Nursing Home Mogul Philip Esformes Pleads Guilty to Medicare Fraud, Given No Additional Jail Time or Fines

Medicare fraudster Philip Esformes pleaded guilty on Thursday to health care fraud, laying to rest a longstanding effort to prosecute him after his 20-year sentence was commuted by former President Donald Trump. Esformes, previously convicted of one of the biggest Medicare frauds in 2019 for his involvement in a billion-dollar Medicare fraud scheme, pleaded guilty […]

In Suing Ohio Medicaid Department, Nursing Home Associations Allege Facilities Were ‘Significantly Shortchanged’

Nursing home associations in Ohio have sued the state Department of Medicaid last week over a Medicaid rate that does not match what’s needed to meet quality incentives. Ohio’s rebasing process splits Medicaid funding into two categories, with 60% based on meeting certain quality incentives and 40% reserved for the “base rate,” or a calculation […]

17 Petersen Nursing Homes Embroiled in Foreclosure Suits Involving Nearly $51M in Loans

An Illinois-based nursing home operator, which owns nearly 100 senior living properties across the state as well as others in Missouri and Iowa, faces legal challenges as prosecutors point to alleged unpaid loans. Petersen Health Care faces two foreclosure cases filed in the Illinois Northern District Court – litigation is linked to an alleged failure […]

Nursing Home Mogul Philip Esformes Agrees to Plea Deal in Medicare Fraud Case

In a major development for the nursing home industry, a plea agreement has been reached in the ongoing legal saga involving South Florida healthcare mogul Philip Esformes. Esformes, previously convicted in 2019 for his involvement in a billion-dollar Medicare fraud scheme, had his 20-year prison sentence commuted by former President Donald Trump in 2020, but […]

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 […]

Iowa Might Join 14 States in Allowing Room Cameras in Nursing Homes

Iowa nursing homes may see cameras in resident rooms – with state legislators progressing a bill on the matter. The legislation will allow the use of “granny cams” despite many operator misgivings, providing families with a video feed of activity inside a resident’s room, according to a report published in the Iowa Capital Dispatch. Fourteen […]

DOL Alleges Back Wages Owed to Over 600 Next Step Healthcare Staff in 25 Nursing Homes

More than 600 skilled nursing workers may be owed back wages across 25 Massachusetts facilities in 21 communities, owned by local operator Next Step Healthcare. The Department of Labor (DOL) filed a complaint in federal court alleging that various nursing home organizations intentionally withheld overtime wages for at least 624 employees, and failed to maintain […]

DOL’s Final Rule on Worker Classification To Increase Legal Woes, Administrative Burdens for Nursing Homes

Many skilled nursing operators will need to reclassify their existing relationships with independent contractors and rethink future ones in the wake of a final rule issued by the Department of Labor (DOL) on Tuesday. The DOL’s new rule revises guidance on how to determine who is an employee and who is an independent contractor under […]

California Law Aims to Aid Appeals Process for Nursing Home Discharges

A new California law effective Wednesday will require nursing homes to offer residents copies of any information on their eviction, helping make appeals against the discharge easier to file. Evictions are one of the most common complaints reported to California’s Long Term Care Ombudsman programs, noted a report produced by CalMatters. In the past five […]

Comprehensive Healthcare Legal Saga Culminates in Acquittal of Individuals, Guilty Verdict for Corporate Defendants

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 […]

$56M Sale of 7 Comprehensive HC Properties May Proceed, As DOL Unable to Block Deal

The U.S. Department of Labor (DOL) failed to block a $56 million deal between Pennsylvania operator Comprehensive Healthcare Management Services and Kadima Healthcare Group for seven properties, according to court documents. The parties convened before the U.S. District Judge William Stickman IV in September when Acting Secretary of Labor Julie Su had asked for a […]

Comprehensive Healthcare Warns Company May Close Unless 7 Nursing Homes Are Sold, DOL Seeks Injunction

Comprehensive Healthcare may be forced to close unless the owners are allowed to sell seven nursing homes, according to a report on Wednesday from TribLive, the website of the Pittsburgh Tribune-Review. Comprehensive currently operates 15 facilities. The seven facilities involved in the sale have a combined 747 beds, according to the report. The U.S. Department […]

Lawsuits Blaming Covid Deaths on Nursing Homes Climb in New York

A rising tide of civil lawsuits related to deaths from Covid-19 are being filed in New York against not only top state officials, but also nursing homes, as family members seek legal recourse. According to a report in the Times-Union newspaper, these cases have proceeded slowly as pre-trial arguments have focused, in part, on whether state […]

Professional Liability Reinsurance Costs Up 50% in Some Markets, As Underwriters Hone in on Agency Use, Access

Some operators of nursing homes are paying higher reinsurance costs – a more litigious environment post Covid being among major factors – while grappling with uncertainty on how claims could impact their businesses. And this is especially true for one area of insurance for nursing homes – professional liability insurance. While not required by most […]

The Delicate Dance of Temp Agency Regulation: 1099 Worker Classification, Wage Caps at Issue in Tight Labor Market

As government entities and organizations in the nursing home space are scrambling for policy changes to regulate staffing agencies, they seem to be prioritizing legislation that addresses price gouging while worker classification also remains on the table. The Protecting the Right to Organize Act (PRO Act) introduced in Congress in 2021 and currently being examined […]

Centers Health Care Owner Allegedly Misused More Than $83M in Government Funds for Nursing Homes, Including to Buy Israeli Airline

Owners, operators and landlords of Centers Health Care in New York are facing a lawsuit filed by the state Attorney General Letitia James on Wednesday, which alleges the four SNFs illegally misused more than $83 million in taxpayer money. Diverted funds went toward, among other things, funding the purchase of Israeli airline El Al, according […]

[UPDATED]: Supreme Court Upholds Resident Right to Sue Publicly Owned SNFs

In a 7-2 ruling, the Supreme Court on Thursday morning ruled that nursing home residents and their families can sue publicly-owned nursing home facilities under the Federal Nursing Home Reform Act. The case presented the question of whether Medicaid beneficiaries can seek relief in federal court when they believe their rights are being violated by […]

Nursing Home Survey Teams Need Not Always Have an RN, Federal Court Rules

A nursing home’s Medicaid survey team doesn’t always have to include a registered nurse (RN), according to a federal district court decision concerning a New York-based facility. The U.S. District Court for the Southern District of New York last week entered into a summary judgment in favor of the U.S. Department of Health and Human […]