Ricky Martin finds new home on small screen

NEW YORK (AP) — Ricky Martin is saying goodbye to Broadway’s “Evita.” But don’t cry for him.

The Latin superstar has a slew of new projects in the works, including two television series and a children’s book.

“It’s about growing,” said Martin in an interview Friday. “It’s a moment in my life where I just need to absorb and be surrounded by amazing actors and musicians and grow as an entertainer. I think this is going to be an amazing year for that.”

Martin takes his final bow in the Andrew Lloyd Webber revival on Jan. 26. Then he heads down under to join the second season of the Australian edition of “The Voice.” But the Grammy winner says not to expect any biting, Simon Cowellesque critiques.

“I don’t believe in tough love. I believe in love, and I believe in being nurturing to new talented men and women,” he said at an M.A.C. Viva Glam event for Saturday’s World AIDS Day. Martin partnered with the cosmetics brand to raise awareness and funding for HIV/AIDS programs worldwide.

The “Livin’ la Vida Loca” singer is developing a new series for NBC, expected in 2013. He’s producing, writing and will star in the currently untitled dramedy, where he hopes to tackle social issues with humor.

He’s also writing his second book and admitted he didn’t have to look far for inspiration.

“I think it’s time to write about things that I’ve been through with my kids that I’m sure many daddys out there will understand,” said the father of 4-year-old twins Matteo and Valentino.

The family-friendly story about self-esteem is slated for release next summer.

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AP writer Sigal Ratner-Arias contributed to this story.

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Follow Nicole Evatt on Twitter at http://twitter.com/NicoleEvatt

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Opinion: A Health Insurance Detective Story

I’VE had a long career as a business journalist, beginning at Forbes and including eight years as the editor of Money, a personal finance magazine. But I’ve never faced a more confounding reporting challenge than the one I’m engaged in now: What will I pay next year for the pill that controls my blood cancer?

After making more than 70 phone calls to 16 organizations over the past few weeks, I’m still not totally sure what I will owe for my Revlimid, a derivative of thalidomide that is keeping my multiple myeloma in check. The drug is extremely expensive — about $11,000 retail for a four-week supply, $132,000 a year, $524 a pill. Time Warner, my former employer, has covered me for years under its Supplementary Medicare Program, a plan for retirees that included a special Writers Guild benefit capping my out-of-pocket prescription costs at $1,000 a year. That out-of-pocket limit is scheduled to expire on Jan. 1. So what will my Revlimid cost me next year?

The answers I got ranged from $20 a month to $17,000 a year. One of the first people I phoned said that no matter what I heard, I wouldn’t know the cost until I filed a claim in January. Seventy phone calls later, that may still be the most reliable thing anyone has told me.

Like around 47 million other Medicare beneficiaries, I have until this Friday, Dec. 7, when open enrollment ends, to choose my 2013 Medicare coverage, either through traditional Medicare or a private insurer, as well as my drug coverage — or I will risk all sorts of complications and potential late penalties.

But if a seasoned personal-finance journalist can’t get a straight answer to a simple question, what chance do most people have of picking the right health insurance option?

A study published in the journal Health Affairs in October estimated that a mere 5.2 percent of Medicare Part D beneficiaries chose the cheapest coverage that met their needs. All in all, consumers appear to be wasting roughly $11 billion a year on their Part D coverage, partly, I think, because they don’t get reliable answers to straightforward questions.

Here’s a snapshot of my surreal experience:

NOV. 7 A packet from Time Warner informs me that the company’s new 2013 Retiree Health Care Plan has “no out-of-pocket limit on your expenses.” But Erin, the person who answers at the company’s Benefits Service Center, tells me that the new plan will have “no practical effect” on me. What about the $1,000-a-year cap on drug costs? Is that really being eliminated? “Yes,” she says, “there’s no limit on out-of-pocket expenses in 2013.” I tell her I think that could have a major effect on me.

Next I talk to David at CVS/Caremark, Time Warner’s new drug insurance provider. He thinks my out-of-pocket cost for Revlimid next year will be $6,900. He says, “I know I’m scaring you.”

