New York nursing home operator accused of neglect settles with state for $45M

NEW YORK (AP) — The operators of four nursing homes in New York will pay $45 million to settle claims that they neglected and mistreated residents, including some who were forced to sit in their own urine and feces for hours, state Attorney General Letitia James announced Thursday.

The Democrat filed a civil lawsuit last year that accused the owners and operators of Centers Health Care of using Medicaid and Medicare funds to enrich themselves, their relatives and associates instead of using funds for resident care. James claimed understaffing at the homes contributed to neglectful care. She said residents lived in squalor and were left unsupervised, leading to injuries.

Under the settlement, Centers and its owners will direct $35 million for improved resident care and staffing. Medicaid and Medicare programs will receive $8.75 million in restitution. Independent monitors for operations and finances were appointed by the court shortly after the lawsuit was filed and reforms have already begun, according to the attorney general.

“Centers’ owners operated the nursing homes with insufficient staffing so that they could pocket tens of millions of taxpayer dollars meant for resident care," James said in a prepared statement. “Residents suffered tragic harm and their families were often left in the dark or in despair about their loved ones.”

Centers, in a prepared statement, said it was pleased to resolve the litigation, “which dismisses all allegations of wrongdoing against Centers.”

“Over the last three decades, Centers has cared for thousands of residents across dozens of facilities, while maintaining the highest standards of care and resident welfare, the statement read. ”We are committed to fully implementing the settlement terms, including a significant investment in resident care.”

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New York nursing home operator accused of neglect settles with state for $45M

New Jersey Nursing Homes Operator Counting on Protocol to Dismiss Lawsuit

By Jane Mundy

 

New Jersey nursing home operator is counting on protocol to dismiss a proposed class action lawsuit claiming poor treatment of residents before and during the COVID-19 pandemic.

 

Lafayette, NJThe Andover nursing homes operator is facing a proposed class action lawsuit claiming poor treatment of residents before and during the COVID-19 pandemic. He argued in federal court to dismiss the nursing home abuse complaint based on state and federal law virus protocol.

Andover Nursing Home Operators

The Andover Subacute Rehabilitation Center I and II are co-owned by Chaim "Mutty" Scheinbaum and Louis Schwartz, according to federal records. NBC News reported (April 2020) that 17 bodies were found in the Andover Subacute Facility I and II morgue. Scheinbaum said the facility was grappling with the pandemic.

In a statement, Scheinbaum said "The owners, administrators and our heroic healthcare staff of nurses and nurse aides have been working relentlessly to contain the virus and safeguard our residents and staff…The health and safety of our residents and staff is our utmost priority and responsibility.“ But Schwartz’s murky history indicates otherwise. He was vice president at Skyline Healthcare, a defunct nursing home chain plagued by allegations of neglect and mismanagement and now involved in at least 12 lawsuits. As well, former employees filed lawsuits accusing the company's owners of stealing their insurance premiums.

Scheinbaum co-owns four facilities that were cited over 25 times for health-related deficiencies during inspections in 2019 and 2020. According to Asbury Park Press, the Andover facilities received average and low marks from federal health care rankings published by the U.S. Centers for Medicare & Medicaid Services.

"Government must limit ownership and management of nursing homes to only those people that demonstrate commitment and capacity to provide the best care possible to residents,” Toby Edelman, senior policy attorney with the nonprofit Center for Medicare Advocacy, told the newspaper.

Proposed Nursing Home Abuse Class Action

Last December Michael Emerson, a resident of Andover since 2019, along with relatives of Albert C. Roberts and Michele Desbiens, filed a willful misconduct complaint against the Andover Subacute Rehabilitation Center I and Andover Subacute Rehabilitation Center II, claiming patients were treated with "a lack of dignity and respect."

Emerson claims he was subjected to "repeated physical and mental abuse." He contracted the coronavirus in March 2020 and says the defendants denied numerous requests by his guardian/attorney-in-fact for his medical records.

Michele Desbiens had been an Andover II resident since 2016. Her son, Paul Desbiens said the facility refused his repeated requests to get his mother treatment for skin cancer in her arm and to have a ureteral stent removed. She contracted the coronavirus in March and died in May, according to the complaint.

Roberts was also an Andover II resident, until he died one month after contracting COVID-19 in April 2020. Brian Roberts, his nephew and administrator of his estate, claimed he only learned of his uncle's death several weeks later, after numerous unsuccessful attempts to reach anyone at the facility for an update, reported Law360.

