Obama Signs Order to Begin Sequester Cuts

President Obama and congressional leaders today failed to reach a breakthrough to avert a sweeping package of automatic spending cuts, setting into motion $85 billion of across-the-board belt-tightening that neither had wanted to see.

President Obama officially initiated the cuts with an order to agencies Friday evening.

He had met for just over an hour at the White House Friday morning with Republican leaders House Speaker John Boehner and Senate Minority Leader Mitch McConnell and his Democratic allies, House Minority Leader Nancy Pelosi, Senate Majority Leader Harry Reid and Vice President Joe Biden.

But the parties emerged from their first face-to-face meeting of the year resigned to see the cuts take hold at midnight.

"This is not a win for anybody," Obama lamented in a statement to reporters after the meeting. "This is a loss for the American people."

READ MORE: 6 Questions (and Answers) About the Sequester

Officials have said the spending reductions immediately take effect Saturday but that the pain from reduced government services and furloughs of tens of thousands of federal employees would be felt gradually in the weeks ahead.

Sequestration Deadline: Obama Meets With Leaders Watch Video

Sequester Countdown: The Reality of Budget Cuts Watch Video

Federal agencies, including Homeland Security, the Pentagon, Internal Revenue Service and the Department of Education, have all prepared to notify employees that they will have to take one unpaid day off per week through the end of the year.

The staffing trims could slow many government services, including airport screenings, air traffic control, and law enforcement investigations and prosecutions. Spending on education programs and health services for low-income families will also get clipped.

"It is absolutely true that this is not going to precipitate the crisis" that would have been caused by the so-called fiscal cliff, Obama said. "But people are going to be hurt. The economy will not grow as quickly as it would have. Unemployment will not go down as quickly as it would have. And there are lives behind that. And it's real."

The sticking point in the debate over the automatic cuts -- known as sequester -- has remained the same between the parties for more than a year since the cuts were first proposed: whether to include more new tax revenue in a broad deficit reduction plan.

The White House insists there must be higher tax revenue, through elimination of tax loopholes and deductions that benefit wealthier Americans and corporations. Republicans seek an approach of spending cuts only, with an emphasis on entitlement programs. It's a deep divide that both sides have proven unable to bridge.

"This discussion about revenue, in my view, is over," Boehner told reporters after the meeting. "It's about taking on the spending problem here in Washington."

Boehner: No New Taxes to Avert Sequester

Boehner says any elimination of tax loopholes or deductions should be part of a broader tax code overhaul aimed at lowering rates overall, not to offset spending cuts in the sequester.

Obama countered today that he's willing to "take on the problem where it exists, on entitlements, and do some things that my own party doesn't like."

But he says Republicans must be willing to eliminate some tax loopholes as part of a deal.

"They refuse to budge on closing a single wasteful loophole to help reduce the deficit," Obama said. "We can and must replace these cuts with a more balanced approach that asks something from everybody."

Can anything more be done by either side to reach a middle ground?

The president today claimed he's done all he can. "I am not a dictator, I'm the president," Obama said.

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Assad forces take Aleppo village, reopening supply line

BEIRUT (Reuters) - Syrian President Bashar al-Assad's forces seized a village southeast of the city of Aleppo on Friday, reopening a supply line to the country's biggest city where they have been battling rebels for eight months, a monitoring group said.

The Syrian Observatory for Human Rights said the capture of Tel Shghaib marked the last step to creating a land supply route north into Aleppo from Hama province, crucial for Assad's forces who have lost control of part of the main north-south highway.

Rebels say they hold most of the city itself and nearly all the rural hinterland. But they have been unable to achieve a decisive victory and complain that they are outgunned and vulnerable to Assad's air force, artillery and ballistic missiles, which killed dozens of people in Aleppo last week.

The United States pledged direct but non-lethal aid to the rebels at a meeting in Rome on Thursday, disappointing Assad's opponents who had hoped for more tangible military support to tip the balance of forces on the ground.

Activists reported another day of fierce fighting around Aleppo, including the military airport at Nairab, three miles north of Tel Shghaib which Assad's forces retook.

