Zionism row risks overshadowing Kerry visit to Turkey

ANKARA (Reuters) - Secretary of State John Kerry will upbraid Turkish Prime Minister Tayyip Erdogan on Friday for his description of Zionism as a crime against humanity, comments which could overshadow his first trip to a Muslim nation since taking office.

Kerry is meeting Turkish leaders in talks meant to focus on Syria's civil war and bilateral interests from energy security to counter-terrorism.

But Erdogan's comment at a U.N. meeting in Vienna this week, condemned by his Israeli counterpart, the White House and U.N. Secretary-General Ban Ki-moon, has clouded his trip.

"This was particularly offensive, frankly, to call Zionism a crime against humanity ... It does have a corrosive effect (on relations)," a senior U.S. official told reporters as Kerry flew to Ankara.

"I am sure the secretary will be very clear about how dismayed we were to hear it," the official, who spoke on condition of anonymity, said.

"To state the obvious, it complicates our ability to do all of the things that we want to do together when we have such a profound disagreement about such an important thing."

Washington needs all the allies it can get as it navigates the political currents of the Middle East, and sees Turkey as the key player in supporting Syria's opposition and planning for the era after President Bashar al-Assad.

But the collapse of its ties with Israel have undermined U.S. hopes that Turkey could play a role as a broker in the broader region.

"The Turkey-Israel relationship is frozen," the U.S. official said. "We want to see a normalization ... not just for the sake of the two countries but for the sake of the region and, frankly, for the symbolism," he said.

"Not that long ago (you) had these two countries demonstrating that a majority Muslim country could have very positive and strong relations with the Jewish state and that was a sign for the region (of what was) possible."

Erdogan told the U.N. Alliance of Civilizations meeting in Vienna on Wednesday: "Just as with Zionism, anti-Semitism and fascism, it has become necessary to view Islamophobia as a crime against humanity."

The head of Europe's main rabbinical group condemned his words as a "hateful attack" on Jews.

Ties between Israel and mostly Muslim Turkey have been frosty since 2010, when Israeli marines killed nine Turks in fighting aboard a Palestinian aid ship that tried to breach Israel's blockade of the Gaza Strip.

In recent weeks, there has been a run of reports in the Turkish and Israeli media about efforts to repair relations, including a senior diplomatic meeting last month in Rome and military equipment transfers.

The reports have not been confirmed by either government.

SUPPORT FOR SYRIAN OPPOSITION

Officials said Syria would top the agenda when Kerry meets Erdogan and President Abdullah Gul, building on the discussions in Rome between 11 mostly European and Arab nations within the "Friends of Syria" group.

After the Rome meeting, Kerry said on Thursday the United States would for the first time give non-lethal aid to the rebels and more than double support to the civilian opposition, although Western powers stopped short of pledging arms.

"We need to continue the discussion which took place in Rome ... in terms of the main goals there is no daylight between us and the Americans," a senior Turkish official said.

"A broad agreement was reached on supporting the opposition. Now our sides need to sit down and really flesh out what we can do to support them in order to change the balance on the ground," he said.

Turkey has been one of Assad's fiercest critics, hosting a NATO Patriot missile defense system, including two U.S. batteries, to protect against a spillover of violence and leading calls for international intervention.

It has spent more than $600 million sheltering refugees from the conflict that began almost two years ago, housing some 180,000 in camps near the border and tens of thousands more who are staying with relatives or in private accommodation.

Washington has given $385 million in humanitarian aid for Syria but U.S. President Barack Obama has so far refused to give arms, arguing it is difficult to prevent them from falling into the hands of militants who could use them on Western targets.

Turkey, too, has been reluctant to provide weapons, fearing direct intervention could cause the conflict to spill across its borders.

(Writing by Nick Tattersall; Editing by Janet Lawrence)

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Italy's lefti-wing leader suggests loose alliance to end deadlock

ROME: Italian left-wing leader Pier Luigi Bersani on Friday held out the prospect of forming a minority government based on a loose alliance in parliament following inconclusive elections, as Europe puts on pressure for a quick solution.

