Brighton Rehab, Mt. Lebanon Rehab officials accused of health care fraud in federal indictment

Federal and state law enforcement officials on Tuesday announced health care fraud charges against the owners and management staff at troubled Brighton Rehabilitation and Wellness Center in Beaver County and Mt. Lebanon Rehabilitation and Wellness Center.

Both facilities, owned by Comprehensive Healthcare Management Services LLC, have long been the target of investigators.

A superseding indictment returned Friday and then unsealed Tuesday lists charges against owner and CEO Sam Halper, 39, of Miami Beach, Fla.; Brighton Director of Nursing Eva Hamilton, 35, of Beaver; Michelle Romeo, 46, of Hillsville, who was a regional manager with oversight over nurses at the facilities; and Director of Social Services Johnna Haller, 41, of Monaca.

Previously charged in the investigation was Mt. Lebanon Rehab’s former administrator, Susan Gilbert, 61, of Cecil, who was accused in February 2021 with conspiracy, health care fraud and obstruction of a federal audit.

Her case is still pending.

Messages left for attorneys representing Halper and Comprehensive Healthcare Management were not immediately returned.

U.S. Attorney Cindy K. Chung and Pennsylvania Attorney General Josh Shapiro announced the charges Tuesday at a news conference at the federal courthouse in Pittsburgh.

“When we entrust institutions in the care of the elderly, we expect it will be enough, at a basic level, with qualified professionals on the job to look after people we love,” Shapiro said.

Tribune-Review investigation on Brighton Rehab from 2021:

• Brighton Rehab no stranger to federal, state scrutiny for resident care
• Hidden Danger: Registered sex offenders often go undetected in care homes
• State lawmakers vow to better protect care home residents from convicted sex offenders

In addition to conspiracy, fraud and obstruction, the superseding indictment also lists charges of falsification of records related to health care matters and falsification of records in a federal investigation.

It does not, however, reference the covid-19 pandemic. Nor does it include any allegations related to the more than 76 residents and staff members who died there in one of the nation’s deadliest outbreaks.

Chung said the charges in the superseding indictment predate covid.

“There are no allegations related to covid or covid deaths in the superseding indictment,” Chung said.

Shapiro said he previously confirmed an investigation into neglect at Brighton Rehab.

“That investigation is ongoing, and I can’t comment beyond that,” he said.

The superseding indictment lays out, in detail, two criminal schemes allegedly used by the defendants to drive up profits at the two nursing facilities.

In one scheme, management would manipulate time sheets and time clocks to make it appear that the facilities were meeting staffing requirements for Medicare and PA Medicaid even when they were not.

Those actions included having nurses punch in for shifts not worked, not punch out during their lunch hour, or having managers in the facilities listed as providing direct patient care in care logs when they were not.

The employees were then paid bonuses to compensate them for clocking in, the indictment said.

In the second scheme, Shapiro said, the defendants were accused of manipulating patient treatment and medical records so that the facilities would receive higher reimbursements than they were owed.

Senior administrators at the Brighton and Mt. Lebanon facilities would review patient files and suggest that care professionals add ailments, such as depression, to their records, Shapiro said.

“This was done to heighten the facility’s ability to collect more money for care,” he said. “Government programs, like Medicare and Medicaid, well, they’re not slush funds for facilities to take advantage of. They were put in place to make sure people who need support and need care, get it.”

The indictment said Halper, who received millions of dollars in payment from Comprehensive Healthcare Management facilities from 2017 to 2020, served in a management role in about 16 nursing facilities in Western Pennsylvania and also was involved in day-to-day operations, such as admissions, discharges and care.

The indictment accuses Halper of directing management staff at Brighton Rehab to keep staffing levels low to reduce costs, even though he and others knew that it led to poor health outcomes for residents.

