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Medicare paid billions to sub-par nursing homes: HHS

SAN FRANCISCO Medicare paid billions in taxpayer dollars to nursing homes nationwide that were not meeting basic requirements to look after their residents, government investigators have found.

The report, released Thursday by the Department of Health and Human Services' inspector general, said Medicare paid about $5.1 billion for patients to stay in skilled nursing facilities that failed to meet federal quality of care rules in 2009, in some cases resulting in dangerous and neglectful conditions.

One out of every three times patients wound up in nursing homes that year, they landed in facilities that failed to follow basic care requirements laid out by the federal agency that administers Medicare, investigators estimated.

By law, nursing homes need to write up care plans specially tailored for each resident, so doctors, nurses, therapists and all other caregivers are on the same page about how to help residents reach the highest possible levels of physical, mental and psychological well-being.

Not only are residents often going without the crucial help they need, but the government could be spending taxpayer money on facilities that could endanger people's health, the report concluded. The findings come as concerns about health care quality and costs are garnering heightened attention as the Obama administration implements the nation's sweeping health care overhaul.

"These findings raise concerns about what Medicare is paying for," the report said.

Investigators estimate that in one out of five stays, patients' health problems weren't addressed in the care plans, falling far short of government directives. For example, one home made no plans to monitor a patient's use of two anti-psychotic drugs and one depression medication, even though the drugs could have serious side effects.

In other cases, residents got therapy they didn't need, which the report said was in the nursing homes' financial interest because they would be reimbursed at a higher rate by Medicare.

In one example, a patient kept getting physical and occupational therapy even though the care plan said all the health goals had been met, the report said.

The Office of Inspector General's report was based on medical records from 190 patient visits to nursing homes in 42 states that lasted at least three weeks, which investigators said gave them a statistically valid sample of Medicare beneficiaries' experiences in skilled nursing facilities.

That sample represents about 1.1 million patient visits to nursing homes nationwide in 2009, the most recent year for which data was available, according to the review.

Overall, the review raises questions about whether the system is allowing homes to get paid for poor quality services that may be harming residents, investigators said, and recommended that the Centers for Medicare & Medicaid Services tie payments to homes' abilities to meet basic care requirements. The report also recommended that the agency strengthen its regulations and ramp up its oversight. The review did not name individual homes, nor did it estimate the number of patients who had been mistreated, but instead looked at the overall number of stays in which problems arose.

In response, the agency agreed that it should consider tying Medicare reimbursements to homes' provision of good care. CMS also said in written comments that it is reviewing its own regulations to improve enforcement at the homes.

"Medicare has made significant changes to the way we pay providers thanks to the health care law, to reward better quality care," Medicare spokesman Brian Cook said in a statement to The Associated Press. "We are taking steps to make sure these facilities have the resources to improve the quality of their care, and make sure Medicare is paying for the quality of care that beneficiaries are entitled to."

CMS hires state-level agencies to survey the homes and make sure they are complying with federal law, and can require correction plans, deny payment or end a contract with a home if major deficiencies come to light. The agency also said it would follow up on potential enforcement at the homes featured in the report.

Greg Crist, a Washington-based spokeswoman for the American Health Care Association, which represents the largest share of skilled nursing facilities nationwide, said overall, nursing home operators are well regulated and follow federal guidelines, but added that he could not fully comment on the report's conclusions without having had the chance to read it.

"Our members begin every treatment with the individual's personal health needs at the forefront. This is a hands-on process, involving doctors and even family members in an effort to enhance the health outcome of the patient," Crist said.

Virginia Fichera, who has relatives in two nursing homes in New York, said she would welcome a greater push for accountability at skilled nursing facilities.

"Once you're in a nursing home, if things don't go right, you're really a prisoner," said Fichera, a retired professor in Sterling, N.Y. "As a concerned relative, you just want to know the care is good, and if there are problems, why they are happening and when they'll be fixed."

Once residents are ready to go back home or transfer to another facility, federal law also requires that the homes write special plans to make sure patients are safely discharged.

Investigators found the homes didn't always do what was needed to ensure a smooth transition.

In nearly one-third of cases, facilities also did not provide enough information when the patient moved to another setting, the report found.

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Arias Prosecutor Too Combative, Experts Say

He has barked, yelled, been sarcastic and demanded answers from accused murderer Jodi Arias this week.

