False Claims Counsel

On February 27, the Department of Justice announced that the operators of an upstate New York nursing home had agreed to pay $7,168,000 to resolve allegations that the home billed federal healthcare programs for services that were so poor they were essentially worthless. According to DOJ’s press release:

The Justice Department, together with the New York State Office of the Attorney General, announced today that the United States and New York State have entered into settlement agreements with the landlord and several individuals and entities involved in the operation of Saratoga Center for Rehabilitation and Skilled Nursing Care (Saratoga Center), a nursing facility in Ballston Spa, New York. Leon Melohn; Alan “Ari” Schwartz; Jeffrey Vegh; Jack Jaffa; 149 Ballston Ave., LLC; Ballston Two, LLC; Saratoga Center for Care, LLC; and Saratoga Care and Rehabilitation Center, LLC (the Settling Parties) collectively agreed to pay $7,168,000 to resolve allegations that they violated the False Claims Act by causing the submission of false claims to the Medicaid program for worthless services provided to residents. Saratoga Center closed in February 2021, after this investigation was initiated.

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Before issuing a license to operate a nursing home, the New York State Department of Health (NYSDOH) thoroughly reviews, among other things, an applicant’s character and competence to ensure that the operator will provide a consistently high level of care to residents. After a months-long vetting process, in 2014, NYSDOH approved Schwartz and Vegh to operate Saratoga Center with Leon Melohn, through entities he managed and controlled, acting as its landlord (Melohn and his entities are hereinafter referred to as the Landlord). This license vested in Schwartz and Vegh the nondelegable duty to oversee the operations of the home. But in or around early 2017, due to a financial dispute, the Landlord required the legally licensed operators to surrender control of Saratoga Center. The Landlord replaced them with Jaffa and a business associate of his, along with various corporate entities, even though none of them had – and they never obtained – the necessary license from the NYSDOH. Jaffa and his associate undertook all the nondelegable duties that remained the responsibility of Schwartz and Vegh.

These unlicensed individuals operated Saratoga Center from February 2017 until it closed in February 2021. During that period, the United States contends that Saratoga Center delivered worthless services to residents, and its physical conditions deteriorated to such a degree that it violated federal and state regulations. Specifically, the operators failed to adequately staff the home, and residents suffered medication errors, unnecessary falls, and the development of pressure ulcers. Additionally, Saratoga Center did not consistently maintain hot water throughout the facility, have an adequate linen inventory, and dispose of solid waste. In 2019, Saratoga Center was placed on the Centers for Medicare and Medicaid Services Special Focus Facility list – a list of the worst-performing nursing homes in the United States. Saratoga Center remained on the list until its closure.

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In connection with the settlement, the United States Department of Health and Human Services, Office of Inspector General (HHS OIG), negotiated voluntary exclusions of the individuals and entities. Schwartz; Saratoga Center for Care, LLC; 149 Ballston Ave, LLC; and Ballston Two, LLC will be excluded from Medicare, Medicaid, and all other Federal health care programs, as defined in 42 U.S.C. § 1320a-7b(f), for a period of ten years. Vegh will be excluded for eleven years. Jaffa and Saratoga Care and Rehabilitation Center, LLC, will be excluded for twenty years.

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The case arose from a government investigation, rather than from a whistleblower’s lawsuit.