I don't do speculation about ranks and whatnot. So I'll just post what I know to be ONE HUNDRED PERCENT TRUE:

John Gambino is practically an invalid. He's THAT sick. Let the guy enjoy whatever time he has left and stop worrying about whether or not he's "active." Sure, he still gets money. But he doesn't leave his house. And it's not to fool the government or some other clandestine nonsense. He doesn't leave his house because the poor guy is half dead.