And in doing so, prosecutor Juan Martinez and his aggressive antics may be turning off the jury he is hoping to convince that Arias killed her ex-boyfriend Travis Alexander in June 2008, experts told ABCNews.com today.

"Martinez is his own worst enemy," Mel McDonald, a prominent Phoenix defense attorney and former judge, told ABC News. "He takes it to the point where it's ad nauseam. You have difficulty recognizing when he's driving the point home because he's always angry and pushy and pacing around the courtroom. He loses the effectiveness, rather than build it up."

"He's like a rabid dog and believes you've got to go to everybody's throat," he said.

"If they convict her and give her death, they do it in spite of Juan, not because of him," McDonald added.

Martinez's needling style was on display again today as he pestered Arias to admit that she willingly participated in kinky sex with Alexander, though she previously testified that she only succumbed to his erotic fantasies to please him.

Arias, now 32, and Alexander, who was 27 at the time of his death, dated for a year and continued to sleep together for another year following their break-up.

Arias drove to his house in Mesa, Ariz., in June 2008, had sex with him, they took nude photos together and she killed him in his shower. She claims it was in self-defense. If convicted, Arias could face the death penalty.

Jodi Arias, Prosecutor Butt Heads in Cross-Examination Watch Video

Jodi Arias Maintains She 'Felt Like a Prostitute' Watch Video

Jodi Arias Admits to Killing Man, Lying to Police Watch Video

Martinez also attempted to point out inconsistencies in her story of the killing, bickering with her over details about her journey from Yreka, Calif., to Mesa, Ariz., including why she borrowed gas cans from an ex-boyfriend, when she allegedly took naps and got lost while driving, and why she spontaneously decided to visit Alexander at his home in Mesa for a sexual liaison.

"I want to know what you're talking about," Arias said to Martinez at one point.

"No, I'm asking you," he yelled.

Later, he bellowed, "Am I asking you if you're telling the truth?"

"I don't know," Arias said, firing back at him. "Are you?"

During three days of cross examining Arias this week, Martinez has spent hours going back and forth with the defendant over word choice, her memory, and her answers to his questions.

"Everyone who takes witness stand for defense is an enemy," McDonald said. "He prides himself on being able to work by rarely referring to his notes, but what he's giving up in that is that there's so much time he wastes on stupid comments. A lot of what I've heard is utterly objectionable."

Martinez's behavior has spurred frequent objections of "witness badgering" from Arias' attorney Kirk Nurmi, who at one point Tuesday stood up in court and appealed to the judge to have a conference with all of the attorneys before questioning continued. Judge Sherry Stephens at one point admonished Martinez and Arias for speaking over one another.

Andy Hill, a former spokesperson for the Phoenix police department, and Steven Pitt, a forensic psychiatrist who has testified as an expert witness at many trials in the Phoenix area, both said that despite his aggressive style, Martinez would likely succeed in obtaining a guilty verdict.

"When it comes to cross examination, one size does not fit all," said Pitt. "But if you set aside the incessant sparring, what the prosecutor I believe is effectively doing is pointing out the various inconsistencies in the defendant's version of events."

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Italy left on financial high-wire

Prime Minister Silvio Berlusconi delivers a speech during a campaign rally in Rome on January 25, 2013.

STORY HIGHLIGHTS

• Brilliant minds are still trying to figure out the financial impact of Italy's election


• The lack of certainty is seen as a negative for Italy -- and the eurozone


• Instability could reignite the eurozone crisis


• But it depends on what deal will be done, and how the markets will respond

Editor's note: Louise Cooper is a financial blogger and commentator who regularly appears on television, radio and in print. She started her career at Goldman Sachs as a European equity institutional sales person and then become a financial and business journalist. She now writes CooperCity.

London (CNN) -- Brilliant minds across the financial world are still trying to work out the implications of the Italian election result.

For the time being, the best answer is that it is probably too soon to tell. After Tuesday's falls, a little stability has returned to markets, possibly because everyone is still trying to work out what to think.

Credit ratings agency Moody's has warned the election result is negative for Italy -- and also negative for other indebted eurozone states. It fears political uncertainty will continue and warns of a "deterioration in the country's economic prospects or difficulties in implementing reform," the agency said.

For the rest of the eurozone, the result risks "reigniting the euro debt crisis." Madrid must be looking to Italy with trepidation. If investors decide that Italy is looking risky again and back off from buying its debt, then Spain will be drawn into the firing line too.