"I am calling it a government of change, which I would take the responsibility of leading," the Democratic Party leader said in an interview with La Repubblica daily, warning that Italy's "governability (is) at risk".

"Like all governments, it will ask for the confidence of parliament," he said.

But Bersani rejected out of hand the possibility of a grand coalition arrangement with Silvio Berlusconi's centre-right forces, after a new anti-establishment party upset the traditional balance of power between Italy's right and left by winning big in the polls early this week.

Bersani said the government he is proposing would have key objectives, including easing austerity measures, creating jobs, helping the poorest and cutting government costs -- echoing at least some of the demands made by the anti-establishment Five Star Movement.

But since a Democratic Party-led coalition did not manage majorities in both houses of parliament, the new government would depend on the support of other parties in the upper house -- an arrangement that analysts have warned would prove "highly unstable" at a time when Italy is facing an acute economic crisis.

Stefano Folli, editorialist for Il Sole 24 Ore business daily, said it would "hand over the government" to the whims of the populist Five Star Movement.

Most analysts say there will have to be new elections within months to resolve the impasse.

It is unclear whether the Five Star Movement would support Bersani after its leader, former comedian Beppe Grillo, said his movement "is not going to give a vote of confidence to the Democratic Party or to anyone else".

Not everyone in his movement agrees with this rejection, however.

The party captured a quarter of the vote with a campaign that mixed advocacy on environmental causes and grassroots local issues with a crusade against political sleaze, drawing many austerity-weary Italians to its ranks.

The party has spooked Europe with its promise to hold a referendum on the euro and cancel Italy's debts, prompting European leaders to urge Italy to stick to its fiscal commitments and form a government as soon as possible.

A deputy from German Chancellor Angela Merkel's Christian Democratic Union (CDU) called on Friday for Italy to leave the euro if it could not stick to EU rules after its inconclusive election.

"If one can't succeed in persuading the people of a country that they have to stick to the commitments they have themselves signed up to in terms of how the common currency works, then you can't demand new elections from outside, but the country must return to its own currency," said Klaus-Peter Willsch.

Markets were jittery in trading on Friday, with the Milan index plunging 1.58 percent -- the worst performer among major European stock markets.

The technocratic cabinet of outgoing premier Mario Monti, who won praise abroad for his budget discipline and economic reforms but became increasingly unpopular at home, will stay in place until a new government is formed.

A centrist coalition led by Monti came in fourth place, garnering far too little support to be able to cobble a majority in alliance with the left.

Bersani meanwhile ruled out another possibility -- the formation of an emergency coalition with his long-time arch-rival Berlusconi -- saying: "The hypothesis of a grand understanding does not exist and will never exist".

The scandal-tainted Berlusconi on Friday made an appearance at his appeal trial in Milan against a tax fraud conviction linked to his business empire.

A verdict in the case is expected later this month, along with a ruling in another trial in which Berlusconi is a defendant on charges of having sex with an underage prostitute and abuse of office while he was still prime minister.

Italy's new parliament must convene by March 15 at the latest under the rules of the constitution. After parliament meets, formal negotiations can begin with Italian President Giorgio Napolitano on a new government.

Guglielmo Meardi, a professor at Warwick Business School in Britain, said Italy was "used to parliamentary instability... and should stay on the rails until the autumn, when fresh elections could be held."

- AFP/al

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Prepared for arrest on return: Yasin Malik

ISLAMABAD: JKLF chief YasinMalik, who created flutters in India by sharing dais with 26/11 mastermind HafizSaeed in Pakistan, said on Friday he is prepared for confiscation of his passport or his arrest on returning home next week.

"I will be flying back to Delhi from Lahore on the regular PIA flight on March 9," Malik said.