I call back Erin at Time Warner. She mentions something about $10,000 and says she’ll get an estimate for me in two business days.

NOV. 8 I phone Medicare. Jay says that if I switch to Medicare’s Part D prescription coverage, with a new provider, Revlimid’s cost will drive me into Medicare’s “catastrophic coverage.” I’d pay $2,819 the first month, and 5 percent of the cost of the drug thereafter — $563 a month or maybe $561. Anyway, roughly $9,000 for the year. Jay says AARP’s Part D plan may be a good option.

NOV. 9 Erin at Time Warner tells me that the company’s policy bundles United Healthcare medical coverage with CVS/Caremark’s drug coverage. I can’t accept the medical plan and cherry-pick prescription coverage elsewhere. It’s take it or leave it. Then she puts CVS’s Michele on the line to get me a Revlimid quote. Michele says Time Warner hasn’t transferred my insurance information. She can’t give me a quote without it. Erin says she will not call me with an update. I’ll have to call her.

My oncologist’s assistant steers me to Celgene, Revlimid’s manufacturer. Jennifer in “patient support” says premium assistance grants can cut the cost of Revlimid to $20 or $30 a month. She says, “You’re going to be O.K.” If my income is low enough to qualify for assistance.

NOV. 12 I try CVS again. Christine says my insurance records still have not been transferred, but she thinks my Revlimid might cost $17,000 a year.

Adriana at Medicare warns me that AARP and other Part D providers will require “prior authorization” to cover my Revlimid, so it’s probably best to stick with Time Warner no matter what the cost.

But Brooke at AARP insists that I don’t need prior authorization for my Revlimid, and so does her supervisor Brian — until he spots a footnote. Then he assures me that it will be easy to get prior authorization. All I need is a doctor’s note. My out-of-pocket cost for 2013: roughly $7,000.

NOV. 13 Linda at CVS says her company still doesn’t have my file, but from what she can see about Time Warner’s insurance plans my cost will be $60 a month — $720 for the year.

CVS assigns my case to Rebecca. She says she’s “sure all will be fine.” Well, “pretty sure.” She’s excited. She’s been with the company only a few months. This will be her first quote.

NOV. 14 Giddens at Time Warner puts in an “emergency update request” to get my files transferred to CVS.

Frank Lalli is an editorial consultant on retirement issues and a former senior executive editor at Time Warner’s Time Inc.

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Murder case against tennis umpire is dropped

From the beginning, the death of professional tennis umpire Lois Goodman's husband was beset by contradictions.

When Alan Goodman, 80, was found dead in April at the couple's Woodland Hills condominium, paramedics noticed a suspicious cut to the side of his head. But Los Angeles police initially agreed with Lois Goodman's account that her ailing husband had fallen down a flight of stairs.

Days later, a coroner's investigator found that the injuries were consistent with being struck by a sharp object. That ultimately led to Goodman's dramatic arrest at a luxury Manhattan hotel as she prepared for the U.S. Open tennis tournament, with authorities claiming she bludgeoned her husband with a coffee mug.

PHOTOS: Murder case against tennis umpire is dropped

On Friday, prosecutors abruptly dropped a murder charge against her. Officials would say only that prosecutors received "additional information," declining to elaborate.

But law enforcement sources told The Times that medical experts consulted by the Los Angeles County district attorney's office concluded that the death could be the result of an accident, contradicting the coroner's determination that it was a homicide.

The finding added to a long list of problems with the case, the sources said, that included a lack of a clear motive as well as other physical evidence that could help the defense. Moreover, genetic tests found none of Goodman's DNA on the piece of the coffee mug that prosecutors had alleged she used to kill her husband.

After she left the courtroom Friday a free woman, Goodman, 70, insisted she was innocent and said she wanted to get back on the professional tennis tour, where she has been a fixture for decades.

"I feel wonderful," she said, standing in the rain outside the Van Nuys courthouse, flanked by her attorneys. "I just feel I have been treated fairly now and it was just a tragic accident."

