of fraud, or a few homicides as well?'

‘And because of the federal fraud piece, this whole thing will be a federal case?'

‘Yes, if in fact the murders have any connection to the fraud,' Mattie said. And realizing Fitzhugh and Connor would get nothing further from Warren and that it would be only a matter of hours before Warren was released, she added: ‘We need to get back, and we have to work fast.'

‘What are you thinking?' Jamie asked.

‘I'm thinking maybe we can find something that will make a charge stick. We've got possible motive for murder – Preston implicating him in fraud, maybe blackmailing him. We have him at the scene of the murder, and know he was trying to leave the country. What we don't have is a witness or physical evidence.'

‘The clothes in the bag?'

‘Possibly, obviously he's worried about them.'

‘You think he killed her and set the fire to try and cover up the fraud?'

‘I don't know. But if he didn't, I bet he knows who did.'

K
yle Sullivan stared out the window of the charge nurse's office on the euphemistically named Safe Harbor Pavilion, the fifty-bed Alzheimer's unit where he'd been working when the fire began. His view was of deep woods and a brook swollen with snow melt and spring rains. He sighed and turned back to the computer screen where he'd been flipping between spreadsheets of the facility's residents as he tried to account for everyone.

His cell rang . . . again. He was beyond tired, operating on adrenalin and caffeine. Everything a blur, from the horrors of Sunday morning, to the realization that no one was in charge.
And how did this fall to me?
And that was the story of his life; he was the responsible one.
It's what you do, Kyle, so deal.
But worse than the responsibility was the guilt that twisted inside . . .
Why didn't I smell smoke? How did it get so big?
Realizing it had to do with how the building that housed the fifty dementia patients was sited to take advantage of the beautiful scenery in the wetlands behind Nillewaug.
This wasn't your fault.
And that horrible feeling when he'd heard the first fire truck, gone outside and seen . . . His immediate thought,
Grandma Alice!
He clicked on his cell, noting he'd need to recharge it, while a part of him wondered what would happen if he just let it go dead. He looked at the caller ID. ‘Oh crap! . . . Hello?'

‘Kyle?'

‘Hi, Lil, is something wrong? Is my grandmother OK?'

‘She's fine, you asked for us to check in.'

‘Right.' Picturing the taller of the two women who'd graciously agreed to look after Grandma Alice. It had been the one blessing in this nightmare.

‘Are you at Nillewaug now?' she asked.

‘Yes.'

‘Have you been home at all? Have you gotten any sleep.'

‘I can't.' He glanced at the clock, a little after noon.

‘The body has limits,' Lil said, reminding him of Grandma Alice in her younger, clearer days. ‘But everything's fine here. And Ada wanted to thank you for helping get her mother out of that place.'

‘Rose is a hoot, and I'll get my grandmother settled as soon as I can.'

‘Not a problem,' Lil said, ‘it really isn't. We have ample space and having someone to look after is good for Rose. So please don't worry about your grandmother, we've got things handled. Kyle?'

‘Yes?'

‘I'm going to ask you a favor, but you need to know you don't have to do it, and if you say no, it's totally fine.'

‘Sure, if I can help.'

‘You may not want to . . . I did a piece on the fire for the Brattlebury Register. It's on the front page of the morning paper. Would you mind if I asked you some questions?'

‘For the paper?' he said, thinking of just how many reporters had tried to get through to him, and were hounding the other nurses and aides. Still, she was taking care of Grandma Alice . . . ‘Shoot, but if I want something off the record . . .'

‘Absolutely. Thanks so much. You mentioned last night that a number of the residents still hadn't been accounted for. Do you have a number?'

He stared at the computer in front of him, and toggled to the spread sheet that listed all the Nillewaug residents, their vital information and contacts. ‘I've got it down to thirty-eight.'

‘Any chance you can get me the names?'

‘Sorry, I think that would get me in trouble with the HIPAA police.' Referencing laws around patient confidentiality.

‘Right.'

‘But you know,' he offered, ‘the cops have the names, they could probably release them. It might actually help in tracking folks down. Because I think what happened – at least this is what I'm hoping – is some families came and got people directly off the grounds. Kind of like what you did with Rose and Alice. There was so much confusion. I've been calling hospitals as far off as Hartford and New Haven, and still . . . thirty-eight unaccounted for.'

‘That's a lot.'

Over the line he heard the click of a keyboard.
Well
, he thought,
this is news, better she get the story.
A part of him, what his savvy twin sister, Kelly, called the smart part, wondered if getting the story might have been part of the motivator for this total stranger to magnanimously agree to take in Grandma Alice. The thought made him feel ashamed. He loved his sister dearly, but her cynicism . . . It worked for her, he supposed, but to go around constantly thinking the worst of people? Not for him. There was too much good in this world to focus on the negative. ‘I'm hoping by the end of the day everyone is accounted for. I don't know if that's realistic, but it's what we're shooting for.'