Chapter 49

"I showed you the map with all their connections." Harry said. "As I said, the LTACHs are the ones we're concerned with. They're the big moneymakers. All the other relationships, they're profitable enough. And it's a good steady flow of revenue. But these LTACHs, Alex, Jessica, I don't know if you looked at all of them, but those Blue Cross bills were over two hundred thousand a month. All the add-ons, tests, drugs and medical supplies, probably another twenty to thirty. We're still adding those up. So you in there for seven months, close to a million if not over. And if they could have kept you longer, eventually persuaded your sisters you were a goner no matter what, they they might have a chance at selling you for spare parts. And with some people they might have pulled it off. And if not, you were a gold mine."

A million dollars on one patient.

"You were a special case," Harry said, "but they could be pulling in close to a million each on any number of patients, considering that the average stay of twenty-five days could easily run a half million. And a lot of that is in kickbacks and sweetheart deals, with the various entities in the CHC umbrella buying and selling to and from each other, most of that money stays in-house. That thirty million I speculated on earlier might be a conservative estimate."

"Who's getting paid at the top?" Jessica asked. "The investors must be finding their investment worthwhile."

"I imagine they are." Harry said. "These people don't like losing, so whatever they do they make sure up front they're able to make it work. They don't accept excuses from the underlings - either they produce or they're out. One thing I found, from public sources, is that they're on their third CEO in four years. So there probably have been problems."

"What about the investors?" Jessica asked.

"That's where it gets dicey. It's a non-profit, so without a court action you can't get them to divulge much. I suspect that CHC kicked in some, but maybe not. If the local guys had plenty, it might be locally funded. I'll have to get people into some places, get in the gossip of the local business community. Probably cultivate some employees of some of the big players. You'd be amazed, or maybe you wouldn't, at the gossip among the people who work at these places. Who's fooling around on their spouses, whose kid has drug problems, which ones are getting arrested and dad has to pay off someone to keep it quiet. Takes a while but that's how a lot of useful information gets collected.

"What kind of money are we talking about," Alex asked, "to get it up and running?"

"From the looks of it not as much as you'd think." Harry said. "When you're talking about a fully functioning hospital, emergency room, all the equipment, hiring staff, it seems like quite a lot. The new NEA facility was said to have cost two hundred million. But it's at least ten times the size, and built forty years later. So a straight comparison, ten percent of two hundred you're already down to ten million turnkey. So sitting there rotting down, forty years old, no prospects - they probably paid under a million. Or bought it for a dollar and 'other valuable considerations'. Which wouldn't surprise me."

"So nothing," Jessica said, "except enough money to hire some staff, maybe buy some equipment and supplies, a few other minor expenses."

"Pretty much. They get their supplies and equipment through the network they're part of. Most of the money stays inside the organization. Some goes out into the local economy through local taxes, utilities expenses, minimal labor costs. But most goes into the coffers of the organization."

Thirty, forty million a year. Out of this little place. That's serious money.

"I don't suppose they're going to like you prying into this." Alex said.

"Not at all. Seriously, this could get ugly. The local people are likely into a lot of other schemes. If it's who I suspect..."

Who? Not wanting to say something.

"Sorry, where was I?" Harry seemed to have just realized he had stopped speaking and that they were waiting.

"Even here in a small place like Jonesboro," he said, "there's a lot of organized crime activity. Jonesboro's a clean-looking place - although it's gone downhill in recent years - and on the surface it's all middle America, just like it seems to be on television. Or did twenty years ago. But the corruption was always there. Old Brodell, don't know if you remember him, was mayor for almost twenty years. Once you're chosen by the machine, it's almost automatic. Just like getting elected to Congress, once you're in there it takes something pretty big to get you out, as long as you serve your masters loyally.

"At this level it's small stuff, trading favors mostly, that helps the insiders get ahead while the outsiders are lucky if they get anywhere. And part of that system is all that money, a lot of it under the table but a lot laundered through legitimate channels. Like the Mob, only slicker. The Mob is a bunch of thugs, even at the top, focused on getting their hands on as much money as they can, any way they can. Covering it up is more of an afterthought, and since they'd kill you without a second thought if you're a potential leak, informers are hard to come by."