The dismissal raised questions about how the case was investigated and whether both detectives and prosecutors rushed to charge Goodman. Last year, the LAPD acknowledged detectives had wrongly arrested a man in the high-profile beating of a San Francisco Giants baseball fan outside Dodger Stadium.

One of Goodman's attorneys, Robert Sheahen, criticized the LAPD's investigation, saying crime scene evidence undercut the theory that Alan Goodman's death was a homicide.

A prominent medical expert, he said, told the defense team that Goodman was more likely to have died from heart failure, noting that his heart was four times the size of a normal heart. Blood evidence showed that an injured Goodman was downstairs at some point but was upstairs in bed by the time paramedics arrived, Sheahen said. Lois Goodman — who suffered from bad knees, a torn rotator cuff, rheumatoid arthritis and severe back pain — was in no physical condition to move her 160-pound husband, the attorney said.

"She would have needed a forklift to take the body up the stairs. It was ridiculous," Sheahen said.

The LAPD declined to comment on details of the case, but LAPD Chief Charlie Beck released a brief statement.

"I am aware that the district attorney today declared that they are not ready to proceed in the Alan Goodman homicide trial and asked the court to dismiss the case without prejudice," Beck said. "This is still considered an open case, and our Topanga-area homicide detectives will continue their investigation."

Sources told The Times that prosecutors would review any new compelling evidence in the case and determine whether to refile charges but believed that would be unlikely. The sources, who spoke on the condition of anonymity because the case was ongoing, said there were obvious problems from the outset, noting that the coroner was never called to the crime scene. Some inside the district attorney's office, they said, had questioned the public way in which Goodman was arrested. New York police took Goodman into custody after she had finished breakfast at a Midtown Sheraton and then walked her past photographers.

Steve Meister, a defense attorney and former Los Angeles County prosecutor, said district attorney's officials deserve credit for dismissing the case when they realized they did not have enough evidence to proceed. Nevertheless, he said, the office should examine whether prosecutors could have anticipated the problems before they decided to file criminal charges.

"There needs to be a ... thoughtful, honest internal review process to figure out what went wrong here, because something clearly did," Meister said.

From the outset, Lois Goodman told police she came home and found her husband dead in bed. She said she believed he crawled there after falling down the stairs and onto a coffee cup he was carrying.

At a court hearing earlier this year, a prosecutor accused her of plotting to kill her husband by wielding the broken coffee mug like an "improvised knife." Shards from the mug were found embedded in his wounds. Prosecutors alleged that she left him to die and went off to "tennis and to get her nails done."

A search warrant executed four days after the death turned up blood throughout the home "inconsistent with accidental death," an LAPD detective wrote in the warrant affidavit. Stains on carpets, the refrigerator door, inside a linen closet and on the wall leading to the garage suggested "a mobile victim" who, police theorized, would have called for help.

They also found that Lois Goodman, married to her husband for nearly 50 years, was communicating on the Internet with another man, according to the warrant. One email described in the warrant included cryptic remarks about her "terminating a relationship" and having "alternative sleeping arrangements," though exactly what she meant remains unclear.

But Lois Goodman's supporters described her as a loving wife who cared for her aging husband. And her lawyers said she passed a lie-detector test administered by a former FBI examiner in which she denied killing her husband.

Hours after the court hearing, a bail bonds official cut off the electronic ankle bracelet that Lois Goodman was required to wear while she was out on bail.

"I didn't do anything. I would never hurt my husband," Goodman said, her eyes filling with tears. "I loved him and I was his caretaker, and he came first and I came second."

andrew.blankstein@latimes.com

jack.leonard@latimes.com

andrew.khouri@latimes.com

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Geek Culture's 26 Most Awesome Female Ass-Kickers

Angelina Jolie extends her reputation as filmdom’s most compelling ass-kicker, Female Division, when Salt opens Friday. Midway through a summer freighted with testosterone, Jolie’s lithe Agent Salt is a potent reminder of the power of feminine fighters.