"It's a significant gain for the regime," the British-based Observatory's director Rami Abdelrahman said of the army's push north, which reversed many rebel advances when they moved south into Hama from Aleppo province at the end of last year.

Further east, on the Iraqi frontier, government troops also managed to wrest back control of the Yarubiyah border crossing after insurgents seized it 24 hours earlier, he said.

SYRIA COULD FALL APART

The revolt against Assad, which erupted in March 2011 with mainly peaceful protests, has escalated into civil war between mainly Sunni Muslim forces and troops and militias loyal to Assad, from the minority Alawite community whose faith derives from Shi'ite Islam.

The United Nations says 70,000 people have been killed, nearly a million have fled the country and millions more have been displaced or need aid.

U.N. Secretary-General Ban Ki-moon said on Friday that Syria, a major Arab state on the fault lines of broader Middle East conflict, would fall apart if the government and rebels keep fighting instead of seeking a negotiated peace.

"This is a very small window of opportunity which we strongly support and encourage them to use that. The opportunity may close soon," Ban said in Geneva.

The government and opposition have both edged away in recent weeks from their previous rejection of dialogue. Foreign Minister Walid al-Moualem said on Monday the government would even talk to armed rebels and opposition coalition leader Moaz Alkhatib has said he is ready to meet Assad's representatives.

But Syrian officials say any serious talks must be on Syrian soil under state control, and have shown no readiness to discuss Assad's departure - the central demand of the opposition. For rebel fighters, who do not answer to exiled civilian opposition leaders, Assad's exit is a precondition for any negotiations.

"I continue to urge the Syrian parties to find their way to the negotiating table. The horrors of the last months and years prove beyond doubt: the military solution in Syria is leading to the dissolution of Syria," Ban said.

He also called on the U.N. Security Council, paralyzed by a standoff between the United States and European allies on one side, pushing for U.N. action against Assad, and Russia and China, who have backed Assad, to unite and address the crisis.

Moscow criticized Thursday's meeting in Rome of largely anti-Assad Western and Arab states for taking positions and steps which "directly encourage extremists" to topple the government by force.

But the Kremlin also said presidents Vladimir Putin and Barack Obama had told their foreign ministers to keep in close touch and seek new initiatives to end Syria's civil war.

U.S. Secretary of State John Kerry said on Thursday Washington would provide non-lethal aid including medical supplies and food to rebel fighters, as well as $60 million to help the civilian opposition provide services including security, education and sanitation.

The European Union said it had amended sanctions on Syria to allow the supply of armored vehicles, non-lethal military equipment and technical aid.

The steps still fell well short of what rebels are looking for - more arms, and prompted the opposition to postpone a Saturday meeting where they had been due to choose a prime minister to head the administration of rebel-held territory.

Alkhatib said he was tired of hearing Western concerns over the growing role of Islamists in the Syrian rebel ranks - one of the main obstacles to greater military support, saying it paled into insignificance alongside the prolonged civilian suffering.

"Many sides...focus (more) on the length of the rebel fighter's beard than they do on the blood of the children being killed," he said, standing next to Kerry after their meeting.

(Additional reporting by Stephanie Nebehay in Geneva and Alissa de Carbonnel in Moscow; Editing by Mark Heinrich)

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Thai tourist industry 'driving' elephant smuggling

BANGKOK: Smuggling the world's largest land animal across an international border sounds like a mammoth undertaking, but activists say that does not stop traffickers supplying Asian elephants to Thai tourist attractions.

Unlike their heavily-poached African cousins -- whose plight is set to dominate Convention on International Trade in Endangered Species (CITES) talks in Bangkok next week -- Asian elephants do not often make the headlines.

But the species is also under threat, as networks operate a rapacious trade in wild elephants to meet the demands of Thailand's tourist industry.

Camps and zoos featuring elephants tightrope walking, playing football or performing in painting contests employ almost 4,000 domesticated elephants for the amusement of tourists.

