AG Shapiro indicts Allegheny County nursing home admin. on multiple counts of fraud

Pennsylvania

(AP Photo/Jean-Francois Badias)

HARRISBURG, Pa. (WHTM) — The former administrator for Mount Lebanon Rehabilitation and Wellness Center in Allegheny County has been charged with conspiracy to defraud the U.S., health care fraud, and obstruction of a federal audit, according to Pa. Attorney General Josh Shapiro and U.S. Attorney Scott Brady on Thursday.

Susan Gilbert, 60, is being indicted on federal charges after a joint investigation that alleged that in her role as an administrator she had employees falsify records to give the appearance that Mount Lebanon Rehabilitation and Wellness Center, a sister nursing home to Brighton, met federal and state staffing requirements.

“These crimes put facility residents at risk by only providing a dangerously low amount of nursing staff just before COVID began to surge across the country,” said AG Shapiro. “By filing these false reports, the facility met minimum staffing levels only on paper — while Pennsylvanians who depended on them to care for their well-being didn’t have enough people to turn to. Our ongoing investigation will hold nursing and long-term care facilities criminally accountable wherever we find evidence someone neglected a resident. If you have information about a potential crime, contact my office at neglect-COVID@attorneygeneral.gov.”

Gilbert and others conspired to defraud the Commonwealth of property and money by impeding, impairing, defeating, obstructing, and interfering with government functions of the U.S. Department of Health and Human Services in the administration of Medicare and Pa. Medicaid, commit health care fraud, and obstruct a federal auditor between October 10, 2018 and February 20, 2020.

The indictment alleges multiple schemes within the conspiracy, Gilbert and co-conspirators;

  • Directed administrative and management-level nursing staff to falsify timecard documentation by clocking in for shifts but no actually working
  • Told their staff to not clock their 30-minute lunch breaks to falsify their timecard documentation
  • Caused management-level nursing staff to be paid bonuses to clock in for shifts they didn’t work
  • Had staff falsify hours worked by management-level nursing staff and other administrative staff on three-week staffing sheets the DOH provided
  • Made staff keep two sets of books to reflect staffing levels, one containing accurate information and one with falsified information to make it appear that the facility had higher staffing levels
  • Directed administrative staff to falsify staffing documents to DOH investigators during federally mandated inspections to make it seem like the facility met state and federal mandated staffing requirements
  • Engaged in the above acts to make it seem like the facility was in compliance with the conditions of participation for Medicare and Pa. Medicaid

“These criminal charges represent the first step in holding accountable those who put profit over the health and safety of seniors,” said U.S. Attorney Brady.  “From 2018-2020, Gilbert and co-conspirators deprived seniors of patient care using inflated nursing hours, falsified timecards and other schemes that they concealed with two sets of records.  We will continue to pursue every lead until justice has been achieved for seniors and their families in western Pennsylvania.”

Gilbert could face up to 10 years in prison, a fine of $250,000, or both for the charges.

The charges are a result of a joint investigation in the federal grand jury and is still considered ongoing.

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