A minority presence in sci-fi and action realms even in 2010, women warriors remain the exception to the guy-centric rule in film, TV, videogames and comic books. But that’s changing, according to Action Flick Chick blogger Katrina Hill, who moderates the "Where Are the Action Chicks?" panel Friday at San Diego’s Comic-Con International.

"Compare the original Predator to this summer’s Predators," she said in an e-mail interview with Wired.com. "The original film was a complete boy’s club, with the only woman in the movie being a hostage. Today, Predators has a kick-ass chick mixed in as an equal amongst these other badass men. So there are steps being taken in the right direction. It just takes time."

The rise of the female fighter will be addressed at no fewer than three other female-dominated panels at this year’s Comic-Con (Thursday’s “Divas and Golden Lassoes: The LGBT Obsession with Super Heroines” and Friday’s “Girls Gone Genre: Movies, TV, Comics, Web” and “Women Who Kick Ass: A New Generation of Heroines,” which features Fringe’s Anna Torv and V’s Elizabeth Mitchell.)

Here’s a look at 26 sexy-fierce female ass-kickers who’ve relied on biceps and brains to periodically kick-start geek culture.

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JLo tones down concert in Indonesia

JAKARTA, Indonesia (AP) — Jennifer Lopez wowed thousands of fans in Indonesia, but they didn’t see as much of her as concertgoers in other countries — the American pop star toned down both her sexy outfits and her dance moves during her show in the world’s most populous Muslim country, promoters said Saturday.

Lopez’s “Dance Again World Tour” was performed in the country’s capital, Jakarta, on Friday in line with promises Lopez made to make her show more appropriate for the audience, said Chairi Ibrahim from Dyandra Entertainment, the concert promoter.

“JLo was very cooperative … she respected our culture,” Ibrahim said, adding that Lopez’s managers also asked whether she could perform her usual sexy dance moves, but were told that “making love” moves were not appropriate for Indonesia.

“Yes, she dressed modestly … she’s still sexy, attractive and tantalizing, though,” said Ira Wibowo, an Indonesian actress who was among more than 7,000 fans at the concert.

Another fan, Doddy Adityawarman, was a bit disappointed with the changes.

“She should appear just the way she is,” he said, “Many local artists dress even much sexy, much worse.”

Lopez changed several times during her 90-minute concert along with several dancers, who also dressed modestly without revealing their chests or cleavage.

Most Muslims in Indonesia, a secular country of 240 million people, are moderate. But a small extremist fringe has become more vocal in recent years.

They have pushed through controversial laws — including an anti-pornography bill — and have been known to attack anything perceived as blasphemous, from transvestites and bars to “deviant” religious sects.

Lady Gaga was forced to cancel her sold-out show in Indonesia in May following threats by Islamic hard-liners, who called her a “devil worshipper.”

Lopez will also perform in Muslim-majority Malaysia on Sunday.

“Thank you Jakarta for an amazing night,” the 43-year-old diva tweeted to her 13 million followers Saturday.

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Small union is causing big problems for ports

The small band of strikers that has effectively shut down the nation's busiest shipping complex forced two huge cargo ships to head for other ports Thursday and kept at least three others away, hobbling an economic powerhouse in Southern California.

The disruption is costing an estimated $1 billion a day at the ports of Los Angeles and Long Beach, on which some 600,000 truckers, dockworkers, trading companies and others depend for their livelihoods.

"The longer it goes, the more the impacts increase," said Paul Bingham, an economist with infrastructure consulting firm CDM Smith. "Retailers will have stock outages, lost sales for products not delivered. There will be shutdowns in factories, in manufacturing when they run out of parts."

Despite the union's size — about 800 members of a unit of the International Longshore and Warehouse Union — it has managed to flex big muscles. Unlike almost anywhere else in the nation, union loyalty is strong at the country's ports. Neither the longshoremen nor the truckers are crossing the tiny union's picket lines.