Can the anti-Berlusconi save Italy?

Louise Cooper, of Cooper City

Standard & Poor's stated that Italy's rating was not immediately affected by the election but I think the key part of that sentence is "not immediately."

At the same time Herman Van Rompuy's tweets give an indication of the view from Brussels: "We must respect the outcome of democratic elections in Italy," his feed noted.

Really? That's a first. The democratically elected Silvio Berlusconi was forced out when he failed to follow through with austerity after the European Central Bank helped Italy by buying its debt in autumn 2011.

"It is now up to Italian political leaders to assume responsibility, compromise and form a stable government," Van Rompuy tweeted.

Did he see the results? The newcomer and anti-establishment comedian Beppe Grillo refuses to do a deal and yet he is the natural kingmaker, polling at 25%.

"Nor for Italy is there a real alternative to continuing fiscal consolidations and reforms," he continued.

Economically yes, but the Italian electorate disagree. And for the time being, Italy has a democracy (of sorts).

Finally: "I am confident that Italy will remain a stable member of the eurozone."

He hopes...

The key to whether the crisis reignites is whether investors begin to back away from lending to Italy. If so, this will be the big test of the ECB's resolve to save the euro.

Read more: Euro crisis coverage

The key thing to look at is Italian bonds, because if borrowing costs rise from 4.8% for 10-year money currently to nearer 6%, then Italy will start to find it too expensive to borrow.

The trillion euro question is if the ECB will step in to help even if it cannot get the reforms and austerity it demands (because of the political situation). That is the crux of the matter. And there will be many in the city today pondering that question.

Clearly in financial markets, taking on a central bank is a dangerous thing to do. Soros may have broken the Bank of England on Black Wednesday 1992, making billions by forcing sterling out of the EMU, but that was a long time ago.

Italy avoids panic at bond auction

What we have learnt from this crisis is not to "fight the Fed" (or the ECB). Last summer, the ECB's chief Mario Draghi put a line in the sand with his "whatever it takes" (to save the euro) speech.

But as part of that commitment he stressed time and time again that any new help from the ECB comes with conditions attached. And those conditions are what have proven so unpalatable to the Italians -- austerity and reform.

So we have two implacable objects hurtling towards each other. The political mess of Italy and the electorate's dislike of austerity and reform (incumbent technocrat Mario Monti only polled 10%).

So what happens next? The status quo can continue if Italian borrowing costs do not rise from here and therefore Italy does not need ECB help.

If markets continue to believe in Draghi and Brussels that the euro is "irreversible," then investors will continue to lend to Italy. Yes, markets will be jittery and fearful, but Italy will eventually sort itself out politically.

The big advantage for Italy is although it has a lot of debt, it is not creating debt quickly (like Greece, Spain or even the UK). And as I said yesterday on my CooperCity blog, the positive outcome from all this could be that Brussels backs off from austerity, which would be a good thing.

However, the basic rule of finance is that high risk comes with high return. Soros took a huge gamble against the British central bank but it reportedly made him a billionaire overnight.

There must be a few hedge funders looking at the Italian situation with similar greed in their eyes. If he wants to save the euro, it is time for Mario Draghi to put the fear of God back into such hearts.

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New Singapore ambassadors to Qatar, Saudi Arabia and Switzerland

SINGAPORE: The government has appointed Mr Wong Kwok Pun as Singapore's first resident Ambassador to the State of Qatar, Mr Lawrence Anderson as Singapore's next Ambassador to the Kingdom of Saudi Arabia, and Mr Tee Tua Ba as Singapore's Ambassador to Switzerland (resident in Singapore).

Mr Wong and Mr Anderson will assume their post on 17 March 2013 and 30 March 2013 respectively.

Mr Wong joined the Singapore Foreign Service in 1975. His most recent appointment was as Ambassador to the Kingdom of Saudi Arabia (August 2009 to February 2013), with concurrent accreditation to the Kingdom of Bahrain (January 2010 to February 2013).

Mr Anderson joined the Singapore Foreign Service in 1984. His most recent appointment was as Director/Special Duties in the Ministry of Foreign Affairs and concurrently as Diplomat-in-Residence at the Civil Service College (February 2011 to February 2013).

Mr Tee was Singapore's Non-Resident Ambassador to the United Arab Emirates from April 2008 to December 2012.