Asked about calls for the revocation of his passport after Saeed joined him at a protest in Islamabad against the hanging of Afzal Guru, Malik said: "It is their wish if they wish to confiscate my passport or to arrest me. Jail is my second home".

Saeed, blamed by India for masterminding the 2008 Mumbai attacks, had briefly participated in the protest organised by the Jammu and Kashmir Liberation Front (JKLF) in Islamabad on February 10.

After photographs appeared in the media of Saeed and Malik, demands were made by political parties for the cancellation of Malik's passport.

"The government needs to come out clean with an action plan. They must arrest, forfeit his passport and take action against Malik and tell the nation. This is a monumental mistake on the part of the home ministry and we will raise at all forums available," BJP had said.

Reports in the Indian media said Malik's activities in Pakistan could cost him the freedom to travel abroad.

Authorities could also decide not to reissue a passport to him.

Malik visits Pakistan several times a year to meet his wife and his young daughter.

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WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

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Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

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Online:

WHO report: http://bit.ly/YDCXcb

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Sequester Set to Trigger Billions in Cuts

Nobody likes the sequester.

Even the word is enough to send shivers of fiscal panic, or sheer political malaise, down the spines of seasoned politicians and news reporters. And today, the sequester will almost certainly happen, a year and a half after its inception as an intentionally unpalatable event amid the stalemate of the debt-limit crisis in 2011.

Automatic budget cuts will be triggered across federal agencies, as President Obama will be required to order sequestration into effect before midnight Friday night. The federal bureaucracy will implement its various plans to save the money it's required to save.

Now that the sequester will probably happen, here are some questions and answers about it:

1. HOW BIG IS IT?

The cuts were originally slated for $109 billion this year, but after the fiscal-cliff deal postponed the sequester for two months by finding alternate savings, the sequester will amount to $85 billion over the remainder of the year. Over the rest of the year, nondefense programs will be cut by nine percent, and defense programs will be cut by 13 percent.

If carried out over 10 years (as designed), the sequester will amount to $1.2 trillion in total.

2. WHAT WILL BE CUT, SPARED?

Most government programs will be cut, including both defense and nondefense spending, with the cuts distributed evenly (by dollar amount) over those two categories.

Some vital domestic entitlements, however, will be spared. Social Security checks won't shrink; nor will Veterans Administration programs. Medicare benefits won't get cut, but payments to providers will shrink by two percent. The Children's Health Insurance Program (CHIP), food stamps, Pell grants, and Medicaid will all be shielded from the sequester.

But lots of things will get cut. The Obama administration has warned that a host of calamities will befall vulnerable segments of the population.

3. WHY DOES IT HAVE TO BE SO BAD?

Questions persist over whether or not it really does.

The sequester will mean such awful things because it forces agencies to cut things indiscriminately, instead of simply stripping money from their overall budgets.

But some Republicans, including Oklahoma Sen. Tom Coburn, have suggested that federal agencies have plenty of flexibility to implement these cuts while avoiding the worst of the purported consequences. Louisiana Gov. Bobby Jindal accused President Obama of trying to "distort" the severity of the sequester. The federal government will still spend more money than it did last year, GOP critics of sequester alarmism have pointed out.

The White House tells a different story.

According to the Office of Management and Budget, the sequestration law forces agency heads to cut the same percentage from each program. If that program is for TSA agents checking people in at airports, the sequester law doesn't care, and Homeland Security Secretary Janet Napolitano can't do anything about it.

Agency heads do have some authority to "reprogram" funds, rearranging their money to circumvent the bad effects. But an OMB official told ABC News that "these flexibilities are limited and do not provide significant relief due to the rigid nature of the way in which sequestration is required by law to be implemented."

4. WHEN WILL THE WORST OF IT START?

Not until April -- but some of the cuts could be felt before then.