The strike started at the L.A. port's largest terminal Tuesday and spread Wednesday to 10 of the two ports' 14 cargo terminals. These resemble seaside parking lots where long metal containers are loaded and unloaded with the help of giant cranes.

The union contends that the dispute is over job security and the transfer of work from higher-paid union members to lower-paid employees in other countries. The 14-employer management group says that no jobs have been outsourced and that the union wants to continue a practice called "featherbedding," or bringing in temporary workers even when there is no work.

The two sides haven't met since negotiations broke down Monday, but they were scheduled to begin talking again Thursday night. The union has worked without a contract for 21/2 years.

The clerical workers are a vital link in the supply chain. They handle the immense flow of information that accompanies each cargo ship as well as every item in the freight. One shipload of shoes, toys and other products is enough to fill five warehouses.

Logistics clerk Trinie Thompson, 41, normally spends her days working with railroad lines and trucking companies to ensure that the right containers are sent along to their proper destinations. On Thursday, she was walking the picket lines at the docks.

"We will be setting up trains to Houston, trains to Dallas, to Chicago, to the Pacific Northwest," said Thompson, who has worked for 10 years for Eagle Marine Services terminal, which is affiliated with the giant APL shipping line.

"For a typical container ship, we will have to set up multiple trains. We might be sending 200 to 300 containers to Chicago alone, and there will be paperwork for all of them."

The strike comes at a time of simmering labor unrest at other U.S. ports, underscoring the unusual power labor holds in maritime trade.

On the East Coast and Gulf Coast, another group of shipping lines and terminal operators called the United States Maritime Alliance has repeatedly failed to reach agreement on a new labor contract with the International Longshoremen's Assn. A strike that might have involved dozens of ports was avoided only after both sides agreed to extend negotiations past the September end of their current contract.

A strike also was narrowly avoided at Portland, Ore., only a few days ago in a dispute between grain shippers and union workers.

Operations at Oakland International Airport and at the Port of Oakland, the third-largest port in the state behind Los Angeles and Long Beach, were affected by a brief strike this month.

Maritime unions "have successfully organized one of the most vital links in the supply chain, and it's a tradition they nurture with all of their younger workers," said Nelson Lichtenstein, a UC Santa Barbara history professor and workplace expert. "They have a very strong ideological sense of who they are, and for now they are strong."

In Los Angeles and Long Beach, the 800 clerical workers have been able to shut down most of the ports because the 10,000-member dockworkers union is honoring the picket lines. Work continues at only four cargo terminals, where the office clerical unit has no workers.

"Longshoremen stand up when other workers need our help," said Ray Ortiz Jr., a member of the International Longshore and Warehouse Union's Coast Committee. "Sure, it's a sacrifice to give up a paycheck when you refuse to cross the picket line, but we believe it's in the long-term interest of the Los Angeles-Long Beach harbor area to retain these good local jobs."

Stephen Berry, lead negotiator for the shipping lines and cargo terminals, said the clerical workers have been offered a deal that includes "absolute job security," a raise that would take average annual pay to $195,000 from $165,000, 11 weeks' paid vacation and a generous pension increase.

At a news conference Thursday, Berry denounced the tactics by the clerical workers, calling them "irresponsible."

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How an Obscure Comic Artist Became John McAfee's Lifeline to the World

Two years ago, Portland animator Chad Essley never could have imagined he would become the webmaster and primary public liaison for John McAfee, the reclusive millionaire and former antivirus software mogul now sought for questioning in a Belizean murder case. But that’s exactly what happened to the aspiring graphic novelist, who is currently at work on an illustrated account of his adventures with McAfee.

The relationship between the fugitive and the cartoonist began in 2010 on a private internet forum where an anonymous entrepreneur hired Essley to produce an animated web short for an antibiotic venture called Quorumex. The mysterious businessman soon revealed himself as McAfee, and the two struck up a friendship. When the news broke this April that a gang suppression unit had raided McAfee’s property in Belize, Essley was taken aback.

