LR care-home operator faces fraud charges
Abuse of Medicaid program alleged in arrest affidavit
The operator of a state-certified home for elderly and disabled adults, which was closed in April, was arrested Wednesday on charges related to abuses of the state’s Medicaid program.
Shavita Wilson, 46, of Little Rock surrendered to authorities at Pulaski County District Court on three outstanding arrest warrants, alleging that she turned in false statements when applying for $14,899 in Medicaid payments, according to an arrest affidavit. She pleaded innocent.
The Arkansas Department of Human Services shut down Wilson’s Adult Foster Care Home, at 5 Sunny Circle in Little Rock, after Wilson refused to let state inspectors inside April 7.
Inspectors finally entered with the help of police after three hours. Inside, they made observations that “gave rise to suspicion of Medicaid fraud, exploitation of adults and possible neglect,” the arrest affidavit said.
The Arkansas attorney general’s Medicaid Fraud Control Unit began a criminal investigation into Wilson’s home after unit chief Lloyd Warford read about the incident at Wilson’s home in the Arkansas Democrat-Gazette a week later.
The incident raised broader questions about loopholes in Arkansas’ Adult Family Home program — a Medicaid waiver program designed to give elderly and disabled adults a less-institutionalized long-term care alternative, especially in rural areas.
In the wake of the Wilson home closure, the Department of Human Services began looking at another home in North Little Rock with connections to Wilson, but that home surrendered its license before inspectors could get there. However, Adult Protective Services did remove residents from the North Little Rock home.
The adult family home program was rolled out in 2011, and over its first five years, five providers participated in the state-supervised program, according to a document obtained under the Arkansas Freedom of Information Act. Only one home, in Earle, remains open.
Advocates fear that some adult family homes remain functional without any oversight. While homes accepting Medicaid must go through an extensive approval process
as part of the program, the Human Services Department doesn’t have the authority to monitor homes that don’t accept Medicaid and house fewer than three residents. The agency can inspect those homes only if it receives a complaint.
Craig Cloud, the director of the department’s Aging and Adult Services Division, said the agency is rethinking its approach to adult family homes and trying to identify any functioning homes across the state. Ultimately, Cloud said, there likely will need to be new legislation passed to give the department statutory authority to oversee all group homes, not just those accepting Medicaid.
Cloud also is leading the creation of new a division at the department, Provider Services and Quality Assurance, which he will direct.
“It’s a priority; it’s high on the list,” Cloud said of expanding the department’s authority to monitor non-Medicaid homes.
The investigation of Wilson’s home showed problems can arise even under state supervision.
When inspectors entered Wilson’s home in April, the only food they found was cans of Vienna sausages, potted meat, pudding cups, protein drinks, cream of wheat and half-gallon containers of juice, the arrest affidavit stated.
Wilson provided a seven-day menu that included a fresher, more nutritious diet plan, but inspectors also found contradictory handwritten notes, instructing workers to give the women at the home “3 waters and 1 protein shake before 11:30 a.m. every morning 7 days a week.”
Another note said the women must be given five Vienna sausages or a full can of potted meat per patient plus refried beans, mashed potatoes, pudding and a sweet roll, the affidavit said. A final note suggested that one resident was being fed a liquid-only diet.
Wilson told inspectors that those instructions were simply for snacks.
“These instructions were, however, consistent with the only food observed in the house,” an attorney general investigator wrote in the affidavit. “The evidence indicates these residents were being fed a low cost, high calorie diet that is grossly inconsistent with program [rules], unhealthy for any person and dangerous for the senior adults in Wilson’s care.”
Investigators also used bank records, a personal calender and a ticket stub to verify that Wilson billed Medicaid for services provided while she was on a cruise for nine days in June 2016.
Authorities suspect Wilson has employed other individuals to care for the residents at the group home, but those caretakers were never approved by the Human Services Department, a violation of state regulations. Indeed, those workers would not have been approved because all four identified by the attorney general’s office were convicted felons, and three had extensive criminal backgrounds, including violent crimes, the affidavit stated.
Wilson also failed to keep adequate records, according to court documents.
She was charged with two counts of Medicaid fraud and one count of failure to maintain Medicaid records. If convicted on all three counts, she could face up to 36 years in prison and a $35,000 fine.