NY Nursing Home Kickback Settlement – Reminder of Need to Make Careful Nursing Home Choices

The New York Medicaid program has been making many headlines in recent months. Implementation of the Affordable Care Act and efforts to control state spending all have significant implications for the program. Interestingly, these developments have opposing outcomes. As the Affordable Care Act provisions are unrolled the program will be expanded, offering services to more New Yorkers. Conversely, the state’s push to control costs and root out fraud limits services in a few ways, sometimes impacting local seniors and their families.

Fraud Repayment From Estate
On the fraud issue, the NY Daily News reported last week on a settlement reached between the Attorney General and the estate of a former nursing home owner.

The agreement stems from charges filed against the former owner of the Kingsbridge Heights Rehabilitation & Center Center in the Bronx. The owner, Helen Sieger, was hit with grand larceny and kickback charges alleging that she paid bribes to a hospital social worker in exchange for the social worker steering patients to become nursing home residents. According to the allegations, the social worker received $300 for each patient he sent to the facility and an extra $1,000 for every ten patients. All of this was profitable, because the nursing home made significant sums for each resident via NY Medicaid.

Ms. Sieger died in jail before the matter went to trial–she was actually caught in a Miami hotel after jumping bail. Last week, her estate reached a settlement with the state, paying back over $2.5 million to New York public offers based on the funds paid as part of this illegal scheme.

In summing up the settlement and the importance of rooting out fraud, the NY Attorney General noted, “Our state’s Medicaid system is a critical resource for all New Yorkers, and in particular, for our most vulnerable, elderly citizens. Those who steal from the elderly deserve to be prosecuted and the stolen funds fully restored.”

Nursing Home Choices – Outside Help
Beyond the need to root out misuse of the program by long-term care providers, this example is also a reminder to New York residents to be careful when making nursing home choices. One hopes that social workers at hospitals and others are making recommendations based on honest assessment about the best interest of the individual. Yet, that is not always the case. At the end of the day there is no shortcut to getting honest opinions from different sources, conducting site-visits, and talking with current residents.

There are times when a serious medical setback strikes and there is little time to be thorough before deciding on a home. That is one reason why working with an elder law estate planning attorney ahead of time can provide immensely valuable, ensuring proper care even no matter what the situation.

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