“After I [heard] about the first raid, I wrote [McAfee] saying, ‘Oh my god! They shot your dogs! I can’t believe that!’” said Essley. “I received a reply that said, ‘We’re fine. Things have calmed down. Time to come to Belize. Moneypenny will arrange the details.’”

Although Essley has done most of his professional work in the field of animation at his studio Cartoon Monkey, producing animations for clients that include Microsoft and Sesame Street, McAfee asked Essley to join him on his estate and document his life in a graphic novel. After spending nearly a month with McAfee this summer, the artist began work on The Hinterland, an illustrated first-person account of his time in Belize.

After McAfee began his recent flight from the law, he first spoke exclusively with Wired’s Joshua Davis, whose coverage is collected in the e-book The Last Stand of John McAfee, and then began talking with other reporters. But he soon became disenchanted with his portrayal through media filters. That’s when he turned back to Essley, one of the few people he still trusted, to set up a website and Twitter account where he could voice his side of the story. Overnight, Essley went from being an eccentric millionaire’s comic book biographer, to serving as webmaster to a wanted man.

“I did it because I had the ability to do so for free, in a keystroke or two,” says Essley. Since then, he has kept McAfee’s often rambling personal blog WhoIsMcAfee.com up and running, and served as one of the only contacts to the millionaire fugitive, who is still on the run.

Essley is clearly concerned when he speaks of McAfee’s well-being, and has questioned his friend about whether staying in Belize is simply a drawn-out form of suicide, particularly given the Belizean police’s history of excessive force, and the country’s sweeping surveillance laws and ability to hold trials without juries.

He shows me photos of McAfee’s taxi driver, bodyguards and friends, some of whom, like Eddie Anona, are still being held by police. He shows me pristine ocean views, fresh lobster cooked at home, and many of the girls that stayed on McAfee’s estate, noting that one of them, Amy Emshwiller, tried to kill McAfee at least twice. The young woman will be a central figure in the graphic novel, which opens with one of her attempts on McAfee’s life — the same incident detailed by Davis in John McAfee’s Last Stand:

[Emshwiller] slipped out of bed and pulled McAfee’s Smith & Wesson out of holster hanging from an ancient Tibetan gong in his bedroom. Her plan, if it could be called that, was to kill him and make off with as much cash as she could scrounge up. She crept to the foot of the bed, aimed, but at the last moment closed her eyes. She pulled the trigger but the bullet went wide, ripping through a pillow. “I guess I didn’t want to kill him,” she admits.

Essley is careful not to give away too much about his graphic novel, but provided two exclusive pages from the book to Wired. An artist by trade, not a programmer or web developer, Essley seems grateful for the potential to have his first graphic novel reach an audience far broader than most independent comics work, but also visibly exhausted by his intermediate role in the media maelstrom and relieved that he’s currently handing over the some of the tasks involved with the website to a friendly benefactor in Quebec.

He hopes this will give him more time to finish drawing The Hinterland, which he says is three-quarters complete and designed to be a printed work — though an e-book with extended multimedia content is a possibility as well.

“As crazy as it sounds, I plan to share whatever revenue this project makes with John, since he’s helped me work on it,” says Essley.

While he maintains that he would take the trip to Belize all over again (“if my wife would let me”), he’s reluctant to return at the moment. “I would be afraid that the police would want to speak with or detain me in some fashion, because of my association with John. There were real dangers while I was there.”

Asked whether he thinks McAfee is responsible for Faull’s murder, Essley responded in a single word: no.

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France’s Depardieu detained for drunken driving

PARIS (Reuters) – French actor Gerard Depardieu was detained for driving his scooter while drunk on Thursday after he had a minor accident in Paris, prosecutors said.

The 63-year-old star of films such as “Jean de Florette” and “Green Card” was held for questioning after he fell from his scooter mid-afternoon, slightly injuring his elbow.

No-one else was hurt in the accident.

One of France’s best-known actors for roles in more than a hundred films, Depardieu has recently grabbed headlines for the wrong reasons.

The incident came just months after a car driver filed a legal complaint for assault and battery against Depardieu in August following an altercation in Paris.