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U.S. will give Syrian rebels medical, food aid, not arms

ROME (Reuters) - The United States will send non-lethal aid directly to Syrian rebels for the first time, Secretary of State John Kerry said on Thursday, disappointing opponents of President Bashar al-Assad who are demanding Western weapons.

More than 70,000 Syrians have been killed in a devastating conflict that began with peaceful anti-Assad protests nearly two years ago. Some 860,000 have fled abroad and several million are displaced within the country or need humanitarian assistance.

Kerry, speaking in Rome after a meeting of the mainly Western and Arab "Friends of Syria" group said his country would more than double its aid to the Syrian civilian opposition, giving it an extra $60 million to help provide security.

The United States would now "extend food and medical supplies to the opposition, including to the Syrian opposition's Supreme Military (Council)," Kerry said.

In their final statement, the Friends of Syria pledged more political and material support to the opposition Syrian National Coalition, a fractious group that has struggled to gain traction inside Syria, especially among disparate rebel forces.

Riad Seif, a coalition leader, said on the eve of the Rome talks that it would demand "qualitative military support", though another coalition official welcomed the shift in the U.S. stance.

"We move forward with a great deal of cautious optimism," said Yasser Tabbara. "We heard today a different kind of discourse," he said, adding the opposition need military and political support.

The modest U.S. policy shift may compound the frustration that had prompted the coalition to declare last week it would boycott the Rome talks. It changed its mind under U.S. pressure.

Many in the coalition say Western reluctance to arm rebels only plays into the hands of Islamist militants now widely seen as the most effective forces in the struggle to topple Assad.

However, a European diplomat held out the prospect of possible Western military support, saying the coalition and its Western and Arab backers would meet in Istanbul next week to discuss military and humanitarian support to the rebels.

MEALS READY TO EAT

Kerry's offer of medical aid and Meals Ready to Eat (MREs), the U.S. army's basic ration, fell far short of rebel demands for sophisticated anti-tank and anti-aircraft weapons to help tip the balance against Assad's mostly Russian-supplied forces.

It also stopped short of providing other forms of non-lethal assistance such as bullet-proof vests, armored personnel vehicles and military training to the insurgents.

The Rome talks were the latest evidence that the United States and its allies have no appetite for military intervention in Syria, after the withdrawal of U.S.-led troops from Iraq and the drawdown under way in Afghanistan.

The final communique called for an immediate halt to "unabated" arms supplies to Damascus by third countries, referring mostly to Assad's allies Russia and Iran.

It also said Syria must immediately stop indiscriminate bombardment of populated areas, which it described as crimes against humanity. NATO officials say Assad's military has fired ballistic missiles within Syria, which the government denies.

Human Rights Watch has reported that at least 171 civilians were killed in four Scud missile strikes last week.

The "Friends of Syria" pledged "more political and material support to the coalition as the sole legitimate representative of the Syrian people and to get more concrete assistance inside Syria", but gave no details on exactly what would be provided.

Kerry said earlier this week he would not leave the Syrian opposition "dangling in the wind" unsure of getting support.

But the White House continues to resist providing weaponry to the rebel forces, arguing there was no way to guarantee the arms might not fall into the hands of militants who might eventually use them against Western or Israeli targets.

"HUGE DEBATE"

U.S. officials have said that the U.S. Defense and State Departments, under former Secretary of Defense Leon Panetta and former Secretary of State Hillary Clinton, privately recommended that the White House arm the rebels but were overruled.

"It's a huge debate inside the administration between those that have to deal with Syria on an everyday basis, the State Department and DoD particularly, and the White House, which ... until now has vetoed any kind of outreach to the armed groups," said Andrew Tabler, senior fellow at the Washington Institute for Near East Policy, a think-tank in the U.S. capital.

The United States says it has already provided more than $50 million in non-lethal assistance such as communications gear and governance training to the civilian opposition.

A source in the Syrian coalition, however, said even the extra $60 million promised by Washington was a pittance compared to what he said was the $40 million a day in humanitarian aid needed for Syrian refugees and internally displaced persons.