"Is organized crime involved here?" asked Jessica.

"Probably. All crime is organized, really. Even in Trumann where you live, you can be sure there's a group, a small one, that controls everything of any importance. Local elections, whether or not businesses have to obey the law, or even get a license to operate, if you're not in the club you don't get the benefits. And you have to pay to play. You have to be pretty small to operate without paying. You get big enough, they send the collector around to sell you their insurance, if you get what I mean."

"I get it." Jessica said. "I don't like the way it makes me feel, knowing most of the people I see every day are compromised to some degree."

"For most it's a small compromise. Moneywise. Most just go along to get along, as they say. But you walk into a bank or a lawyer's office, or a hospital, the people there are just working for living, for the most part. But as you move up the food chain, the compromises get bigger. But you've got too much invested by then. Big house you can't really afford, cars you can't afford or need, but your peers have them. Country club membership, a vacation home if you get to that level. And the vacations. If you want to fit in. A lot of those people are in debt, and will never get out. The ones that are insiders though, they've got a lot more money, on or off the books it's dirty."

"How do you know who's in and who's not?" Alex asked.

"It's not easy." Harry said, "Some of them you can spot, others are more subtle. Or not in as deep, but still in. You know Jerry Brewer, don't you?"

"I may have. Someone I know? Knew?"

"He was in your senior class." Harry said. "I noticed it when I was investigating him. One of the things I came across was a class picture. I found your name before his."

"So we went to school together. Does he somehow figure into this?"

"I don't know yet. I was looking for something else, when you came in I remembered seeing your name somewhere. He runs Glenwood Jewelers on Caraway Road. Fancy shops down there."

"Runs it?"

"He's the manager. Guy that owns it is filthy rich, at least by local standards. He's mostly into high-dollar real estate now, but he made his first fortune with a chain of medical supply stores. Wheelchairs, walkers, those mobility scooters everybody got now. Paid for by Medicare and Medicaid. He got in at the right time, when the government started throwing money into it with the usual incompetence. Massive fraud, eventually they sued a few of the manufacturers for bribery and kickbacks, but nothing much came of it. About five or six years ago Carlisle, sorry, you probably don't remember, Kenneth Carlisle was the owner, sold out to a bigger company. All I have on the price is rumors, both companies were privately held, but the most consistent ones I get are in the thirty to forty million range. Given the size and the habit big companies have of overpaying when they want something bad, it's probably about right.

"With his earnings for about twenty years of running it, he's sitting on a lot of cash. And the word is he's pretty tight. Doesn't go out and blow off steam in Vegas a couple of times a year, house isn't near one of the biggest. And he's got the jewelry store, and probably a couple of other ways to launder money."

"A jewelry store?" Alex asked.

"A favorite. Along with flower shops. Mob used those since Capone's day. And still does. Lot of cash business, ones like his are too small to attract the notice of the IRS as long as they're reasonably careful. Don't get too greedy, that's usually what gets them.

"The reason I asked you about Brewer, he lives out in Carriage Hills. One of the bigger houses, and they're all big. Drive by sometime. He went to work working for Carlisle when he opened that store. Go by there any day, maybe there's a customer or two in an hour, or not. Sure, a lot of rich folks blow a lot of money on jewelry, but not so the store manager can live in a house like his. About a four to five acre place he lives on, big wood fence around about an acre of it. They don't like the RVs and boats and extra vehicles visible. And he's got a few. A few years back, he was at his hunting club, setting up trail cameras for deer season. Fell out of a tree, broke his back. They couldn't fix it, and he's in a wheelchair. Drives a big Chevy Silverado 2500, a crane in the back to lift his wheelchair in and out."

"Jewelry store manager, huh?"

"We've been to Carriage Hills a time or two." Jessica said. "Emma lives there. She had office parties there occasionally. It's about the most expensive part of town, and exclusive. You can't buy a house there unless you know the right people."

"Right," Harry said, "and some of those right people pretty unsavory. But you wouldn't know it, knowing them casually. At Chamber of Commerce meetings and ribbon-cuttings, charity events, all smiles and pleasant small talk. Underneath, there's some ugly stuff. I've seen more than I want to, but I've got to follow this."