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Nursing Home Operator Jailed in Florida for Alleged $1 Billion Health Fraud

A wealthy nursing home operator with mansions in Miami and Los Angeles is the subject of a U.S. Justice Department investigation and prosecution that alleges he orchestrated a Medicare and Medicaid bribery and kickback scheme totaling losses of more than $1 billion. Authorities in July stated it was the largest single criminal health care fraud case ever filed against an individual by the DOJ. 

Now, the subject of that investigation, Philip Esformes, is fighting to be released on bond, as federal authorities are placing enormous pressure on the courts to keep him locked up in South Florida, where he was arrested at one of his Miami Beach waterfront estates this summer. Although the court has been bombarded with letters of support for Esformes, some of which have included receipts related to his many philanthropic efforts, he remains at the Miami Federal Detention Center.

Authorities say Esformes and his father siphoned millions of taxpayer dollars every single year from federal programs intended to aid the sick and disabled over the course of 14 years. The pair had nursing homes across the country, including about 20 in Florida. According to the latest federal indictment, he and his co-conspirators took money from these federal programs in the name of some 14,000 patients at various facilities. In many cases, federal authorities allege, patients were given treatment that wasn’t necessary and in some cases was actually harmful.

There were even reported instances where drug addicts were reportedly brought to these nursing home facilities with the promise of free painkillers. It was not only their incentive to come, it was their reason to stay. Prosecutors say some of those patients were receiving powerful medications like fentanyl and OxyContin without a doctor’s prescription.

One woman deposed by prosecutors revealed she was offered a bed at one of the nursing home facilities because she “looked homeless.” This was a woman who did not need the types of skilled nursing services that she received – and for which Medicaid was billed.

Another allegation asserts Esformes and another defendant attempted to bribe a state regulator in order to obtain advanced knowledge of when state inspectors intended to conduct a “surprise” visit. That way, Esformes and his facilities could “clean up” and either modify or falsify records.

One resident, an elderly woman, told agents who raided the nursing home where she lived that just days earlier, a staffer punched her in the stomach when she’d complained about the poor level of care she’d been receiving.

The 47-year-old Esformes, who vehemently maintains his innocence, faces a life sentence if convicted on the various obstruction, conspiracy and fraud charges he faces. Court records show he has $78 million in personal assets without any liabilities or debts. Posting bond would be no issue, but prosecutors are pressing the court not to offer any, citing as evidence a secretly-recorded conversation in which Esformes reportedly offered to cover costs for a co-conspirator to flee the country in an attempt to avoid trial in the U.S. He allegedly offered to use federal dollars to do this by inflating the cost of new furnishings for one of his nursing homes. He also in that conversation reportedly referred to black Americans using a racial epithet, and it’s worth noting a substantial number of patients who reside in these facilities are black.

Separate from all of this, there are at least 20 wrongful death lawsuits pending against seven of defendant’s nursing homes just in Miami-Dade County. Four of those centers were placed on the state’s troubled facilities list.

One of those nursing home lawsuits alleges after a patient was viciously attacked by another resident, he was transferred to a different facility where he was poorly monitored, resulting in a horrible fall and traumatic brain injury, from which he soon after died.

Another patient, 73, who was receiving hospice care, was beaten to death in his own bed by a fellow resident, and not discovered until the next morning. It was later revealed that the victim, who was invalid and bed-bound with six months to live, should never have been housed with a younger patient who had a long history of violence.

Another patient, 75, drowned in a nearby lake. Staffers could not explain to state investigators how the man, who suffered dementia, was able to get out. In another elopement case, a resident was killed by a car after he wandered into traffic. In neither case did staffers call 911. It was first responders who discovered the victims’ residence and alerted the nursing home administration of their absence.

Call Freeman Injury Law — 1-800-561-7777 for a free appointment to discuss your rights. Now serving Orlando, West Palm Beach, Port St. Lucie and Fort Lauderdale.

Additional Resources:

Nursing home operator from Chicago jailed as feds allege $1 billion scheme, Oct. 4, 2016, By David Jackson and Gary Marx, Chicago Tribune

More Blog Entries:

Griffith v. SSC Pueblo Belmont Operating Co. – Jurisdiction in Nursing Home Lawsuits, Oct. 10, 2016, Fort Lauderdale Nursing Home Abuse Lawyer Blog

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