Nursing homes fined $15M for staffing fraud after guilty verdict

Two nursing homes in Pennsylvania have been ordered to pay more than $15 million to resolve claims of Medicare and Medicaid reimbursement fraud, stemming from millions of dollars the two organizations were paid based on reported staffing levels that didn’t match reality. 

Brighton Rehabilitation and Wellness and Mt. Lebanon Rehabilitation and Wellness are required to pay $12.6 million and $2.7 million, respectively, for inflating staffing numbers to make it appear they were meeting minimum requirements in the law when in fact they were not. 

Both facilities are owned by Comprehensive Healthcare Management Services, a for-profit entity that runs long-term care operations. 

The judgment was ordered by a federal court after the U.S. Department of Justice (DOJ) filed a lawsuit. A jury found the nursing homes guilty of making fraudulent statements and bilking federal healthcare programs for the illegitimate billable hours that staff were said to be working.

Together, the two facilities were found guilty of 10 counts of fraud during a five-week trial. Brighton and Mt. Lebanon Rehabilitation were also placed on lengthy probation as part of their sentencing, though this applies to the organizations themselves.

While five employees were arrested and charged in connection with the scheme, all were acquitted by a jury. All the indictments were filed in federal court in August 2022.

At the trial, evidence showed that Brighton and Mt. Lebanon nursing facilities falsified staffing data to appear compliant with Medicare and Medicaid requirements, including listing staff who weren’t present or providing care. Testimony revealed that, despite inadequate staffing, the facilities continued to admit new patients, contributing to poor resident care and incidents like an unmonitored violent assault. Judge Colville, who presided over the case, condemned the conduct as a serious breach that defrauded taxpayers and endangered both residents and staff, calling it a “tragic set of events.”

The trials took place in December 2023, but a federal court did not impose a sentence on the nursing homes until May 2025, according to an announcement from the DOJ.

“Protecting the health, safety, and dignity of the residents of these nursing facilities and ensuring adequate staff to care for these vulnerable resident populations has been our office’s primary focus and objective throughout this prosecution,” Acting U.S. Attorney Rivetti said in the DOJ’s statement. “Choosing to prioritize profits over patient care, these facilities lied and falsified records regarding meeting minimum requisite staffing levels to avoid sanctions and to continue to receive federal funding, all the while failing to provide residents with the level and quality of care they deserved.”