Conservation activists accuse the industry of using illicitly-acquired animals to supplement its legal supply, with wild elephants caught in Myanmar and sold across the border into one of around 150 camps.

"Even the so-called rescue charities are trying to buy elephants," said John Roberts of the Golden Triangle Asian Elephant Foundation.

Domestic elephants in Thailand -- where the pachyderm is a national symbol -- have been employed en masse in the tourist trade since they found themselves unemployed in 1989 when logging was banned.

Just 2,000 of the animals remain in the wild.

Prices have exploded with elephants now commanding between 500,000 and two million baht ($17,000 to $67,000) per baby, estimates suggest.

The number of baby elephants "coming into the system" is far higher than would be possible "from actual breeding", said Roberts, whose group decided to stop buying elephants seven years ago and now has 26 residents.

"I cannot see a way to buy an elephant which doesn't cause another elephant to be smuggled," he added.

Between 50 and 100 wild baby or young female elephants are sold from Myanmar each year, according to estimates by British charity Elephant Family.

The group's head of conservation, Dan Bucknell, told AFP that while some trafficked elephants may be taken elsewhere, the majority enter the Thai market.

"Thailand is certainly a hub," he said.

Smuggling such a large mammal should in theory require elaborate planning to avoid the police but in reality traffickers just "do it over a normal road", said wildlife trade researcher Vincent Nijman of Oxford Brookes university.

"Elephants can be in a truck or even walk" across the Thai border in front of complicit customs officers and border guards, he said.

Demand is not only threatening the 4,000 to 5,000 wild elephants in Myanmar, but is also hitting populations in Thailand's other neighbour Laos.

Young domestic elephants are exported across the border, furthering the decline of a population of around 480 animals, said Gilles Maurer of the group ElephantAsia.

Laos, known as the "land of a million elephants", only has between 300 and 500 wild pachyderms left and Maurer said that as the domestic population shrinks, "there is a strong risk" that poachers will turn to them.

Last year Thai authorities conducted several raids on elephant camps and seized some 25 animals -- 19 remain under their protection.

"It is likely the 19 seized elephants were smuggled wild animals as their paperwork did not match up," said forest ranger Pradung Jitraon, of Thailand's National Parks department, who participated in the operation.

Activists have welcomed the initiative but are also calling for broader reforms. "The system now is so weak," said Petch Manopawitr of the World Wildlife Fund in Thailand.

Thailand needs "more control, more transparent monitoring of the population, of what they do in terms of new born elephants", he said, calling for a proper database of elephants, using DNA testing or microchips.

Such a system, he added, would allow foreigners to visit elephant camps safe in the knowledge they are not "harming or threatening the wild population".

- AFP/ck

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Lawyer accuses Pak of 'blocking' book on Sarabjit

MUMBAI: Pakistani lawyer-activist Awais Sheikh has accused the authorities of stalling the release of his book on Indian prisoner Sarabjit Singh.

Sheikh wrote an email to say, "At 3pm on Friday my guests and I arrived at Lahore Press Club for the launch ceremony and were shocked to see the doors locked. The administration informed us that they were unable to allow the function owing to a security threat."

Invitees including Hamid Khan, former president of Pakistan's Supreme Court Bar Association and I A Rehman, director of the Human Rights Commission of Pakistan, and other guests were reportedly displeased with the authorities for "blocking" the function.

Sheikh alleged that those who "feared that the facts of Sarabjit Singh's matter would be revealed through the book were responsible for this unlawful and unfair act".

He claimed his writings would make the people of Pakistan "aware of the gross injustice done to Sarabjit".

He also claimed that an anonymous letter addressed to his wife was delivered at his residence Friday morning by an "unknown person". The writer allegedly threatened to harm his family if he went ahead with the press conference on Sarabjit. Sheikh is yet to approach the police in this matter.

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Arias Recounts Each Moment of Stabbing, Slashing

Accused murderer Jodi Arias was forced to recount today each detail of how she killed her ex-boyfriend, Travis Alexander, including re-enacting how he allegedly tackled her when she shot him, leaving her crying in her hands on the witness stand.

