In a rare case in which a nursing home business faced criminal charges over staffing misconduct, two Pennsylvania facilities owned by Comprehensive Healthcare Management Services were found guilty Monday of healthcare fraud and other counts.
The jury’s finding came after five weeks of testimony in the complicated case involving Brighton Rehabilitation and Wellness Center and Mt. Lebanon Rehabilitation and Wellness Center. The US Attorney’s Office for the Western District of Pennsylvania also prosecuted five company and facility leaders for their roles in a scheme that led to overbilling; the jury found all five not guilty.
Brighton Rehab itself was found guilty of healthcare fraud and five counts of falsification of records in a federal investigation, while Mt. Lebanon was found guilty of one count of falsification of records related to healthcare matters and three counts of falsification of records in a federal investigation. The nursing home defendants are scheduled to be sentenced in May before US District Judge Robert J. Colville.
Neither prosecutors nor defense attorneys offered a solid explanation as to why the jury reserved its convictions for the corporate defendants. But US Attorney Eric Olshan told McKnight’s Long-Term Care News in an email Monday night that his office would pursue similar cases in the future, if warranted.
“Our legal system entrusts the jury with making determinations of guilt, and as in all cases, we respect the jury’s verdict,” he said. “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. 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.”
Several counts in the indictment that precipitated this fall’s trial carried up to $250,000 in fines, or jail times in the case of individuals. In a press release issued by the US Attorney’s Office Monday evening, prosecutors said the companies faced a maximum of five years probation, $500,000 in fines, or both, on the counts for which they were convicted.
A message from McKnight’s Long-Term Care News left with a nursing leader at Brighton Rehabilitation for Comprehensive Healthcare Management Services was not returned Monday.
Prosecutors had alleged two different schemes to enrich the nursing homes’ operations. In the first, leaders were accused of falsifying payroll documents to make it appear the nursing homes were meeting required staffing levels, including having non-working direct care staff clock in for shifts they never intended to work. In the second, administrators were accused of changing assessments to make it appear patients were clinically depressed or needed more therapy as a means of delaying discharge and driving Medicare or Medicaid reimbursements.
But in court, attorneys for the individual defendants framed the case as one of sloppy record keeping and government malfeasance, rather than intentional fraud, TribLive reported.
They also hit at the credibility of 20 former nursing home employees as having an ax to grind. Some were fired, others quit and some were offered immunity in exchange for their testimony, the Pittsburgh Tribune-Review noted in its coverage of last week’s closing arguments.
Kirk Ogrosky represented Sam Halper, Brighton’s CEO and 12% owner and an officer at Mt. Lebanon. Orgosky argued there was no evidence Halper was involved in ordering or completing incorrect staffing records but instead told the jury that a handful of staff members came up with a scheme to cheat the buildings’ corporate owners.
“Throughout this case, all defendants cooperated with the US Department of Justice in every way possible. Yet, DOJ pursued individuals without regard for the truth,” Halper said in a statement shared with TribLive. “Thankfully, the jurors were able to hear the evidence and find that the facts did not support DOJ’s claims.”
Ogrosky did not return a message from McKnight’s seeking additional comment Monday.