The United States has provided some $365 million in humanitarian aid for Syrian refugees in countries such as Turkey, Jordan and Lebanon and for internally displaced people, channeling this money through non-governmental organizations.

More than 40,000 people a week are fleeing Syria and the total number of refugees will likely pass 1 million in less than a month, far sooner than the United Nations had forecast, a senior U.N. official told the Security Council on Wednesday.

U.N. High Commissioner for Refugees António Guterres said his agency had registered 936,000 Syrians across the Middle East and North Africa, nearly 30 times as many as in April last year.

"We expected to have 1.1 million Syrian refugees by June. If things continue to accelerate like this, it will take less than a month to reach that number," he told the 15-member council.

(Writing by Alistair Lyon; Editing by Jon Boyle)

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SingPost sets up S$10m fund to help low-wage employees

SINGAPORE: SingPost is setting up a $10 million "Inclusivity Fund", which will benefit its low-wage workers.

Over 70 per cent of the fund will go to helping the workers cope with the rising cost of living. This will include retention awards and enhancements to their wages.

Part of the fund will also go into training to help them upgrade their skills.

Staff with school-going children can also stand to benefit from bursaries and scholarships.

The fund will be disbursed over five years and benefit some 3,400 workers.

The company will also be investing about S$30 million to enhance its delivery and improve processes.

- CNA/xq

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Left pulls off emphatic win in Tripura sweeping 50 of 60 seats

AGARTALA: The Left Front on Thursday retained power in Tripura for the fifth consecutive time, sweeping 50 of the 60 seats and leaving the Congress badly bruised with just 10 seats.

Hundreds of Left activists, mainly from the Communist Party of India-Marxist CPI(M), celebrated across the state as election results left the Congress in gloom.

The CPI(M) bagged 49 seats while the Communist Party of India (CPI) won one seat.

It was the best result for the Left since 1978, when it won a record 56 seats. It increased its 2008 tally by one seat.

"This is a verdict in favour of development, peace and stability besides good governance," a beaming chief minister Manik Sarkar said.

"People voted and supported the Left Front for taking up development work and for curbing militancy," Sarkar added.

Sarkar, 64, who retained his Dhanpur seat in west Tripura, is the only political leader to be chief minister for a record fourth term in Tripura, a Marxist bastion. It was Sarkar's sixth electoral win.

While the Congress managed to retain its 2008 tally of 10 seats, its ally the Indigenous Nationalist Party of Tripura (INPT) drew blank. It had won one seat five years ago.

The Trinamool Congress, which fielded 22 candidates in 2008, did not contest this time to prevent a split in non-Left votes. But even that did not help the Congress.

The Left Front wrested four seats from the Congress-INPT-NCT (Nationalist Conference of Tripura) coalition. The Congress snatched three seats from the Left.

"Left Front candidates have increased their winning margin in most seats," an Election Commission official said.

The 49 seats of CPI(M) is three more than what it got in 2008. The CPI won one seat and lost another.

The Revolutionary Socialist Party (RSP) and Forward Bloc lost the two and one seats they contested.

Finance minister Badal Chowdhury posted the highest winning margin of 12,450 votes.

Assembly speaker Ramendra Chandra Debnath, commerce minister Jitendra Chowdhury, school education minister Tapan Chakraborty, information minister Anil Sarkar and tribal welfare minister Aghore Debbarma won by huge margins.

Teacher-turned-politician Anil Sarkar, 75, who is also a poet and writer, was re-elected on CPI(M) ticket from Pratapgarh in western Tripura for a record ninth time.

Congress leader Ratan Lal Nath won from Mohanpur for the fifth time while state Congress president Sudip Roy Barman retained his Agartala seat for the fourth time.

Former Tripura assembly speaker Jitendra Sarkar, who this time contested on Congress ticket, wrested Barjala seat from the CPI(M). He won by 254 votes.

