A federal grand jury in Pittsburgh indicted the former administrator of a skilled nursing facility in the region on charges of conspiracy to defraud the U.S., health care fraud, and the obstruction of a federal audit, U.S. attorney Scott W. Brady and Pennsylvania Attorney General Josh Shapiro announced Thursday.
The three-count indictment names Susan Gilbert, the former administrator of Mount Lebanon Rehabilitation and Wellness Center (MLRWC), as the only defendant. She served as administrator of the SNF from about November 2017 until March 2020.
The nursing home was one of two facilities where court-authorized warrants were served in September 2020, alongside an investigation by the Federal Bureau of Investigation (FBI) of the Brighton Rehabilitation and Wellness Center.
Brighton was the site of a major COVID-19 outbreak in the spring, and two of the owners of that facility, Sam Halper and Ephram Lahasky, have indirect ownership of MLRWC, according to ownership records on the Centers for Medicare & Medicaid Services (CMS) Care Compare website that were cited by the Pittsburgh Tribune-Review.
Halper and Lahasky did not respond to e-mailed messages from Skilled Nursing News requesting comment.
The indictment is an only accusation, and the defendant is presumed innocent unless proven guilty. Court filings available Thursday did not list an attorney for Gilbert.
Gilbert was accused of conspiracy “with persons known and unknown to the grand jury” to commit fraud against Medicare and Pennsylvania’s Medicaid programs.
“Among other things, the defendant, Susan Gilbert and/or other co-conspirators, directed administrative and management-level nursing staff, including, among others, the Director of Nursing, the Assistant Director of Nursing, and other administrative staff, to ‘clock in’ for shifts but not actually work,” the indictment alleged. “In doing so, MLRWC created falsified timecard documentation that made it appear as though these individuals were providing direct resident care, when in fact they were not in the building and therefore not providing direct resident care.”
Other charges against Gilbert and/or co-conspirators included:
- Providing monetary bonuses to management-level nursing staff for “clocking in” for shifts they did not work.
- Directing staff not to clock in and out when leaving the facility for 30-minute lunch breaks, creating false documentation that created the appearance of resident care.
- Directing staff to include hours worked by management-level nursing staff and other administrative staff on three-week staffing sheets provided to Department of Health (DOH), when those employees were not providing direct resident care during those hours.
- Causing administrative to keep two different books reflecting staffing levels, one with accurate information and one with information falsified to create the appearance of higher staffing levels.
- Directing staff to provide the falsified documents to DOH investigators during federally required inspections, to create the appearance of meeting staffing requirements and compliance with the conditions of participation for Medicare and Pennsylvania’s Medicaid program.
“This indictment shows that health care fraud is not a victimless crime,” special agent in charge Maureen R. Dixon of the Health and Human Services (HHS) Office of Inspector General (OIG) said in a statement announcing the indictment. “Falsifying records to avoid quality of care requirements can result in substandard, dangerous conditions for nursing home residents and a waste of taxpayer dollars.”