Nursing homes singled out in annual Justice report on elder abuse

by Kimberly Marselas

The Justice Department’s civil division this week published its annual report to Congress on efforts to combat elder fraud and abuse, highlighting several high-profile nursing home investigations in addition to pages of international financial scams.

The priority Justice Department officials are putting on “ensuring patient safety and … stopping fraud, waste, and abuse” in nursing homes could serve as notice to providers that the department intends to continue pursuing cases against facilities despite the Trump administration’s broader deregulation push.

While the report devotes the most space to US and international fraudsters who aim to scam elders out of their savings, the department also touted holding multiple nursing home operators “accountable for providing grossly substandard care to vulnerable Medicare and Medicaid beneficiaries.”

Nursing homes were the only healthcare providers targeted in the report.

It highlights four nursing home cases associated with the National Nursing Home Initiative, which enhances the department’s efforts to investigate and pursue nursing home operators that provide grossly substandard care to their residents. 

“Over the past year, the Department’s National Nursing Home Initiative has redoubled its efforts to work with key partners in identifying and reporting abuse in our nation’s nursing homes,” report authors wrote, noting coordination with the Department of Health and Human Service’s Office of Inspector General and the Centers for Medicare and Medicaid Services. “This Initiative focuses on some of the worst quality nursing homes and their owners, operators and affiliates around the country.”

Cases included in this year’s report include:

• A June settlement with the nonprofit American Health Foundation and three affiliated nursing homes, accused of billing Medicare and Medicaid for grossly substandard skilled nursing services between 2016 and 2018 

• A $4.5 million settlement with The Villas Nursing Facilities and six Detroit-area nursing homes in July. The government alleged they accepted taxpayer funds while providing grossly substandard care to their residents. The case originated as a federal whistleblower lawsuit by Villa employees, who claimed they personally witnessed the mistreatment of residents, the Justice Department noted.

• A restitution collection of $15 million in May, following the previous convictions of two Pittsburgh area nursing homes for making false statements in connection with the payment of healthcare benefits and for obstructing and impeding a CMS investigation. Comprehensive Healthcare Management Services and its Brighton Rehabilitation and Wellness Center and Mount Lebanon Rehabilitation and Wellness Center were found guilty on six and four counts, respectively, by a federal jury in December 2023.

• Guilty pleas in January from KBWB Operations LLC, which did business as Atrium Health and Senior Living, and its former CEO Kevin Breslin, on one count each of healthcare fraud and one count of tax conspiracy related to the operation of numerous skilled nursing facilities.

In all, the report outlines more than 280 criminal and civil enforcement actions against more than 600 defendants, including scams in which the accused stole or attempted to steal more than $2 billion from more than one million older Americans. 

For additional coverage of the Justice Department’s efforts to head off and disable scammers, see McKnight’s Senior Living. 

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Nursing homes singled out in annual Justice report on elder abuse