- CNA/de

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Pope: At times 'Lord seemed to sleep'

STORY HIGHLIGHTS

• NEW: Benedict XVI says there were "times when the Lord seemed to sleep" in past 8 years


• NEW: "I really felt all the support and all the love, the prayers," says a priest in the crowd


• Benedict: The Roman Catholic Church has been through stormy waters, but God won't let it sink


• He is to leave office at 8 p.m. Thursday for a life of seclusion and prayer

Rome (CNN) -- In front of rapt crowds, Pope Benedict XVI spoke of moments of struggle as well as joy Wednesday during his final public address from a stage set up in St. Peter's Square.

In an unusually personal message, he told how there were "times when the water was rough and the wind, as in the whole history of the church, and the Lord seemed to sleep."

But even as the church passes through stormy seas, God will "not let her sink," he added, in what was his final general audience before he steps down Thursday evening.

Those words will be seen by many as a comment on the series of child sex abuse scandals and corruption claims that have rocked the Roman Catholic Church in the course of his pontificate.

Benedict recounted how when he was asked to be pope eight years ago, he had prayed for God's guidance and had felt his presence "every day" since.

"It was a part of the journey of the church that has had moments of joy and light, but also moments that were not easy," he said.

Vatican reveals Pope Benedict's new title

'Tough choices'

Dressed all in white and looking serene, the pope used his last general audience to call for a renewal of faith and speak of his own spiritual journey through eight years as leader of the world's 1.2 billion Catholics.

Benedict thanked the cardinals, the clergy in Rome, Vatican officials and priests worldwide for their work, as well as their congregations, saying "the heart of a pope extends to the whole world."

Knowing his strength was fading, he had taken the step of resignation well aware of its gravity and novelty, but also "with a deep peace of mind," he said.

"Loving the church also means having the courage to make tough choices," he said, as he called on the faithful to pray for him and the new pope.

Benedict gave an insight into the life of the pontiff, describing it as without any kind of privacy, with his time devoted entirely to the church -- perhaps particularly difficult for a man known for his love of scholarship.

His life in retirement will be "simply a return to the private place. My decision is to forgo the exercise of active ministry, not revoke it. In order to return to private life, not to a life of travel, meetings, receptions, conferences and so on," he said.

As he finished, cheers erupted from the tens of thousands gathered in the square -- acknowledged by Benedict with an open-armed embrace.

'Support and love'

Benedict's final papal audience

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Vatican officials said 50,000 tickets had been handed out for Benedict's last general audience -- but authorities said they had prepared for as many as 200,000 people to show up to witness the historic moment in person.

The pope in retirement: What to expect

Benedict, who spoke first in Italian, also gave greetings in French, German and English, among other languages, reflecting the church's global reach.

CNN iReporter Joel Camaya, a priest from the Philippines who is studying in Rome, said it was very moving to be among those gathered in the huge plaza.

Waves of applause rose up to meet Benedict, especially when he addressed the pilgrims in different languages. "I really felt all the support and all the love, the prayers, from those who were present," he said.

After the pope left, people's mood was festive, with many chatting or singing, Camaya said, but at the same time nostalgic because it's the last time they will hear Benedict speak.

"Especially for people who have got used coming here for the audience and for the (Sunday) Angelus, it's something to be missed," he said.

Those lucky enough to have tickets for the final audience listened from seats in front of St. Peter's Basilica. Among them were many of the Roman Catholic Church's senior clergy. Others packed around the edges of the square and surrounding side streets, hoping to catch a glimpse of the pontiff.

Among the crowds were groups of pilgrims who had traveled to Rome for the special occasion, as well as local residents and curious visitors keen to share in the moment.

Opinion: Benedict a pope aware of his flaws

Benedict arrived and left in his Popemobile, allowing him to pass close by many people in St. Peter's Square.

Standing in the glass-topped vehicle, flanked by security, he waved as he slowly made his way along pathways through the crowds. Some waved flags and banners as they stood under cold but clear skies.

Normally in winter, the pope would give his weekly Wednesday general audience inside a hall within Vatican City, but the event was moved outside because of the anticipated huge crowds.

Pontiff emeritus

The pope didn't give the usual brief personal greetings to people afterward, but was to meet with delegations of heads of state in Vatican City.

Benedict, who stunned the world's Catholics when he announced his resignation just over two weeks ago, will leave office at 8 p.m. local time Thursday.