During hours of dramatic cross-examination by prosecutor Juan Martinez, Arias bawled as he asked her about stabbing, slashing and shooting Alexander on June 4, 2008.

"You would acknowledge that Mr. Alexander was stabbed, and that the stabbing was with the knife, and it was after the shooting according to you, right?" Martinez said in rapid succession.

"Yes, I don't remember," Arias said, covering her face with her hands.

"Do you acknowledge the stab wounds, and we can count them together, were to the back of the head and the torso?" Martinez said, flashing a photo of Alexander's bloodied body onto the courtroom projector. " Do you want to take a look at the photo?"

Arias, burying her face in her hands and shutting her eyes on the stand, mumbled, "No."

Alexander's sisters, seated in the front row of the gallery, also looked away, crying.

Arias, 32, is accused of killing Alexander on June 4, 2008 out of jealousy. He was stabbed 27 times, his throat was slashed and he was shot in the head twice.

Arias claims she killed in self-defense after Alexander had become increasingly violent with her. She could face the death penalty if convicted.

Martinez also forced Arias to demonstrate in court today how she claims Alexander lunged at her "like a linebacker," causing her to fire the gun at him. The pair argued over how exactly Alexander was positioned, and Martinez pushed her to explain what she meant.

"He lunges at me like a linebacker," Arias said.

"Like a linebacker, what does that mean?" Martinez asked.

Jodi Arias Under Attack in Third Day of Cross-Examination Watch Video

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

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

"He was low. It was almost like he dove," she said, and trying to explain it further, added, "He was like a linebacker is the only way I can describe it unless I get up to act it out which I'd rather not do."

Catching Up on the Trial? Check Out ABC News' Jodi Arias Trial Coverage

Timeline of the Jodi Arias Trial

"Go ahead and do it," Martinez said. "Just stand. Go ahead."

Judge Sherry Stephens initially cleared the court as Arias demonstrated and then Martinez had her do it again after the jury and spectators were allowed back into the courtroom.

Standing and moving away from the witness box, Arias bent at the waist and spread out her arms and meekly made a slight lunging motion.

According to her testimony, Arias fired the gun as Alexander rushed at her, tackling her to the ground. She said she does not remember how she stabbed or slashed him.

It was a day of dramatics and anger as the prosecution pressed Arias on the details of the killing, with Martinez ending the afternoon of questioning by accusing Arias of lying throughout her direct testimony.

At one point Arias dissolved into tears, unable to answer pointed questions when shown a photo of Alexander's body lying crumpled in the bottom of the stall shower.

After a short pause, Martinez asked dryly, "Were you crying when you were shooting him?"

"I don't remember," Arias moaned.

"Were you crying when you stabbed him?" he said. "How about when you slashed his throat?"

"I don't remember, I don't know."

Martinez pressed on, "You're the one that did this right? And lied about all this right?"

"Yes."

"So then take a look at it," he barked.

Arias did not answer Martinez's question, crying into her hands instead. The judge, after a moment, called for the lunch recess to take a break from the testimony. Arias' attorney walked over and consoled her, telling her to "take a moment."

Until that moment, Arias had given vague answers to Martinez as he asked about the hours leading up to the murder. Arias, 32, has testified that she drove to Alexander's house on June 4, 2008, for a sexual liaison, that she had sex with Alexander and the pair took nude photos before an explosive confrontation ended with her killing him. She claims she doesn't remember stabbing Alexander, but insists it was in self-defense.

Martinez questioned her claims, asking exactly what they argued about and who encouraged whom to take the nude photos. He pointed out that Arias told Detective Esteban Flores of the Mesa police department that she had to convince Alexander to take the nude photos in the shower, but that she testified on the stand that Alexander had wanted them.

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Shark fin-hungry China drives "chaotic" fishing in Indonesia

BENOA, Indonesia: Dozens of weary Indonesian fishermen sail into a busy port on the resort island of Bali celebrating their lucrative and controversial haul that is destined to end up at Chinese banquets.