The plaintiffs pointed out that inspections—since 2015— by Centers for Medicaid & Medicare Services "repeatedly found each of the facilities to be grossly deficient in many aspects" regarding their duty to residents. The CMS' assessment ratings for the facilities are three stars, which is classified as "average," for Andover I, and one star, the lowest possible rating, for Andover II. And in April 2020, a CMS inspection report from April investigating the coronavirus outbreak at Andover II in late March 2020 concluded “the facility was not following infection control safety practices and guidance recommended by CMS and CDC during a COVID-19 pandemic.”

Defendants Relying on COVID-19 Protocol

The Defendants are counting on the Public Readiness and Emergency Preparedness Act  (PREP Act) and the New Jersey COVID-19 immunity law to toss the class action.

 

In a February 10, 2021 ruling (the “Garcia Ruling”) the Central District of California Court held that the PREP Act provides senior living facilities with an exemption from civil liability for actions taken by such facilities to protect facility residents from COVID-19.

According to the National Law Review, “In the Garcia Ruling, the CDCA Court considered whether the PREP Act’s liability immunity extended to, and completely insulates, senior living facilities/communities for imperfect countermeasures taken by such facilities in response to COVID-19. In evaluating the impact of its decision, the CDCA Court noted that the presumption of complete immunity for providers under the PREP Act is a tough one to overcome once a federal court decides to weigh in on the issue.”

The case is Michael Emerson et al. v. Andover Subacute Rehabilitation Center I et al., case number 2:20-cv-20066 in the U.S. District Court for the District of New Jersey.

 

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New Jersey Nursing Homes Operator Counting on Protocol to Dismiss Lawsuit

Md. gets $2.2M in settlement with nursing-home operator over evictions

WASHINGTON — The State of Maryland has settled a case against a nursing-home operator accused of “resident dumping” — the unwarranted eviction of elderly residents in an attempt to get more money from the government.

The office of Attorney General Brian Frosh announced the settlement Friday with Neiswanger Management Services, which operated five nursing facilities in the state, and its owner, Matthew Neiswanger. The company, which stopped operating nursing homes in February of this year, is now permanently “precluded” from doing so, and can no longer be a Maryland Medicaid provider. The company will also pay the state $2.2 million and drop a lawsuit against some workers at the state Department of Health.

Frosh’s office said in the statement that the company issued eviction notices to hundreds of nursing-home residents for supposed nonpayment, although the residents in fact were paid up.

The company did this when their facilities were at full capacity, and did so because the residents were on Medicaid and the company wanted to replace them with people whose care would be paid for by Medicare, which typically pays more, Frosh’s office said.

The company sent out at least 1,061 eviction notices between Jan. 1, 2015, and May 31, 2016, more than twice the number issued by Maryland’s other 225 licensed nursing homes combined, the attorney general’s office said.

Many evicted residents were “dumped … in homeless shelters and predatory unlicensed assisted living facilities, where they faced financial exploitation and abuse,” Frosh’s office said.

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Md. gets $2.2M in settlement with nursing-home operator over evictions

Maryland Sues ‘Inhumane’ Nursing Home Provider

WASHINGTON (CN) – The state of Maryland wants treble damages from a nursing home operator that it says has dumped at least 1,000 elderly residents, oftentimes at homeless shelters, after they’ve exhausted their Medicare coverage for a short-term stay.

Maryland Attorney General Brian Frosh notes that Medicare pays for post-hospitalization care “at substantially higher daily rates than Medicaid pays for long-term care,” making it more lucrative for unscrupulous facilities to replace one resident for someone whose care will be reimbursed at a higher rate.

Frosh filed the complaint on Dec. 21 in Montgomery County Circuit Court, taking aim at Neiswanger Management Services, or NMS, the operator of five nursing homes across the state.

“Each year, NMS unlawfully evicts from its nursing facilities hundreds of frail, infirm, mentally ill, and physically and intellectually disabled people,” the complaint states.

Frosh says NMS gave 1,061 residents the boot between January 2015 and May 2016 – more than twice as many evictions as all other nursing homes in the state combined over the same time period.

NMS usually accused the evictees of not paying for their care, but the complaint says the real reason for this inhumane conduct is maximizing reimbursements from taxpayer-funded public health insurance programs.