At that point, a transition period will begin, as around 115 cardinals gather in Rome to pick a successor in a secretive election known as a conclave.

The Vatican has been rewriting the rules to cope with an almost unprecedented situation -- Benedict is the first pope to resign in nearly 600 years.

He will meet with the cardinals Wednesday and Thursday, before being flown by helicopter to the papal summer residence at Castel Gandolfo.

Pope to resign: Your thoughts

There, from a balcony, he will greet crowds one last time before his resignation takes effect and the Swiss Guards, who by tradition protect the pope, ceremonially leave the residence's gate.

More details were given Tuesday of how the 85-year-old's life in retirement will play out.

He will keep the papal title Benedict XVI, rather than reverting to the name Joseph Ratzinger, and will be referred to as "his holiness," said the Rev. Federico Lombardi, a Vatican spokesman.

He will also go by the title his holiness "pontiff emeritus" or "pope emeritus."

Interference fears

Pope Benedict XVI wearing red shoes.

Living out of the public eye in a small monastery within Vatican City, Benedict will wear a simple white robe, without the papal red cape, and will swap his red shoes for brown ones. He is expected to devote his time to prayer and study.

Catholic author Michael Walsh told CNN he was unsurprised by Benedict's desire for more privacy.

"He's a rather private man. He wants to get back to his books and his cats, he wants to get back to prayer," he said. "He's obviously coming towards the end of his life -- he's 85 -- so I understand that."

But, Walsh added, "what I don't understand is that he says he wants to be part of it all, which could be disastrous if you take it at face value," referring to Benedict's promise not to abandon the church.

"The notion that you have two people that claim to be pope, in a sense, is really going to be very confusing," Walsh said.

Vatican officials have said they don't anticipate any interference from Benedict as a new pope takes office.

However, his influence will be felt in as much as he appointed 67 of the cardinals who will enter the conclave.

Whoever his successor may be will have plenty on his plate, from allegations swirling in the Italian media that gay clergy may have made themselves vulnerable to blackmail by male prostitutes -- a claim forcefully denied by the Vatican -- to the festering issue of the church's handling of child abuse by priests.

The Vatican said Monday that a report by three cardinals into leaks of secret Vatican documents, ordered by Benedict last year and seen only by him, would be passed on to the new pontiff.

Opinion: How next pope must tackle child sex abuse

Cardinals' conclave

Meanwhile, the cardinals who must elect the new pope are already gathering in Rome, Lombardi said.

The dean cardinal will on Friday summon the cardinals to a general congregation, Lombardi said. That could come as soon as Monday, although the date is not yet fixed.

The cardinal-electors will then decide exactly when to hold the conclave, during which they will select a peer via paper ballot. The voting process will end when only when one cardinal gains two-thirds support.

Special prayers will be said during the "sede vacante," or empty seat period, seeking guidance for the election of the new pope. The cardinals will lead the prayers.

After his resignation, Benedict, who cited the frailty of age as the reason he resigned, will no longer use the Fisherman's Ring, the symbol of the pope, Lombardi said. The ring will be destroyed, along with Benedict's papal seal, after his departure from office.

Smoke signals: How is a new pope elected?

CNN's Barbie Latza Nadeau reported from Rome and Laura Smith-Spark wrote and reported from London. Vatican correspondent John Allen and Sarah Brown contributed to this report.

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Two cops, suspect dead in Calif. shootings

Updated 1:50 a.m. EST

SANTA CRUZ, Calif. Two police officers were shot and killed Tuesday while investigating a sexual assault, and a suspect was also fatally shot, authorities said.

Santa Cruz police Chief Kevin Vogel says Sgt. Loren Butch Baker and Detective Elizabeth Butler were gunned down in mid-afternoon Tuesday as they followed up on a sexual assault investigation. He says Baker was a 28-year veteran of the department and Butler had been with the department 10 years. Vogel says Baker was married and the father of two daughters, while Butler leaves behind two young sons.

A suspect, identified as 35-year-old Jeremy Goulet, was shot and killed a short time later while authorities were pursuing the gunman, the Santa Cruz County sheriff's office said.

Residents on the adjoining streets where the shootings occurred received an automatic police call warning them to stay locked inside. About half an hour later, more than a dozen semi-automatic shots echoed down the streets in a brief shootout that killed the suspect.

