'Profits over people': 2 nursing homes guilty of fraud ordered to pay $15M

Two Pittsburgh-area nursing home companies must pay more than $15 million in restitution for health care fraud, a federal judge ordered on Tuesday.

In December 2023, a jury found the companies — Comprehensive Healthcare Management Services LLC and Mt. Lebanon Operations LLC — guilty in U.S. District Court of making false statements related to paying health care benefits.

Comprehensive, which operated Brighton Rehabilitation and Wellness Center in Beaver County, was ordered to pay more than $12.6 million to the U.S. Department of Health and Human Services and serve five years probation.

Mt. Lebanon Operations, which ran Mt. Lebanon Rehabilitation and Wellness Center, owes the government more than $2.7 million and must spend a year on probation.

U.S. District Judge Robert J. Colville meted out the sentences over the objection of the defense attorneys in the case, who argued that their clients had no ability to pay any judgment.

“As to both fines and restitution, one of the defendants here is already bankrupt and the other soon will be — so neither has any ability to pay,” they wrote in a sentencing memo.

In addition, the defense continued, the government is not entitled to restitution.

“The government has never been able to show that it suffered any pecuniary loss in this case, except by speculative leaps that lack any basis in fact and contradict the testimony of its own witnesses at trial,” the filing continued. “Moreover, it has never claimed that the beneficiaries in this case received care that they did not need or that Medicare or Medicaid would not have paid for at a different facility.”

The nursing homes’ attorneys also argued that the government never alleged at trial that any patient received improper care at either facility.

However, during Tuesday’s sentencing hearing, the prosecution presented testimony from family members of former nursing home residents, including one woman who was assaulted by a male resident when no staff were available to intervene.

“These family members described a significant decline in staffing following acquisition of the nursing homes by the defendant companies and detailed how decreased staffing levels negatively impacted their relatives’ care, treatment, health, well-being, and hygiene,” according to a statement from Troy Rivetti, the acting U.S. Attorney in Pittsburgh.

Rivetti said the companies lied to the government and carried out health care fraud by falsifying records about minimum staffing levels, a hot-button topic in the nursing home field.

Kevin Rojek, the top FBI agent in Pittsburgh, had harsh words for the companies.

“Families counted on these facilities and their operators to care for their loved ones with honesty, integrity, and compassion,” Rojek said. “Instead, these facilities put profits over people.”

Federal prosecutors said the nursing homes evaded penalties for understaffing by presenting false information to regulators, such as adding to staffing sheets names of employees who were not working.

All the while, prosecutors said, the nursing homes pushed for new patients despite low staffing and concerns among nurses about not being able to provide adequate care to patients.

During the five-week trial in 2023, the government called 29 witnesses. The jury returned a mixed verdict, finding the companies guilty but exonerating five executives.

Comprehensive has been the subject of a number of investigations and court actions in recent years, including being ordered last year to pay nearly $36 million for labor violations stemming from 15 of their facilities.