Tribune-Review investigation on Brighton Rehab from 2020:

• A coronavirus outbreak at Brighton Rehab turned into one of the nation’s worst, but problems at the nursing home started well before the pandemic
• Brighton Rehab residents, families outraged by lax oversight during outbreak
• After months of uncertainty, Brighton Rehab has manager in place through the end of year
• As outbreak spun out of control, Brighton Rehab ownership remained mum. It still does.
• Brighton Rehab under scrutiny for hydroxychloroquine use to thwart coronavirus

Brighton Rehab, which originally was owned by Beaver County and operated as Friendship Ridge, was purchased by Comprehensive Healthcare Management in March 2014 for $37.5 million.

It has been under fire for years, and especially following the covid-19 pandemic. More than 300 staff members and residents were infected.

The FBI served search warrants at both Brighton Rehab and the Mt. Lebanon facility in September 2020.

The investigation was a collaboration with the Health and Human Services division of the Office of Inspector General, the IRS and state Attorney General’s Office.

State Rep. Rob Matzie, D-Ambridge, said in a statement that he had asked Shapiro to investigate Brighton Rehab in 2020 over their handling of the covid-19 pandemic.

“Seniors in skilled nursing facilities are an extremely vulnerable population,” he said. “When families make the gut-wrenching decision to admit a loved one, they have a right under the law to expect the highest level of care and an honest accounting of that care.

“Today, justice has been served,” he said.

Brighton Rehab and Comprehensive Healthcare Management also have been named as defendants in several lawsuits in both state and federal court where they were accused of improperly handling their covid-19 response, as well as negligence and mismanagement prior to the pandemic.

Attorney Robert Daly, whose law firm jointly represents 34 plaintiffs suing Brighton Rehab, said he was not disappointed by the news that the indictment unsealed Tuesday does not include allegations related to the pandemic.

“The findings of the indictment echo what we have been claiming in our civil cases all along,” he said. “The connection from our perspective is clear. If you don’t have enough people there, and you’re falsifying hours, you can’t have an appropriate infection control plan in place.”

Making it worse, Daly said, is that Brighton Rehab staff never asked for help.

“If they were criminally acting, they know if they ask for help in March 2020 that they will be charged,” he said. “They were understaffed, and they couldn’t handle infection control, and they couldn’t ask for help.

“It was out of control, and it stayed out of control for months.”

Daly said he also heartened to hear Shapiro say that there remains an ongoing investigation into neglect at Brighton Rehab.

“It is incredible work they’ve done,” he said.

Matthew Yarnell, president of SEIU Healthcare Pennsylvania, the union that represents certified nursing assistants at Brighton, said workers have sounded the alarm about bad nursing homes for years.

“Nursing home owners who break the law and operate in bad faith cannot be allowed to continue expanding their portfolios and buying additional nursing homes when they have a track record of practices that harm workers and residents,” Yarnell said.

Zach Shamberg, president and CEO of the Pennsylvania Health Care Association, said his organization has lobbied for improvements in the change-of-ownership process for nursing facilities in Pennsylvania — including allowing the state to look into the operating history of a provider and request operating plans moving forward.

“The state of Pennsylvania has sent a clear message to current and future operators: actions with the potential to jeopardize quality care will not be tolerated,” Shamberg said. “PHCA and our members have led the charge to create changes to our industry that further accountability, increase staffing levels and will soon redefine how changes of ownership occur with a more robust process — all to enhance care for Pennsylvania’s vulnerable seniors and adults with disabilities.”

In addition, PHCA, of which Comprehensive Health Care is not a member, worked with Gov. Tom Wolf’s administration and SEIU to increase staffing ratios from 2.7 hours of direct care each day per resident to 3.2 hours.

Comprehensive owns dozens of other facilities across Pennsylvania and nationwide. Chung said she could not confirm whether any of those other facilities are being investigated.

If the superseding indictment results in convictions against Brighton and Mt. Lebanon, Chung said, they could be barred by the government from participating in Medicare or Medicaid programs but it would not necessarily result in their closure.

“Things should be able to continue, although, of course, management may be affected,” Chung said.

While it is difficult to put a dollar value on the fraud, Shapiro said, “It’s more egregious that the people in these facilities did not receive the care that was promised.”

“These charges against the two entities and five individuals represent a dereliction of duty to report accurate information, criminal schemes designed to manipulate the system and above all else companies and individuals who put profits before truthful reporting and the care of our elderly.”