Witnesses described hearing a "multitude of gunfire" - with 20 or more shots fired during that gun battle between the suspect and law enforcement, reports CBS San Francisco station station KPIX-TV.

Police were going door-to-door in the neighborhood, searching homes, garages, even closets, although the sheriff said authorities didn't know if another suspect remained at large.

Police, sheriff's deputies and FBI agents filled intersections, some with guns drawn, in what is ordinarily a quiet, residential neighborhood in the community about 60 miles south of San Francisco.

A store clerk a few buildings away from the shooting said the barrage of gunfire was "terrifying."

"We ducked. We have big desks, so under the desks we went," said the clerk, who spoke on condition of anonymity and asked that her store not be identified because she feared for her safety.

She said she remained locked in her store hours after the shooting and was still scared.

Two schools were locked down during the shooting. The students were later evacuated by bus to the County Government Center about half a mile away.

As darkness fell, helicopters and light aircraft patrolled above the neighborhood, which is about a mile from downtown Santa Cruz and the Santa Cruz Beach Boardwalk. The campus of University of California, Santa Cruz, is about five miles away.

The city's mayor, Hilary Bryant, said in a statement that the city was shocked over the shootings.

"Tonight we are heartbroken at the loss of two of our finest police officers who were killed in the line of duty, protecting the community we love," the statement said. "This is an exceptionally shocking and sad day for Santa Cruz and our Police Department."

Santa Cruz has faced a recent spate of violence, and community leaders had scheduled a downtown rally Tuesday to speak out against shootings. That and a city council meeting were canceled after teary-eyed city leaders learned of the deaths.

Those shootings include the killing of Pauly Silva, a 32-year-old martial arts instructor who was shot outside a popular downtown bar and restaurant on Feb. 9.

Two days later, a UC Santa Cruz student waiting at a bus stop was shot in the head during a robbery. She is recovering from her injuries.

Then on Feb. 17, a 21-year-old woman was raped and beaten on the UC Santa Cruz campus. Four days later, a Santa Cruz couple fought off two men who came in their home before dawn and threatened them with a sword.

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Inside Organized Retail Crime Raids

We used to call it shoplifting, but these days the foot soldiers of retail crime rings are known as boosters. Police even have an acronym for these operations: ORC, which stands for Organized Retail Crime.

"It's just like a Fortune 500 company," said Sergeant Eric Lee of the Gardena Police Department in Gardena, Calif. "All of this is just organized."

Watch the full story on "Nightline" TONIGHT at 12:35 a.m. ET

Police say big retail stores, from Walgreens to J.C. Penny, are getting hit by highly sophisticated shoplifting networks that steal and resell everything from underwear to razors to milk. According to the National Retail Federation, theft can amount to annual losses as high as a $37 billion for retail businesses.

"Every store in every city has to go through this," Lee said. "They wait until no one's paying attention and they walk out."

Tide detergent is currently a hot target because it is compact, expensive and easy to sell on the streets for profit, police said. The Street name: "liquid gold."

"Sometimes we get rings that just do alcohol," Lee said. "And then we get some that do just meat and seafood."

Investigators say boosters move the loot for cents on the dollar to fencing operations -- the black market resellers of the stolen goods -- which sell the stolen merchandise in plain sight in stores. Boosters, fencers, Mr. Bigs, all of those involved in these shoplifting operations can potentially make millions a year from boosting and re-selling stolen goods.

Craigslist Crackdown: Cops Go After Thieves Watch Video

And Mike Swett is on the case. A former Riverside County sheriff's deputy in Los Angeles, Swett was badly injured in a car wreck and now works as a full-time private investigator on the ORC beat who has worked with Target, Marshalls, T.J. Maxx. Stores hire him to do his own undercover police work, catching thieves before involving local law enforcement.

"Kind of like working a narcotics case, it's like you've got low-level, mid-level and then top dog," Swett said. "We like to go after the top dog and the only way to get to the top dog is mid-level first."

At his command center -- his apartment -- Swett showed off the boxes upon boxes of tapes and photographs he has collected, the fruits of countless silent stake-out hours.

Swett said he has been casing two joints in L.A. for months, both alleged to be mid-level fencing operations. "Nightline" was invited to ride along with him when he sent undercover agents in for a final reconnaissance mission.

At some stores and shopping malls, clerks do little to stop shoplifters and often let them run, which has contributed to the growing fencing operations.

