Deaths Abound in New York’s Jail Infirmaries. So Do Profits.

“There was a complete failure by the medical staff to properly assess and provide treatment for a gravely ill individual,” the investigation report said. “Had Loori been timely sent to the hospital for a diagnosis and treatment, his death could have been prevented.”

The medical workers responsible for Loori’s death didn’t work for Broome County, but for companies under a corporate contractor, PrimeCare Medical. For-profit health care companies like PrimeCare have proliferated in New York jails in recent decades — even as scores of incarcerated people have died after they were provided inadequate care, according to a New York Focus review of court records, state death investigations, and financial reports.

Much of the neglect can be traced to the profit motive. Around New York and across the country, municipalities have replaced county-provided jail health care with private jail medical companies, which promise to improve care even as they seek to bank as much of their contract revenue as possible. In many instances, counties pay the companies preset fees based on how much care they estimate jail populations will need. And while some contracts have mechanisms to adjust the fee based on care provided, companies don’t always share the requisite information. The fewer procedures and services staff provide, the more the companies profit.

One company linked to dozens of deaths pocketed 25 percent of the money it received from nine New York county contracts over five years, documents show.

In other cases, companies have found ways to avoid spending on care they promised to provide. In 2023, Broome County audited PrimeCare, finding that, in the year and a half surrounding Loori’s death, the company failed to provide nearly 4,500 hours of medical care the county had paid for — over $250,000 worth of services unrendered. (PrimeCare denied the deficit, but paid the difference anyway — to maintain a relationship with the county, the company claimed.)

In an interview with New York Focus, PrimeCare’s CEO, Tom Weber, acknowledged that companies are incentivized to withhold care. “Years ago, the model would’ve been defined as ‘as little care as possible,’” he said. But public attention keeps companies in check, he asserted.

“There’s a lot more sympathy and empathy [for incarcerated people] out in the community,” he said. “And because of that, if something happens, we’ve seen various cases where there’s uproar.” Neglect is bad for business, Weber said: “The biggest risk to our business is litigation, lawsuits, bad, bad outcomes.”

Public attention hasn’t curtailed those bad outcomes. Since 2020, at least 82 people have died in New York jails outside of New York City, according to the State Commission of Correction, which oversees jail conditions and investigates deaths. Of the 44 of those deaths for which SCOC has published investigative reports, it attributed at least 27 to inadequate health care.

In 2021, a Utica woman deteriorated for nine days while staff neglected to call the jail doctor even as she became less able to move; she died of Covid, MRSA, and sepsis. In 2022, a jail nurse in Rockland County falsified records to say she had checked a man’s restraints; he died when they cut off blood to his heart. Later that year, a baby died after being born in a Syracuse jail cell, her mother’s cries ignored for six days.

After 16 of those deaths, SCOC recommended that the jails reconsider their medical providers. Yet as outrage has mounted, providers have evaded. Some have rebranded, changing names amid scandals. Others have begun to leave the state, their contracts taken up by different companies with nearly identical models and patterns of alleged neglect, creating a revolving door of medical profiteering.

Last year, New York state passed a law expanding its ability to regulate New York-based private medical contractors. The law requires contractors to seek state approval if they want to change their corporate structure, but leaves their business model untouched. They continue to proliferate in New York: More than half of the state’s county jails use for-profit medical providers.

The current system is a win-win for jails looking to offload responsibility for sick incarcerated people and corporations seeking to profit off of medical neglect, according to Andrew Pragacz, a sociologist and anti-incarceration activist.

“Every time a private medical provider doesn’t provide care,” Pragacz said, “they make money.”

In 2015, Yasir Barton thought the Broome County Jail was starving his brother. “He was skinny,” he said of the last time he saw his sibling, Salladin Barton. “Looking back, I could see death in his eyes.”

It was medicine that was killing Barton, not malnutrition. Medication prescribed to treat his bipolar and schizoaffective disorders changed his body’s ratio of potassium and sodium. It was a well-documented side effect, and a hospital told the jail to reduce his risk by restricting his fluid intake. But medical staff never sought his discharge paperwork and didn’t conduct their own blood tests. They watched as Barton downed water and powdered drinks, according to a SCOC investigation and court records. Corrections officers found him dead on the floor, a lethal amount of potassium in his blood. He had been incarcerated for 19 months after his most recent arrest. He died before going to trial.

At the time, Broome County contracted with Correctional Medical Care, or CMC, which SCOC and a federal judge later held responsible for Barton’s death. The company’s actions shouldn’t have been a surprise: The jail had “abundant notice” of CMC’s record of providing “seriously inadequate” medical care, the judge wrote.

