False Claims Act Lawsuit Blames Nursing Home Operators for Defrauding Medicare

Nursing Home Blamed for Defrauding MedicareResponsibilities of a Nursing home owner

By the look of it, a nursing home is a special institution created to help the elderly. With its primary responsibility being caring for senior citizens who are going through illnesses or have simply become disabled to care for themselves, a nursing home is always looked upon with a lot of respect. For the patients who reside therein, the facility soon turns into home- provided they are cared for and looked after in the best possible manner and their interests are prioritized over and above other motives.

Therefore, the philosophy behind a nursing home’s existence, its quality of care and the way it values senior citizens stems from the philosophy of the owner. However, if the owner himself is dishonest to the purpose behind running a nursing home, the entire foundation becomes shaky.

A prime example of this thought comes from a recent case that was filed under the False Claims Act Lawsuit where owners of a nursing home chain have a monetary philosophy behind a thoughtful venture.

Running a nursing home with kickbacks

For Morris and Phillips Esformes running a nursing home is not any different from running a profit making business. Alleged under the False Claims Act Lawsuit, the Esformes are being trialed for taking kickbacks from Omnicare, a pharmacy that bought over Total Pharmacy and got secured selling rights because of the kickback payment.

According to Mureen Nehl, the whistleblower in this case, the Esformes agreed to the kickbacks back in 2004 when Total was being sold to Omnicare. The latter acquired Total Pharmacy at an inflated $32 million, part of which went to the Esformes. According to the District Judge John Tharp Jr., “Phillip Esformes largely paid for his substantial stake in Total Pharmacy by delivering the Esformes Homes as customers.”

The Esformes son and father run/influence close to two dozen pharmacies, all of which had to buy medical supplies from Total by default. Such a rule goes against the legal clause that empowers every nursing home to act in the best interest of its residents and chose a pharmacy that serves them best. Therefore, for the sake of a share in the profits, the Esformes found it easy to order the nursing homes to abandon their existing pharmaceutical contracts and select a pharmacy by default without determining its potential to serve more than two dozen nursing homes.

With big bucks in front of them, the owners of a chain of nursing homes did not feel responsible to think twice about the well-being of the residents under their care. Unknown to those patients, the nursing facility that they called home was only working to make profits by violating federal laws and keeping them as a later priority. Such neglect on the part of the owners or direct caregivers is not new. There have been a number of cases filed and tried in court against them; however, unfortunately, the occurrence of this crime seems to know no bounds.

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Jonathan did a great job helping my family navigate through a lengthy lawsuit involving my grandmother's death in a nursing home. Through every step of the case, Jonathan kept my family informed of the progression of the case. Although our case eventually settled at a mediation, I really was impressed at how well prepared Jonathan was to take the case to trial. Lisa
After I read Jonathan’s Nursing Home Blog, I decided to hire him to look into my wife’s treatment at a local nursing home. Jonathan did a great job explaining the process and the laws that apply to nursing homes. I immediately felt at ease and was glad to have him on my side. Though the lawsuit process was at times frustrating, Jonathan reassured me, particularly at my deposition. I really felt like Jonathan cared about my wife’s best interests, and I think that came across to the lawyers for the nursing home. Eric