"[The stores] don't want their employees to get injured," Swett said. "So oftentimes they will call the police, but by the time we get there they are already in their car and they are gone."

This leaves professional investigators like Swett to put the pieces together and bust open the gangs to lead over-stretched police departments to the prey.

When raid day arrived, a motorcade of squad cars departed from the Gardena, Calif., police department and pulled up to one fencing operation. Swett said the merchandise being sold was boosted goods.

"There is Victoria's Secret, expensive Victoria's Secret, the gift sets," he said, pointing down a line of tables. "J.C. Penny, Miramax, its real stuff not counterfeit."

He spotted a bottle of Katy Perry brand perfume, which usually retails for around $90 but one seller had it priced at $59.

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JPMorgan to slash 19,000 jobs by end-2014

NEW YORK: US banking giant JPMorgan Chase plans to axe up to 19,000 jobs by the end of 2014 as it seeks to rein in costs, the company said Tuesday in an investor presentation.

JPMorgan Chase intends the majority of the cuts -- between 13,000 to 15,000 -- in the mortgage banking division, where the company spent $9.1 billion in 2012.

Another 3,000 to 4,000 jobs will be eliminated in the non-mortgage areas of its consumer and community banking division.

JPMorgan Chase estimated its full-year expenses will drop by $3 billion in 2014 from the 2012 level as the company seeks corporate and investment bank cost synergies, according to the presentation.

JPMorgan shares were down 0.5 percent in morning trade amid an overall rising market.

The Wall Street bank reported earnings of $21.3 billion in 2012, up from $19 billion a year earlier, but revenue that slightly missed market expectations.

The jump in profits came despite an embarrassing $6.2 billion trading loss stemming from a London trader nicknamed the London "whale."

The trading losses led to several resignations and reassignments and resulted in a lower 2012 take-home pay for JPMorgan chief executive Jamie Dimon.

-AFP/ac

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Could your child be a bully?

Boys and girls use physical violence to exert their power, researchers say.

STORY HIGHLIGHTS

• A sociologist describes bullying in schools as "social combat"


• Students are fighting to improve their social status through violence or rumors


• Bullies are often bullied themselves as they fight to the top, experts say

Editor's note: Don't miss the premiere of "The Bully Effect" on "AC360" at 10 p.m. ET Thursday, Feburary 28. And visit CNN.com Health on Wednesday, February 27, for our story on how technology has changed bullying.

(CNN) -- Eva was a bully. Tall for her age, she used her height to intimidate her peers. She made fun of those without designer clothes and got suspended several times for fighting.

She was also well-liked, outgoing, funny -- and a victim of bullying herself.

"When you're in junior high, you're just trying to figure out who you are," the 24-year-old Los Angeles resident remembers. She says she bullied others because she was, as were most kids, insecure.

As a parent, you probably have a picture in your head of the kid you'd vote Most Likely To Bully Others. He's burly, wears a letter (or leather) jacket and has been a senior longer than most students are in high school.

But experts say the bullies tormenting students nowadays aren't like the ones we see on the big screen. It's not just a small group of jocks, or the loner stoner pushing kids into lockers between periods. It can be almost anyone, at any time. And the most likely targets of bullies? The bullies themselves.

"AC360": Fighting for your bullied child

Sociologist Robert Faris calls it "social combat." He says the majority of bullying takes place in the middle of a school's social hierarchy, where students are jostling with each other for higher status.

Think of it like a giant game of king of the hill. Each kid is struggling to make it to the top, not afraid to step on others to get there. The closer you get to being king, the more vicious the competition gets between rivals.

"Bullying works," Faris says simply. "When kids pick on other kids, their status increases."

Faris teamed up with CNN's "AC360" in 2011 to study bullying at a high school in Long Island, New York. Researchers asked more than 700 students about their friendship circles and bullying behaviors. Faris has also completed similar studies in rural North Carolina -- where the demographics were different, but the results were the same.

Faris found 56% of students surveyed were involved in aggression, victimization or both at any given time. The main motive behind a student's bullying was to increase his or her popularity. The higher a student rose on the social ladder, the more likely they were to bully others -- and to be bullied themselves.

"There's always some tension in these friendship groups," Faris says. "Who's closer to whom and who's hanging out together, and I think that's what's driving a lot of these kids."

The same is true for middle-school students, according to UCLA psychology professor Jaana Juvonen, who's been studying bullying since the mid-1990s.

