Ex-care home admin accused of fraud
The former administrator of a Mt. Lebanon nursing home allegedly kept two sets of books on the care that staff provided to residents: One counted the actual number of direct care hours, while a second book that was given to state inspectors when they visited used falsified figures to make it seem as if the home provided the legally required hours of care for its residents.
Susan Gilbert, 60, of Cecil, the administrator of the Mt. Lebanon Rehabilitation and Wellness Center, was indicted on three federal health care fraud charges, according to a joint announcement Thursday by Scott Brady, U.S. attorney for the Western District of Pennsylvania, and state Attorney General Josh Shapiro.
It was not known if Ms. Gilbert has an attorney representing her, and attempts to reach her Thursday were not successful. Comprehensive
Healthcare, which owns the Mt. Lebanon facility, did not respond to a request for comment.
In an interview later Thursday, Mr. Shapiro said the charges against Ms. Gilbert are only the first to be filed in criminal cases involving nursing homes across the state, resulting from investigations he first made public in August.
“I can tell you that there will be more charges relatively soon,” he said by phone Thursday, “and that even that won’t be the end of this. Today’s indictment is just one piece of a larger puzzle.
“I’ve been very clear since COVID began that we will hold anyone accountable, no matter who, whenever we find evidence that our loved ones were criminally neglected,” he said.
The charges against Ms. Gilbert are just the “first step in holding accountable those who put profit over the health and safety of seniors,” Mr. Brady said in a news release.
The fraud charges allege that Ms. Gilbert and/or unnamed co-conspirators began their fraud scheme in October 2017, at about the time Ms. Gilbert began working in Mt. Lebanon, and continued up through February 2020, just before COVID-19 outbreaks began in nursing homes here.
The indictment against Ms. Gilbert on Wednesday, but announced Thursday, comes nearly six months after FBI agents served a search warrant on both the Mt. Lebanon nursing home and Brighton Rehabilitation and Wellness Center, which is also owned by Comprehensive Healthcare.
Mr. Brady’s statement of Ms. Gilbert’s indictment being a “first step,” and Mr. Shapiro’s that there were additional indictments coming, may both be a reference to additional indictments forthcoming against
employees of Brighton, which had one of the worst and most deadly COVID-19 outbreaks of any nursing home in the country, with at least 82 people dying from the infectious disease.
Mordy Lahasky, one of the owners of Comprehensive Healthcare, said in an op-ed in the Pittsburgh PostGazette on Wednesday that he expects employees at Brighton to be indicted before the end of the month because Mr. Brady, who was appointed to his post by former President Donald Trump, is about to leave office.
“Now my employees, who shouldered these burdens without help or effective guidance from the federal government, are facing prosecution, and I feel a responsibility to tell the public,” he wrote, in part. “The U.S. attorney’s office intends to indict my employees for failing to contain a virus that devastated the entire industry, our country and the world. It is not
right, and I will not stand quietly by while this happens.”
Although it is not yet known what the criminal investigation into Brighton is focused on, a civil lawsuit in October filed by 15 families of residents and those who died at Brighton alleged, among other problems at the nursing home, that Brighton was chronically understaffed when it came to caring for residents with significant health issues.
“If the same thing [about falsifying care hours at Mt. Lebanon] was going on at Brighton, what was happening at Brighton would be even worse than we alleged,” Bob Daley, one of the attorneys representing the families in the civil lawsuit, said on Thursday.
Mr. Daley noted that given the specifics of Thursday’s indictment against Ms. Gilbert alleging she kept two books of care hours, “it will be interesting to see what information Mr.
Lahasky and his colleagues have to contradict those allegations.”
According to the indictment against Ms. Gilbert, the scheme to falsify records began just months after Comprehensive bought the facility in late 2016 from Golden Living.
Golden Living is a nursing home operator that was sued by Mr. Shapiro’s predecessor earlier in 2016 on a claim of providing deficient care and misleading its customers about its operations, including at the Mt. Lebanon facility.
Golden Living sold the facilities named in the lawsuit, including not only Mt. Lebanon but also facilities in Monroeville and Murrysville, to Comprehensive.
The indictment alleges nine “overt acts” in which Ms. Gilbert submitted either falsified Nursing Care Hours forms or Three-Week Nursing Time Schedules to state inspectors when they visited.
Those forms were
fraudulent, the indictment says, because Ms. Gilbert “and/or other co-conspirators known and unknown ... directed employees of [Mt. Lebanon] to falsify records to give the appearance that [Mt. Lebanon] met federal and state staffing requirements.”
The general, current state staffing requirement for nursing homes states that nursing homes must provide 2.7 hours of direct care to each resident, at a minimum, each day. That figure is arrived at by taking the total hours worked daily and dividing it by the number of residents.
Mt. Lebanon’s most recent figure provided to state regulators is that it provides 2.94 hours of direct care per resident per day.
According to the indictment, Ms. Gilbert and others ensured the facility would meet that threshold by having managementlevel employees — including the director of nursing and assistant director of nursing — “clock in” for shifts that they did not actually work. In return for pretending to work, those employees would be paid “monetary bonuses,” the indictment said.
Ms. Gilbert and others also directed the staff not to clock in and out for their 30-minute lunch breaks, to make it appear that those hours when they were eating lunch were actually direct care hours with residents.
Since so many people in Mt. Lebanon knew about at least a portion of the scheme alleged, the indictment seems to indicate that there may have been a whistleblower in-house who tipped the government off.
Though Mr. Shapiro would not speak specifically to Thursday’s indictment, he said that the state’s email tip line — Neglect-COVID@attorneygeneral.gov — has received a “significant number of tips … and those tips have proven particularly helpful.”
Mt. Lebanon had about 55 nursing employees — registered nurses, licensed practical nurses and nurse’s aides — on average in 2019, according to the facility’s most recent federal Cost Report data.
All of that was logged into one book that kept track of direct care hours, while another book was kept for the hours actually worked, minus the lunch breaks and administrative staff’s pretend shifts.
“One book contained accurate information regarding the actual hours nursing staff provided direct residential care, while the other contained falsified information that made it appear as though [Mt. Lebanon] had higher staffing levels,” the indictment alleged.
Mr. Shapiro said that “Ms. Gilbert went out of her way to try to cover her tracks … to cover up the fact that they had inadequate staffing at this facility.”
An arraignment for Ms. Gilbert has been scheduled for March 17.