“In 2015, the five NMS facilities received more than $100 million in reimbursement from Medicare and Medicaid, including more than $35 million from Maryland’s Medical Assistance program,” the complaint states.

Evicted regardless of their health status, former NMS residents frequently appear in hospital emergency rooms within days or weeks of eviction, according to the complaint.

Frosh says these individuals are usually “facing serious or life-threatening medical complications caused by their evictions,” and that the state is left to cover the cost of the emergency care they require.

“NMS often abandons its evictees far from their hometowns, in places where they have no family connections to assist them,” the complaint states.

Mark Yost, CEO of NMS told the Washington Post that they would fight the complaint.

“NMS strongly denies any wrongdoing and disputes the entirety of the attorney general’s allegations in this matter,” Yost said. “We intend to prove our case and will respond in the appropriate forum in due time.”

Attorney General Frosh details how NMS tossed out one cancer-stricken woman named Vonda Wagner from its Hagerstown facility last year.

A woman named Sharon Isaacs allegedly drove the 85-pound woman to one of the Baltimore row houses she operated and housed with “frail and disabled people.”

“NMS and Ms. Isaacs have a longstanding partnership under which NMS rids itself of residents whose Medicare post-hospitalization benefits it has already extracted or whose public health insurance profile it otherwise regards as no longer attractive, and under which Ms. Isaacs then strips these vulnerable and often helpless NMS evictees of social security payments and other public benefits,” the complaint states.

The complaint names seven individuals as defendants but Isaacs is not one of them.

During Wagner’s stay at the row house for several weeks, she was deprived of her medication and was fed only instant ramen noodles and water, according to the complaint.

Frosh says Isaacs beat Wagner and dropped her at a homeless shelter when upon learning that Wagner had canceled a state-issued debit card Isaacs had confiscated.

Wagner eventually went to the emergency room and remains homeless to this day, according to the complaint.

Another resident had more than $2,000 in social security benefits stolen from him in a similar scheme, according to the complaint, which also describes the abandonment of a “cognitively impaired” resident in the driveway of her son’s house on a 95-degree day. The son allegedly found his mother wandering toward the woods.

Frosh says more than 700 current residents in the five nursing homes Neiswanger manages are at risk of eviction if the court does not step in and grant the state’s request for an order preventing the company from issuing more evictions without reason.

“NMS and its leadership have compromised the health and safety of hundreds of vulnerable people with whose care they have entrusted,” Frosh said in a statement. “My office will fight to put a stop to NMS’ unsafe and inhumane practices. We will also seek to recover from NMS the public funds that the Medicaid program paid to NMS while it was engaging in this unlawful conduct, as well as the amounts that the Medicaid program paid to hospitals and other medical providers that cared for former NMS residents after they were evicted.”

The state seeks $10,000 per violation of the False Health Claims Act as well as three times the damages Maryland sustained for such violations.

In addition to NMS CEO Yost, the complaint names as defendants former CEO Matthew Neiswanger and the administrators of each nursing home it operates.

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Maryland Sues ‘Inhumane’ Nursing Home Provider

Attorney General Frosh Files Lawsuit Against Nursing Home Operator

Attorney  General  Frosh  Files Lawsuit  Against  Nursing  Home Operator

for  Resident  Dumping  and  Submission  of False Claims  to Medicaid

Program Company Unlawfully and Unsafely Evicted Dozens of Frail and Disabled

Residents to Homeless Shelters and Unlicensed Assisted Living Facilities

BALTIMORE,  MD (December 21, 2016)

–

Maryland Attorney General Brian E. Frosh today announced that his office has filed suit in the Circuit Court for Montgomery County against Neiswanger Management Services, LLC (“NMS”), the operator of five Maryland nursing homes, for unsafely and unlawfully evicting frail and disabled people from its facilities, and for submitting false claims to the Maryland Medicaid program.

The complaint filed today alleges that NMS, among other unlawful conduct, dumps evicted residents in homeless shelters and trafficks others to unlicensed, sham assisted living facilities, which have no capacity to provide care to people with complex medical needs, and which sustain themselves by extracting social security payments and other public benefits from vulnerable people.  The complaint further alleges that NMS often dumps its evicted residents far from their home communities, in places where they know no one.  Evicted NMS residents frequently appear in hospital emergency rooms within days or weeks of their eviction.

