Pennsylvania operator Comprehensive Healthcare Management Services was found guilty in a sprawling health care fraud case, following a five-week federal trial in Pennsylvania, involving two of its facilities.
Brighton Rehabilitation and Wellness Center and Lebanon Rehabilitation and Wellness Center were found guilty of making false statements in connection with the payment of health care benefits and for the purpose of obstructing and impeding the investigation and proper administration of a matter within the jurisdiction of the Centers for Medicare & Medicaid Services (CMS), according to a statement from the office of U.S. Attorney Eric Olshan, Western District of Pennsylvania.
Brighton was convicted of six counts and Mt. Lebanon of four counts.
“Today, the jury held the two corporate defendants criminally liable for a total of 10 counts of making false statements and obstructing CMS’s critically important work of ensuring that nursing facilities comply with the law,” said Olshan. “This office and our law enforcement partners will continue to seek accountability for any individual or business that pursues profit through deceit and does so at the expense of vulnerable members of our community.”
Sentencing is scheduled in May before the U.S. District Judge Robert J. Colville. The law provides for a maximum total sentence of five years’ probation, a $500,000, or both.
On Monday, individual defendants – the executives at the two facilities and Comprehensive’s CEO – involved in the case, were, however, found not guilty on all counts. The five individuals originally charged were exonerated on Monday: Sam Halper, owner and CEO of Comprehensive; Eva Hamilton, director of nursing for Brighton; Michelle Romeo, regional manager with oversight at both properties; Susan Gilbert, former administrator at Mt. Lebanon Rehab; and Johanna Haller, former regional director of social services for Comprehensive’s facilities.
The criminal case alleged two different schemes by the defendants. In one, staff were accused of falsifying documents so it appeared they were meeting staffing requirements, listing “ghost employees” on staffing sheets that were not working, according to reports.
The other alleged scheme involved nursing home administrators changing patient depression scores and therapy recommendations, and delaying discharge dates to increase reimbursement.
Philadelphia-based law firm Welsh & Recker, which represented Haller, said such acquittals among individuals are “exceedingly rare” for federal criminal trials.
“We are deeply gratified by today’s verdict,” said Catherine M. Recker, a Welsh & Recker co-founding partner. “We have said from the very beginning that our client was completely innocent of the charged conduct. She did nothing wrong and looks forward to putting this matter behind her.”
A key to the jury’s finding, the firm said, was the fact that Haller conducted interviews of residents to document acuity.
The case, filed in the Western District of Pennsylvania, was captioned United States v. Gilbert.