Last year, Depardieu outraged fellow passengers by urinating in the aisle of an Air France flight as it prepared to take off, forcing the plane to turn back to its parking spot.

A passenger on the flight said Depardieu appeared to be drunk and insisted he be allowed to use the bathroom during takeoff, when passengers must remain seated.

(Reporting by Gerard Bon; Writing by Leigh Thomas; Editing by Jon Hemming)

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The New Old Age Blog: Forced to Choose: Nursing Home vs. Hospice

An older person, someone who will die within six months, leaves a hospital. Where does she go?

Almost a third of the time, according to a recent study from the University of California, San Francisco, records show she takes advantage of Medicare’s skilled-nursing facility benefit and enters a nursing home. But is that the best place for end-of-life care?

In terms of monitoring her vital signs and handling IVs — the round-the-clock nursing care the skilled-nursing facility benefit is designed to provide — maybe so. But for treating end-of-life symptoms like pain and shortness of breath, for providing spiritual support for her and her family, for palliative care that helps her through the ultimate transition – hospice is the acknowledged expert.

She could receive hospice care, also covered by Medicare, while in the nursing home. But since Medicare only rarely reimburses for both hospice and the skilled-nursing facility benefit at the same time, this hypothetical patient and her family face a financial bind. If she opts for the hospice benefit, which does not include room and board at the nursing home, then she will be on the hook for hundreds of dollars a day to remain in the facility.

She could use the hospice benefit at home, of course. But, “we know these patients are medically complex,” said Katherine Aragon, lead author of the study in The Archives of Internal Medicine, and now a palliative care specialist at Lawrence General Hospital in Massachusetts. “And we know that taking care of someone near the end of life can be very demanding, hard for families to manage at home.” And that assumes the patient has a family or a home.

For some patients, a nursing home, though possibly dreaded, is the only place that can provide 24/7 care.

But if she uses the skilled-nursing facility benefit to pay for room and board in a facility, she probably has to forgo hospice. (The exception: if she was hospitalized for something unrelated to her hospice diagnosis. If she has cancer, then trips and breaks a hip, she can have both nursing home coverage and hospice. If cancer itself caused the bone to fracture, no dice.)

Let’s acknowledge that these are lousy choices.

The study, using data from the National Health and Retirement Study from 1994 through 2007, looked at more than 5,000 people who initially lived in the community – that is, not in a facility. About 30 percent used the skilled-nursing facility benefit during the final six months of life; those people were likely to be over 85 and family members said, after their deaths, that they had expected them to die soon. (The benefit is commonly referred to as S.N.F., which people in the field pronounce as “sniff”).

The choice to use S.N.F. had ongoing repercussions. Almost 43 percent of those who used it died in a nursing home and almost 40 percent in a hospital. Just 11 percent died at home, though that is where most people prefer to die, studies repeatedly show.

Among those who didn’t use the S.N.F. benefit, more than 40 percent died at home.

In effect, nursing homes were providing end-of-life care, expensively and probably not so well, for almost a third of the elderly population.

The skilled-nursing facility benefit, Dr. Aragon pointed out in an interview, is meant to provide rehabilitation. “The hope is that someone will get stronger and go home,” she said.

Sometimes, of course, that is what happens.

“What we may be missing is that this patient is on an end-of-life trajectory,” she continued. “Maybe they can’t get stronger.”

Moreover, Dr. Aragon pointed out, nursing homes often have financial incentives to keep re-hospitalizing patients. After three days in a hospital, the skilled-nursing facility benefit starts anew, and it reimburses at a higher level than Medicaid, which pays for most nursing home care.

Because this unhappy choice between hospice care and nursing home reimbursement reflects federal policy, there may be little that individual families can do. If physicians are willing to honestly discuss their patients’ prognosis, to assess whether a nursing home stay will lead to rehabilitation or whether it is where a patient will likely die, sooner rather than later, families may have some personal options.