The fishermen show off about 100 shark fins, already sliced off the carcasses, that are ready to be sold to middle-men and then most likely onwards to mainland China or cities around the world with big Chinese populations.

"We don't only look for sharks -- we mainly catch tuna and marlin -- but finding sharks is a good bonus. Their fins are worth a lot and the meat is easy to sell locally," said 33-year-old Warsito, who goes by one name.

Fishermen around Bali sell shark fins fresh off the boat for between US$15 and US$50, helping to satiate an ancient but fast-growing Chinese appetite for soup in which it is the main ingredient.

Shark fin soup was once a delicacy for China's elite, but shark populations have been decimated around the world as the country's 1.3 billion people have grown wealthier and incorporated it into their festivities.

While the Chinese government has banned shark fin soup from state banquets, and some five-star restaurants in Hong Kong and Singapore have dropped it from their menus, a burgeoning middle class in China continues to stoke demand.

Humans kill about 100 million sharks each year, mostly for their fins, according to the UN Food and Agriculture Organisation (FAO), and conservationists are warning that dozens of species are under threat.

Ninety percent of the world's sharks have disappeared over the past 100 years, mostly because of overfishing in countries such as Indonesia, the FAO said.

Conservationists also point out that "finning" -- slicing the valuable fins from live sharks -- is simply inhumane, as the rest of the animal is typically dumped back into the ocean where it bleeds slowly to death.

How to save the shark will be a top concern at the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) that begins in Bangkok, Thailand, on Sunday.

World authorities will look at restricting trade of certain shark species.

Restrictions would apply to manta rays and five shark species -- the porbeagle, scalloped hammerhead, great hammerhead, smooth hammerhead and oceanic whitetip -- and must be approved by two-thirds of member states.

However, experts say laws to restrict trade will mean little unless there are total bans on fishing, with greater efforts needed to control unregulated fisheries.

Indonesia is particularly important because it is the world's biggest fisher and exporter of sharks, with thousands of small-time fishermen such as those in Bali able to operate with impunity.

Management of the Indonesian industry has been "total chaos", Conservation International Indonesia marine programme director Tiene Gunawan said, with no national restrictions on the trade.

In 2010, the Indonesian government designed a national plan of action to better manage the shark fishing industry, but it has so far issued no regulations.

Rampant shark fishing has already affected ecosystems in Indonesian waters, Gunawan said, including the world-famous diving spot Raja Amapat in the region of Papua.

However recent efforts by the provincial authorities there -- emanating from a recognition that there is greater economic benefit in maintaining shark populations -- could be a model for the future.

After authorities in Raja Ampat noticed a surge in boats carrying hundreds of shark fins but no carcasses, the local government banned shark fishing in 2010.

Last week the ban was made into law, creating the country's only shark and manta ray sanctuary. It is also the first in the Coral Triangle, a massive region in Southeast Asia known as the "Amazon of the ocean".

"What they realised, and our studies support this, is that the value of a dead shark is much lower than if we keep it alive for tourism," Gunawan said.

-AFP/fl

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630 cases of child sexual abuse reported in Mizoram during 2003 to 2009

NEW DELHI: There is an alarming increase in the number of child abuse as well as juvenile delinquency in Mizoram, with as many a 630 cases of child sexual abuse reported during 2003 and 2009. Yet, there seem to be no urgency or sincerity on the part of the state government to implement the Juvenile Justice (Care and Protection of Children) Act of 2000.

Children are not safe anywhere in the state as most cases of child sexual abuse were committed by relatives, friends and teachers of the victims. Sexual abuse of children remains high. A study commissioned by the Social Welfare Department of Mizoram government and released in October 2012 recorded 630 cases of child sexual abuse during the period of 2003 to 2009.

Juvenile delinquency remains equally high. During the last decade from 2002 to 2011, the National Crime Records Bureau under the Ministry of Home Affairs recorded a total of 1,699 cases of "juvenile delinquency" in Mizoram. These include 1,258 cases registered under the Indian Penal Code and 441 cases under the Special and Local Laws.