Juvonen and her team recently followed more than 1,800 students through seventh and eighth grade to determine how physical aggression and the spreading of rumors played a part in social prominence.

"What we've learned about bullying during the last decade or so is that it takes many forms," Juvonen says. "Some of these forms are extremely hard to detect. They're covert."

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Administrators have cracked down on physical aggression in schools, enforcing zero tolerance policies for fighting between students. But Juvonen says that has led to subtler forms of bullying.

Rumors -- most often about a student's sexuality or insulting family members -- play a big role, according to Juvonen's research.

Faris recalls he got his "ass kicked" regularly as a child. Two brothers used hunt him down every day after school as he walked home from the bus stop.

But he says a daily beating was much less painful than the isolation he felt when his family moved across the country and he couldn't seem to fit in. "That was much harder to deal with than a bloody nose," he remembers.

In his later research, Faris found friends often exclude each other from gossip sessions or parties to put down a rival and boost their own status. Social media has also increased the prominence of this abstract form of bullying.

"The status competition is always there; there's no break from it," he says. "They go home and they get online and they see their friends doing things together and they're not invited, or worse, people are harassing them."

If the 2004 movie "Mean Girls" taught us anything, it's that girls are the queens of covert bullying; no one could make you feel as badly about the way you look as the popular clique. Juvonen's study, however, found boys and girls spread rumors to boost their social status -- and that both genders use physical aggression to assert power.

Eva knows this firsthand. She and her friends used to "jump" other girls, pulling their hair or punching them just because they talked to the wrong guy.

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"I look back and shake my head," says Eva, who asked CNN not to use her last name because she's applying for medical school next year. But "when you're in elementary school and junior high, there's nothing else. We don't have responsibilities. We don't have skills. We buy candy and do homework."

"Part of the problem here is that kids are kind of stuck in a cage," Faris agrees. "They don't have formal roles and responsibilities. ... They have to work status out for themselves."

And if we put adults in a similar situation, he says, we'd see the same behavior.

For that reason, Faris advocates programs and activities that de-emphasize social status and re-emphasize the qualities of a good friend. He hopes that one day students will leave high school with a small group of close friends, rather than the 300 or 400 they know on Facebook.

Tips for parents

1. Be a good example -- kids often learn bullying behavior from their parents.

2. Teach your child what it means to be a good friend.

3. Make your home a safe haven for kids after school.

4. Use teachable moments on TV to show the power of bystanders.

5. Listen. Don't be in denial about incidents that are brought to your attention.

Juvonen says anti-bullying programs should focus on bystanders -- teaching kids that watching is just as bad as doing the bullying yourself. Studies in Canada have shown, she says, that if a child intervenes, the bullying incident stops within seconds.

Juvonen suggests parents use teachable moments on TV or in the news to show children right from wrong in a bullying situation. "They could be the ones pointing out to their kids that they have a lot of power as bystanders," she says.

Juvonen knows it's unreasonable to expect a child to be brave on his or her own; no one wants to become the next victim. So she suggests teaching kids about the weight of a group.

"Bullying involves this imbalance of power where the bully has the high status and is using this status," she says. "You can try to offset the power balance by telling kids to join one another as they try to intervene."

Parents also need to be aware of how easy it is for children to get sucked in to this social combat, Juvonen says. They can't be in denial about incidents that are brought to their attention.

"Anyone in that situation should be asking, 'What's going on?' 'What is it about these situations that brings about this kind of behavior?' " Parents should be having frequent conversations about what's happening at school, know who their children are hanging out with and keep an eye out for warning signs that something's not quite right, she says.

"The parent's role is really to be there as a buffer, be the one who listens."

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Before she was a bully, Eva was a victim, she says. Older kids would call her names or hold her down to show they were stronger. She's the baby in the family, she says, and her parents didn't have time to pay attention to what was going on.

"(Bullying) comes from home, from family members," she says. "We hear our cousins and uncles talking crap about someone. We think it's funny. We think it's cool."

Eva never faced consequences for bullying, other than her suspensions. She believes that if someone had sat her down and told her that bullying was wrong, she would have listened. For years, she worried that one of her former victims would invite her on the "Maury Show" for a face-to-face showdown. She still feels badly about the pain she inflicted.

"I can't take it back," she says. "But if I could do it all over again, I wouldn't do what I did."

Did you ever bully anyone? Share your story in the comments below or on iReport.

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