If they knew that death was likely within a few months, they might try to provide care at home with hospice help for that limited time, difficult as that is. Or they might be able to muster enough money to pay for a few months in a nursing home, so that their parent can be a resident and still receive hospice care.

But these are still lousy choices. “Palliative care should be part of nursing home care,” said Alexander K. Smith, the study’s senior author and a palliative care specialist at the University of California, San Francisco. “And that regulation that prevents concurrent use of the S.N.F. benefit and hospice isn’t in the interest of patients and families.”

Coming up in a future post: Experimenting with a concurrent-coverage option.

Paula Span is the author of “When the Time Comes: Families With Aging Parents Share Their Struggles and Solutions.”

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As downtown L.A. grows trendier, Spring Street Arcade is left behind

The salesmen at the Spring Street Arcade spend their day gazing out at a city that's passing them by.

All around, a trendy downtown is on the rise — pet stores selling gourmet dog chews, chic bars with ginger and juniper soda cocktails, a new generation of mostly young residents jogging in spandex and cruising on bikes.

But inside the 88-year-old shopping arcade, with its giant curved skylight, arched Spanish Renaissance entryways and Beaux Arts exterior, many of the stores are vacant, and the remaining merchants seem stuck in another era. Bargain-rate clothes, toys, suitcases and DVDs share shelf space with dusty boomboxes and T-shirts from '90s rock bands like Korn and Nirvana.

Mohad Azimi lingers through the morning outside his kitchen appliance shop, chatting with the Taiwanese salesman at the toy store next to him. These days, the jokes focus on a new Starbucks that's just opened at Spring and 6th streets. Maybe that's where all the people are going now, the merchants say.

"Look around here — business is dead," Azimi says as he looks across the arcade's empty corridor, which stretches from Spring to Broadway. "Nobody comes inside."

Azimi opened his business in the early 1990s, after emigrating from Afghanistan. Back then, Los Angeles was still enjoying a boom in immigration from places like Guatemala, Mexico and El Salvador, and the mall was so busy on the weekends that you could barely walk inside. Broadway was a bustling promenade, with shoppers pouring in on bus lines from all over the city.

Families would come to buy kitchenware at Azimi's shop, sometimes shipping the products back to relatives in Latin America. And while they were there, he says, they'd pick up toys and clothes for their children.

Azimi still stacks the same goods on a white plastic table at the front of his shop — toaster ovens, blenders and microwaves in battered cardboard boxes. Inside the cluttered shop, there are old keyboards, calculators and Nintendo GameCube consoles.

But he makes only a few sales each week, he says, and he's not sure he can make it to the end of the year.

"The new residents, they don't have a family, they don't have anyone to cook for," Azimi says. "They just have a dog."

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When the Spring Street Arcade opened in 1924, it was hailed as Los Angeles' premier shopping center — and celebrated with a bash that brought out Will Rogers and Charlie Chaplin.

Back then, the area was filled with department stores, high-end shops and rows of movie palaces. Even as downtown faded after World War II and the department stores and movie houses closed down, the small merchants along Broadway, Main and other downtown streets managed to find new customers.

By the 1980s, hundreds of them were making a good living catering to the city's rising Latino immigrant community, both new immigrants and Mexicans who would cross the border for shopping runs.

The retail economy was so strong that Broadway storefronts famously commanded rents similar to those of Rodeo Drive in Beverly Hills.

But changes in immigration patterns, improved economic conditions in Mexico, competition in other communities and the recession have left many downtown merchants fighting to survive. While new, "500 Days of Summer" residents are frequenting bars and restaurants and coffeehouses, they have little need for the bargain shops that line the arcade.

Joel Kotkin, an urban studies fellow at Chapman University, says the shift is evident all around downtown.

It's the "gradual dissolution of one economy — a really vibrant, unique economy — and an attempt to replace it with another," he says. "The question is, are we just seeing the death of something that will be replaced, or will we have this parallel universe of yuppies alongside the decline?"

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Inside the arcade, merchants are quick to reminisce about the prosperous years — and lament how it went so wrong.

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