That record went back years. In October 2009, Joaquin Rodriguez curled up on his side and vomited from diabetes complications while incarcerated at Rochester’s Monroe County Jail, which contracted with CMC for medical services. He went untreated for 36 hours and died after five days. In a report, SCOC accused CMC of “gross negligence and gross incompetence.” It described the company as “a business corporation holding itself out as a medical care provider.”

More people soon died under CMC’s watch: in 2010, a 26-year-old in Dutchess County and a 53-year-old in Monroe County. The year after that, a 28-year-old in Schenectady County, a 21-year-old in Ulster County, a 51-year-old in Dutchess County, a 40-year old in Broome County, and a 41-year-old in Tioga County all died in jails with care provided by CMC.

In 2014, Mark Cannon dizzily stumbled through the halls of the Albany County Jail, according to a SCOC investigation. There wasn’t a physician in the jail at the time, and the nurse on duty delayed calling one, even as he collapsed and foamed at the mouth. The nurse didn’t check Cannon for neurological issues, either. She gave him Gatorade and put him to bed. Five days later, he was brain-dead from a stroke that would have been treatable if caught in time.

CMC later asserted that deaths are inevitable. “The population we’re dealing with is getting sicker and sicker through the years,” CEO Emre Umar said in a deposition. Like Weber of PrimeCare, he alluded to “bad outcomes”: “Some of these are unavoidable.”

SCOC asserted that CMC’s treatment of Cannon demonstrated such a “callous disregard of a patient in a life threatening condition that it shocks the conscience.”

The year Cannon died, CMC’s contract with Albany County was worth $3.9 million. CMC predicted that about $135,000 would go to profit — a mere 3.5 percent.

Instead, the company made more than triple that: $489,000.

In fact, from 2010 to 2015, CMC banked over $19 million of the $80 million in contracts it secured with nine local correctional facilities in New York, according to internal budget documents — a 25 percent profit margin.

In 2014, the year the attorney general published the results of its investigation, a doctor at CMC founded a new medical practice, CBH Medical, which was later licensed as a professional corporation in New York.

The CBH website directed people to the company’s partner, CMC. The two companies shared an office — the same suite in Blue Bell, Pennsylvania. Of the four members of CBH’s core team today, three held the same position at CMC in 2018. Yet CBH is incorporated as a separate company. By partnering with CBH, CMC is following the letter of New York’s law, even though the same people are making the decisions.

CMC and CBH did not respond to multiple requests for comment.

“In my view, [there’s] no difference. They’re just playing games,” said Ronald Benjamin, a Binghamton attorney who has brought multiple lawsuits against CMC.

CMC held on to most of its contracts and added CBH as a partner. The following year, it made $303,000 on its Albany County contract — a 24 percent profit.

For six days, Cheree Byrd pleaded with jail staff. She said her water had broken and that she was in labor, but NaphCare partner staff didn’t send her to a hospital. She gave birth in her cell to a premature baby, who died soon after.

Shortly after Byrd’s baby’s death, Onondaga County’s contract with the NaphCare partner expired. (“We are confident in the quality of care we and our affiliated companies provide to our patients,” a NaphCare spokesperson said in a statement after declining an interview request.) The county replaced it with a company formerly known as Correct Care Solutions, the largest correctional medical care provider in the country. In 2019, a CNN investigation found that the company had been sued for more than 70 deaths nationwide. Emphasis on “cost containment” techniques had led it to understaff facilities and provide minimal training.

A private equity firm later acquired Correct Care Solutions, merged it with another private medical provider, and renamed it Wellpath. Federal investigations into Wellpath’s work in California found that the company’s doctors and nurses failed to diagnose and treat common diseases and infections and shredded medical documents. Wellpath-contracted staff have repeated that behavior in New York.

At the Rockland County Jail, Wellpath’s on-call physician didn’t respond to reports of Ferdy Jacinto-Martinez’s dangerously elevated blood pressure in the days leading up to his death. He died on a trip to the hospital, when restraints used to hold him in an ambulance gurney compressed his neck, causing cardiac arrest. A nurse falsified records to say that they had checked his restraints prior to the ambulance ride; security video showed they never entered his room, SCOC found.

Despite the scandals, Wellpath’s presence in New York jails grew. In addition to Onondaga County’s agreement with NaphCare, the company and its affiliates took over at least three former CMC contracts across the state. The company, which did not respond to requests for comment, currently operates in at least six counties.

For SCOC’s part, the commission regularly asks counties to inquire into the fitness of their medical providers. But it doesn’t force them to choose new vendors.

“The appointment of the jail’s health care provider is by the authority of the county legislature or board of supervisors,” a SCOC spokesperson said.