UPDATED 10:44 pm 2.May.2019
Esformes is Not Alone – a New York Nursing Facility Unnamed and Likely Unconnected to Esformes but with the Same M.O.
Dear Readers:
Several months ago we received a call. It was from a woman caring for a family member in a nursing/rehabilitation center in New York. We were told that at the time her relative was admitted, the ownership was a well known and rather notorious facility group. The home had been flagged for numerous violations under the initial ownership, publicly available information. We did not write anything because we did not want the entanglements and could not at the time substantiate her claims.
By the time her relative left, we were told the home had changed hands and was owned by another group; and the care had significantly deteriorated. At some point during late 2018/early 2019 the facility changed hands. Those records, at least the ones that illustrate a uniquely questionable transfer, are available online. We have been told, and several articles have come out publicly that nursing homes will often just switch hands because under new ownership, the ratings available on the Medicare/Medicaid sites gets wiped clean, even though ownership may not completely change. It’s a strategic misrepresentation, a game, and apparently legal.
Our caller’s complaints when she first contacted us was that her relative was not getting the care charged to Medicaid. He was not getting the therapy charged and claimed. He was allegedly getting treatment and medication that was not actually being provided and the care he was supposed to get was nowhere to be found. She complained endlessly to the facility and elicited the assistance of the Department of Health and various NYS entities.
The facility would not release him to her care or discharge him. Each time she would be told her relative was being released, she would then be told that she was not getting discharge papers. The administration kept claiming something new was wrong with her relative, a new service was required, new forms of care were needed.
That service was never forthcoming, though Medicaid was charged.
She contacted us regularly both before and after the home changed hands and we have that information and photographs, a few of which support some of her claims. She also contacted the State and we have been told that they initially tried to assist; but as soon as the facility changed hands, the Department of Health refused further assistance. We wonder whether someone on the State level has been paid to keep this quiet to allow for this owner to continue to operate.
We will protect our caller’s confidentiality except as necessitated by law enforcement.
At one point her relative was sent to a hospital and was summarily returned to the facility after recovering from repeated bouts of pneumonia. We have been advised that the Social Worker at the hospital conveyed to her that they are told to continue sending people to the nursing home in question and others under the same ownership. Our caller has commented that she thinks people at the hospital are being incentivized to send people to these facilities. We cannot substantiate this part of the story yet. It would take someone with access to subpoenas to get those records.
It is, however, another reason why the facility and its ownership remains unnamed in this post.
We have been told, and this has been corroborated by a number of former patients at the same facility, that there is a pattern and practice of charging healthcare and medicaid exorbitant sums of money for treatment that is never supplied, for therapy that is never provided and for medications that are not actually doled out. The patients can get copies of their bills if they demand them (and some have) and they know when their loved ones are being denied services, or simply not offered those services.
There is much more.
From our own research we discovered a few red flags. The current ownership structure raises questions. The facility’s owners appear to be a group; but we have discovered that this particular nursing facility has a series of UCC liens on it in the State of New York from March of 2019 or thereabouts under the name of someone not listed on the official records of the State or available records as a “direct” owner. This is not quite kosher, unless the person listed on the UCC’s was granted rights to encumber the facility absent direct ownership or as an “indirect owner.” That seems odd. And what does that actually mean?
Why would anyone have the rights to encumber assets they do not own directly?
As to the condition of this facility, we would avoid it for even a fish tank, nonetheless the health of the elderly and most vulnerable within our community. We have been told beyond the litany of potentially questionable behaviors, the odd ownership structure and the seemingly financially incestuous relationship between the direct versus the indirect owners, the place is understaffed, dirty and the patients are not receiving even a modicum of the care required. We have further been advised that the food is inadequate, if edible, the sheets and linens are not cleaned regularly and bandages and other first aid measures are not properly attended to and it takes extreme measures to convince staff to have a patient sent to the hospital.
Our hope is that the owners who may or may not read this post, be well advised that we are following this story carefully. We are digging and will continue to dig. Should law enforcement want information we will gladly pass it on.
To the owners, may you one day wind up in your own nursing care facilities; and may you get no better than the worst care you provide your victims, and they are victims.
Esformes is not alone. Our elderly deserve better. The State of New York should be paying attention.
Friday, April 19, 2019
A federal jury in Miami found nursing home owner Philip Esformes guilty on 20 counts related to bribery, money laundering, kickbacks, and obstruction of justice.
The jurors found Esformes guilty on 20 counts related to bribes he paid to a variety of individuals in order to carry out his scheme, including doctors, state health agency officials, and even a former University of Pennsylvania men’s basketball coach.
Prosecutors accused Esformes of fraudulently receiving $450 million from Medicare and Medicaid through his South Florida network of facilities for services that were either provided because of bribes, that were not needed in the first place, or were not provided at all. Through this process, prosecutors say that he pocketed $38 million for himself through a network of 256 bank accounts.
Prosecutors claimed that Esformes would bribe doctors to refer patients to his nursing homes, and then move them to his assisted living facilities once he had charged Medicare for the maximum 100 days the government would pay out for skilled nursing services. Esformes owns seven nursing homes and nine assisted living facilities in the South Florida area.
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