Despite the situation, the state government went slow on implementing JJ Act. In fact while the JJ Act was enacted in 2000, the statutory support services namely the Juvenile Justice Boards and the Child Welfare Committees in Mizoram have been set up in all the eight districts only during 2010-11.

"Mizoram has failed miserably in providing institutional care. The lack of separate Special Home and the poor facilities in the existing Observation Home-cum-Special Homes at Aizawl and Lunglei, overcrowding, lack of segregation of the juveniles on the basis of the nature of their crimes severely undermine the Juvenile Justice (Care and Protection of Children) Act," said Suhas Chakma, director of Asian Centre for Human Rights.

According to an ACHR report, the Observation Home-cum-Special Home at Lunglei is overcrowded and facilities are poor. The Home has a capacity to house only 10 inmates (boys only). The Officer-in-Charge took the initiative of adding four extra beds for the inmates as sometimes number of inmate increases beyond the capacity. However, many a times the inmates exceeded 14 and in such situations the inmates had to sleep on the floor.

Also the Mizoram government has failed to utilise the grants under Integrated Child Protection Scheme (ICPS) provided by the Ministry of Women and Child Development. On July 6, 2012, Mizoram informed the Project Approval Board under ICPS that Rs 75.25 lakhs was lying unspent from the grants of 2011-12. Further, the state government informed that it had received construction grant for two Government Homes in 2011 but this grant has remained unutilised.

According to ACHR report, there are 28 recognised Children Homes in Mizoram and almost all of them are either privately owned or run by faith based organisations. As majority of the Children Homes are run through charity and children are admitted without the consent of the Child Welfare Committees, the lack of supervision by the state government is responsible for poor conditions of the Children Homes.

The First Step Children Home, Aizawl is inhospitable for small children and the Home's authorities have decided to close it down but the state government is yet to take a decision about it. Children are subjected to abuse and torture in many of the Homes. On July 13, 2009, a 13-year-old child was beaten to death by the officials at the Herald for Christ's Children Home, a government recognised Children Home at Lungleng, about 15 kms north of Aizawl.

"The NHRC has awarded compensation of Rs 3,00,000 to the mother based on the complaint filed by ACHR. But the particular murder shows the violence against children who require the outmost care," said Chakma.

ACHR recommended to the Mizoram government to establish the new Special and Observation Homes sanctioned by the Ministry of Women and Child Development in the districts not having such homes; separate the Observation Homes and Special Homes at Aizawl and Lunglei; ensure judicial utilisation of funds within the financial year; implement the recommendations made by the PAB under ICPS to establish more Observation Homes, Special Homes, Children Homes, and Shelter Homes and improve facilities at the Homes; ensure segregation of juveniles and children as per age and nature of offences; provide educational and vocational training facilities both within and outside the Homes and tie up with vocational training institutes; appoint adequate number of staff, including the Warden at the Observation Home-Cum-Special Home at Aizawl, and staff at three Shelter Homes at Aizawl, Mamit and Champhai; improve the functioning of the JJBs and CWCs through proper selection of the members and imparting adequate training; reduce the number of pendency cases both at JJBs and CWCs by increasing the number of sittings; and ensure regular inspections including surprise visits to all the juvenile justice and care institutions, whether run by government or private entities.

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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:

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

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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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Iran upbeat on nuclear talks, West still wary

ALMATY (Reuters) - Iran was upbeat on Wednesday after talks with world powers about its nuclear work ended with an agreement to meet again, but Western officials said it had yet to take concrete steps to ease their fears about its atomic ambitions.

Rapid progress was unlikely with Iran's presidential election, due in June, raising domestic political tensions, diplomats and analysts had said ahead of the February 26-27 meeting in the Kazakh city of Almaty, the first in eight months.

The United States, China, France, Russia, Britain and Germany offered modest sanctions relief in return for Iran curbing its most sensitive nuclear work but made clear that they expected no immediate breakthrough.

In an attempt to make their proposals more palatable to Iran, the six powers appeared to have softened previous demands somewhat, for example regarding their requirement that the Islamic state ship out its stockpile of higher-grade uranium.

