Medicaid Funding Suspended for Two More Nursing Homes in NJ, Owners Linked To Alleged Fraud

Two more nursing homes in New Jersey have their Medicaid funding suspended following allegations of massive fraud by the owners related to their New York facilities. Deptford Center for Rehabilitation and Healthcare, and Hammonton Center for Rehabilitation and Healthcare will lose their Medicaid funding on May 24, according to the Office of the State Comptroller […]

OIG Chief: Nursing Home Quality, Safety is ‘My Top Priority’

Improving nursing home oversight and quality will be “top priority” for the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG), as the Biden administration pushes ahead with its reform initiatives. “My top priority is propelling meaningful improvement in the quality and safety of care in the more than 15,000 Medicare- and […]

Former Skyline CEO Charged with Medicaid, Tax Fraud

Former Skyline Healthcare owner Joseph Schwartz on Monday was charged with Medicaid and tax fraud – more than three years after the nursing home chain collapsed. The Arkansas Attorney General’s office charged Schwartz, who lives in Brooklyn, N.Y., with eight counts of Medicaid fraud and two counts of tax fraud – all felonies – according […]

SavaSeniorCare to Pay $11.2M to Settle False Claims Allegations

The nursing home operator SavaSeniorCare LLC and its related entities have agreed to pay $11.2 million to resolve allegations it violated the False Claims Act (FCA), the Department of Justice (DOJ) announced Friday. That amount encompasses both federal and state settlements, with additional payments possible “if certain financial contingencies occur,” according to the DOJ. The […]

Skilled Nursing Facility Surveys Skyrocket During Pandemic

Skilled nursing facility surveys have skyrocketed over the past year, with some worrying that surveyors have also grown more aggressive. Federal data indicates that the number of surveys conducted nationwide has risen 132% percent since 2020, leaving some wondering how fairly standards are being applied when COVID-19 is already forcing facilities to contend with staff […]

Led by Biden’s HHS Pick, California Sues Brookdale Over Alleged Nursing Home Data Reporting Fraud

The state of California on Monday filed a lawsuit against Brookdale Senior Living (NYSE: BKD), accusing the company of submitting false nursing home staffing data to the federal government and improperly handling resident discharges. California attorney general Xavier Becerra — President Biden’s pick to serve as secretary of the Department of Health and Human Services […]

Federal Grand Jury Indicts Former Nursing Home Administrator Over Alleged Staffing Fraud

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, […]

Nursing Home Management Firm CareOne Pays $700K to Settle False Claims Act Allegations

A management company that provided financial back-office services to health care facilities agreed to pay $714,996 to resolve allegations that it violated the False Claims Act — specifically related to claims for reimbursement of Medicare bad debt — acting U.S. attorney Rachael A. Honig announced this week. The federal government through the U.S. Department of […]

Trump Commutes Prison Sentence for Nursing Home Executive in Record-Breaking Fraud Case

As part of a slew of clemency grants announced by the White House on December 22, President Donald Trump commuted a 20-year prison sentence for Philip Esformes, who used to control a network of skilled nursing and assisted living facilities running from Miami to Chicago. The remaining parts of Esformes’ sentence, including supervised release and […]

Former Rosewood Owner Indicted on 10 Fraud Counts in Nursing Home ‘Ponzi Scheme’

The federal government this week announced a multiple-count indictment against a former Chicago-area nursing home owner, alleging that he and a top executive ran a “Ponzi scheme” that defrauded investors out of $22.8 million. Zvi Feiner, formerly the owner and CEO of the Skokie, Ill.-based FNR Healthcare LLC, stands accused of misleading investors about the […]

Longwood Management, Affiliates to Pay $16.7M in False Claims Act Settlement Over Rehab Services

Longwood Management Corporation, along with 27 individual affiliated skilled nursing facilities, will pay $16.7 million to settle federal allegations of rehabilitation billing fraud, the Department of Justice announced Monday. The government accused the Los Angeles-based firm of pressuring therapists to hit predetermined targets for rehab minutes under the Ultra High category, which provided the greatest […]

Judge Reinstates Part of Previously Tossed $348M FCA Verdict Against Nursing Home Manager [Updated]

The U.S. Court of Appeals for the Eleventh Circuit this week reinstated part of a False Claims Act (FCA) verdict that was overturned in 2018, issuing a judgment of more than $255 million against two skilled nursing facilities, two related entities providing management services at the facilities, and an affiliated company providing rehabilitation services. The […]

OIG Launches Multiple Investigations into Nursing Home Response to COVID-19

The Department of Health and Human Services’ (HHS) watchdog arm added multiple probes of nursing homes’ response to COVID-19 to its list of top 2020 priorities, with a particular focus on infection control. The HHS Office of the Inspector General (OIG) last Friday announced two coronavirus-related investigations as part of its ongoing 2020 Work Plan […]

DOJ Forms Nursing Home Task Force, Promises Criminal and Civil Penalties for Owners and Operators

The Department of Justice this week announced the creation of a specialized task force targeting “grossly substandard care” in nursing homes, with both criminal and civil penalties on the table for owners and operators. About 30 individual facilities across nine states are already under investigation, the DOJ revealed in announcing its new National Nursing Home […]

Rise of Data Could Bring More False Claims Act Cases, CMS Scrutiny to Skilled Nursing

Attend any conference geared toward long-term and post-acute health care operators, and you’ll hear a common thread: Data is king. In a landscape defined by value-based payment models such as Medicare Advantage plans and accountable care organizations (ACOs), investing in data analytics has become almost a prerequisite for success. If a given operator can prove […]

Nursing Home Operator Guardian Elder Care to Pay $15.5M in False Claims Act Settlement

Guardian Elder Care, a nursing home operator with more than 50 buildings, will pay $15.5 million to resolve federal accusations of medically inappropriate therapy practices, the Department of Justice announced Wednesday. The Brockway, Pa.-based Guardian faced allegations — brought by a pair of former employees — that the company pressured therapists to perform unnecessary services […]

Greystone Confirms Takeover of 13-Property Rosewood Skilled Nursing Portfolio from HUD

Greystone on Monday formally announced its takeover of 13 properties from the federal government, marking a new chapter for the much-publicized Rosewood Care Centers portfolio. The New York City-based investment firm installed an operational affiliate, Greystone Healthcare Management-Midwest, as the operator of the former Rosewood buildings in Illinois and Missouri, which include 12 skilled nursing […]

Ambulance Company Operator Given Prison Time, $750K Fine in Skilled Nursing Fraud Case

The operator of an ambulance company that primarily served nursing homes and other outpatient care sites has been sentenced to 30 months in federal prison after pleading guilty to defrauding Medicare and Medicaid. Joseph Valdie Kimble, the former operator of the Longview, Texas-based Tiger EMS, must also pay more than $750,000 in restitution to the […]