CPI(M) candidate Ratan Das wrested Ramnagar after a gap of 25 years. He defeated former state Congress chief Surajit Datta by just 15 votes.

"This is a great victory for the Left Front. Good governance is one of the key factors," CPI-M spokesperson Gautam Das told IANS.

Notable Congress losers included former chief minister Samir Ranjan Barma, party leader Subal Bhowmik and INPT president and former militant leader Bijoy Kumar Hrangkhawl.

Tripura made history when a record 93.57 percent of the 2.3 million voters exercised their franchise February 14. There were 249 candidates.

The Left has ruled Tripura since 1978 barring one term (1988-93).

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Medicare paid $5.1B for poor nursing home care

SAN FRANCISCO (AP) — 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 cost 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 AP. "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, NY. "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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On the Web:

The OIG report: http://1.usa.gov/VaztQm

The Medicare nursing home database: http://www.medicare.gov/NursingHomeCompare/search.aspx?bhcp=1&AspxAutoDetectCookieSupport=1

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Follow Garance Burke on Twitter at —http://twitter.com/garanceburke.

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Benedict Pledges 'Obedience' to New Pope

In his farewell remarks to colleagues in the Roman Catholic Church, Pope Benedict XVI, the first pontiff to resign in nearly 600 years, promised "unconditional reverence and obedience" to his eventual successor.

Benedict, in a morning meeting at the Vatican, urged the cardinals to act "like an orchestra" to find "harmony" moving forward.

Benedict, 85, is spending a quiet final day as pope, bidding farewell to his colleagues and moving on to a secluded life of prayer, far from the grueling demands of the papacy and the scandals that have recently plagued the church.

His first order of business was a morning meeting with the cardinals in the Clementine Hall, a room in the Apostolic Palace. Despite the historical nature of Benedict's resignation, not all cardinals attended the event.

With their first working meeting not until Monday, only around 100 cardinals were set to attend, the Vatican press office said Wednesday. Those who are there for Benedict's departure will be greeted by seniority.

Angelo Sodano, the dean of the College of Cardinals, thanked Benedict for his service to the church during the eight years he has spent as pontiff.

Pope Benedict XVI Delivers Farewell Address

In the evening, at 5:00 p.m. local time, Benedict will leave the Vatican palace for the last time to head to Castel Gandolfo, the papal summer residence outside Rome. Before his departure, the German-born theologian will say some goodbyes in the Courtyard of San Damaso, inside the Vatican, first to his Secretary of State Cardinal Tarcisio Bertone and then to the Swiss Guards who have protected him as pontiff.

9 Men Who Could Replace Pope Benedict XVI

From there it is a short drive to a heliport for the 15-minute flight via helicopter to Castel Gandolfo, just south of the city. Benedict will not be alone on his journey, accompanied by members of the Pontifical Household such as two private secretaries, the head of protocol, his personal physician and his butler.

Once Benedict lands in the gardens at Castel Gandolfo, he will be greeted a group of dignitaries, such as the governor of the Vatican City state Giovanni Bertello, two bishops, the director of the pontifical villas, and the mayor and parish priest. Off the helicopter and into a car, Benedict will head to the palace that he will call home for the coming months. From a window of the palace, Benedict will make one final wave to the crowd at the papal retreat.

It is there, at 8:00 p.m., that Benedict's resignation will take effect once and for all. Once the gates to the residence close, the Swiss Guards will leave Benedict's side for the last time, their time protecting the pontiff completed.

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For some U.S. Catholics in Rome for the historic occasion, Benedict's departure is bittersweet. Christopher Kerzich, a Chicago resident studying at the Pontifical North American College of Rome, said Wednesday he is sad to see Benedict leave, but excited to see what comes next.

"Many Catholics have come to love this pontiff, this very humble man," Kerzich said. "He is a man who's really fought this and prayed this through and has peace in his heart. I take comfort in that and I think a lot of Catholics should take comfort in that."

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