Iran's chief nuclear negotiator Saeed Jalili said the powers had tried to "get closer to our viewpoint", which he said was positive.

In Paris, U.S. Secretary of State John Kerry commented that the talks had been "useful" and that a serious engagement by Iran could lead to a comprehensive deal in a decade-old dispute that has threatened to trigger a new Middle East war.

Iran's foreign minister said in Vienna he was "very confident" an agreement could be reached and Jalili, the chief negotiator, said he believed the Almaty meeting could be a "turning point".

However, one diplomat said Iranian officials at the negotiations appeared to be suggesting that they were opening new avenues, but it was not clear if this was really the case.

Iran expert Dina Esfandiary of the International Institute for Strategic Studies said: "Everyone is saying Iran was more positive and portrayed the talks as a win."

"I reckon the reason for that is that they are saving face internally while buying time with the West until after the elections," she said.

The two sides agreed to hold expert-level talks in Istanbul on March 18 to discuss the powers' proposals, and return to Almaty for political discussions on April 5-6, when Western diplomats made clear they wanted to see a substantive response from Iran.

"Iran knows what it needs to do, the president has made clear his determination to implement his policy that Iran will not have a nuclear weapon," Kerry said.

A senior U.S. official in Almaty said, "What we care about at the end is concrete results."

ISRAELI WARNING

Israel, assumed to be the Middle East's only nuclear-armed power, was watching the talks closely. It has strongly hinted it might attack Iran if diplomacy and sanctions fail to ensure that it cannot build a nuclear weapon. Iran denies any such aim.

Israeli Prime Minister Benjamin Netanyahu said economic sanctions were failing and urged the international community to threaten Iran with military action.

Western officials said the offer presented by the six powers included an easing of a ban on trade in gold and other precious metals, and a relaxation of an import embargo on Iranian petrochemical products. They gave no further details.

In exchange, a senior U.S. official said, Iran would among other things have to suspend uranium enrichment to a fissile concentration of 20 percent at its Fordow underground facility and "constrain the ability to quickly resume operations there".

The official did not describe what was being asked of Iran as a "shutdown" of the plant as Western diplomats had said in previous meetings with Iran last year.

Iran says it has a sovereign right to enrich uranium for peaceful purposes, and wants to fuel nuclear power plants so that it can export more oil.

But 20-percent purity is far higher than that needed for nuclear power, and rings alarm bells abroad because it is only a short technical step away from weapons-grade uranium. Iran says it produces higher-grade uranium to fuel a research reactor.

Iran's growing stockpile of 20-percent-enriched uranium is already more than half-way to a "red line" that Israel has made clear it would consider sufficient for a bomb.

In Vienna on Wednesday, a senior U.N. nuclear agency official told diplomats in a closed-door briefing that Iran was technically ready to sharply increase this higher-grade enrichment, two Western diplomats said.

"Iran can triple 20 percent production in the blink of an eye," one of the diplomats said.

The U.S. official in Almaty said the powers' latest proposal would "significantly restrict the accumulation of near-20-percent enriched uranium in Iran, while enabling the Iranians to produce sufficient fuel" for their Tehran medical reactor.

This appeared to be a softening of a previous demand that Iran ship out its stockpile of higher-grade enriched uranium, which it says it needs to produce medical isotopes.

Iran has often indicated that 20-percent enrichment could be up for negotiation if it received the fuel from abroad instead.

Jalili suggested Iran could discuss the issue, although he appeared to rule out shutting down Fordow. He said the powers had not made that specific demand.

The Iranian rial, which has lost more than half its foreign exchange value in the last year as sanctions bite, rose some 2 percent on Wednesday, currency tracking websites reported.

(Additional reporting by Fredrik Dahl and Yeganeh Torbati in Almaty, Georgina Prodhan in Vienna, Zahra Hosseinian in Zurich, Gabriela Baczynska in Moscow, Dan Williams in Jerusalem and Marcus George in Dubai; Writing by Timothy Heritage and Fredrik Dahl; Editing by Louise Ireland)

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