“NMS and its leadership have compromised the health and safety of hundreds of vulnerable people with whose care they have been entrusted,” said Attorney General Frosh . “My office will fight to put a stop to NMS’s unsafe and inhumane practices.  We will also seek to recover from NMS the public funds that the Medicaid program paid to NMS while it was engaging in this unlawful conduct, as well as the amounts that the Medicaid program paid to hospitals and other medical providers that cared for former NMS residents after they were evicted.”

NMS operates nursing facilities in Anne Arundel County, Montgomery County, Prince George’s County and Washington County. The complaint alleges that, in violation of the Maryland Patient’s Bill of Rights, NMS has unsafely evicted hundreds of frail, infirm, mentally ill, and physically and intellectually disabled people. During a 17-month period, from January 1, 2015 to May 31, 2016, NMS issued at least 1,061 eviction notices to residents of its facilities.  Maryland’s 225 other licensed nursing facilities, all together, issued a combined total of less than half that number during the same period. The complaint further alleges that NMS identifies residents for eviction based on the status of their public health insurance benefits, in order to maximize reimbursement from Medicare and Medicaid. Because the Medicare program typically reimburses nursing facilities at a higher rate than Medicaid, NMS often seeks to evict residents, according to the complaint, when its facilities are at full capacity and when Medicaid long term care recipients can be replaced with prospective residents whose care will be paid for by Medicare.

Maryland nursing facilities are required to provide social work and discharge planning services to residents whenever discharge is anticipated.  When nursing facilities bill Medicaid, they are seeking reimbursement for providing social work and discharge planning services, and they are certifying that they comply with the basic protections afforded to residents under the Maryland Patient’s Bill of Rights.  The complaint filed today alleges that, in violation of the Maryland False Health Claims Act, NMS often did not provide the social work and discharge planning services for which it billed Medicaid, and that, by submitting claims to Medicaid, NMS falsely certified its compliance with the Patient’s Bill of Rights.

In the complaint, the Attorney General requests that the court prohibit NMS from unsafely evicting residents and from engaging in other unlawful practices, and that the court impose civil penalties and award treble damages to the State.

Source:
Attorney General Frosh Files Lawsuit Against Nursing Home Operator

Nursing home operator from Chicago jailed as feds allege $1 billion scheme

For years, wealthy nursing home operator Philip Esformes seemed to live in perpetual motion, using private jets to travel between his Water Tower Place condominium and his mansions in Miami and Los Angeles.

Now federal authorities are applying extraordinary court pressure to keep Esformes locked in a Florida detention cell where he awaits trial for allegedly orchestrating an unprecedented $1 billion Medicaid and Medicare bribery and kickback scheme.

"This is the largest single criminal health care fraud case ever brought against individuals by the Department of Justice," Assistant Attorney General Leslie Caldwell said at a July 22 news conference announcing the charges.

Arrested at one of his $2 million estates on the Miami Beach waterfront that morning and placed in immediate detention, Esformes has been denied bond despite a barrage of court pleas that include letters of support from nursing home patients and the recipients of his philanthropy.

His confinement in the Miami Federal Detention Center marks a new challenge for a business family that has withstood two decades of Justice Department probes and Tribune investigations into allegations of patient abuse, corruption and substandard conditions at their Illinois, Florida and Missouri nursing home facilities.

From their Lincolnwood offices, Esformes and his father and business partner, Morris Esformes, took in millions of dollars annually from federal programs for the sick and disabled.

Both have cultivated reputations as prominent philanthropists. Morris Esformes has an endowed medical professorship named for him at the University of Chicago, and they have given millions of dollars to synagogues, schools and medical facilities in the United States and Israel.

The Esformeses sold their Illinois nursing facilities about four years ago but kept their headquarters in the Chicago suburbs as they continued to operate 20 or so homes in Florida, government records and Tribune interviews show.

The new federal indictment alleges that Philip Esformes and a handful of Miami co-conspirators bilked Medicaid and Medicare for 14 years by cycling some 14,000 patients through various Esformes facilities, where many received unnecessary or even harmful treatments. Drug addicts were allegedly lured to the facilities with promises of narcotics, and prosecutors say some received OxyContin and fentanyl without a physician's order to entice them to stay.  (Click to Continue)

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Nursing home operator from Chicago jailed as feds allege $1 billion scheme