Nursing Home Operator Allegedly Linked to Kickback Scheme
Nursing home operator Philip Esformes has reportedly been linted to a kickback scheme, an allegation he vehemently denies.
According to co-workers of Chicago physician Roland Borrasi, Borrasi told them that he made cash payoffs to Esformes in exchange for access to a pool of patients. Reportedly, Lynn Madeja, a medical biller for Borrasi, told government agents, "I got to give Phillip $1,000 or $10,000." Borrasi allegedly told Madeja that he "had to make it up" (with cash) to "use" Esformes patients.
Abhin Singla, a member of of Borrasi's medical group, cooperated with federal agents and wore a wire. He told federal agents that "Esformes controls the flow of patients in and out of his nursing homes to ensure that he is receiving the maximum allowed benefit." Reportedly, in a March 2001 incident, Singla was with Borrasi when Esformes called and told him to admit at least five nursing home residents to area hospitals. Borrasi did so without question, telling Singla "someone would find something wrong with the patients to justify the admissions".
While Esformes denies the allegations, Kimberly Reevas, a former Rock Creek psychiatric hospital discharge planner and social worker, helped unravel the scheme saying that Esformes was often at the hospital and was deeply involved in steering patients to his facilities. Further, Reevas said that Esformes told Rock Creek social workers that they were "only to send patients with public aid, public aid pending, disability, or Medicare".
Esformes and his father, Morris Esformes, were part of a group that paid the U.S. Justice Department $15.4 million in 2006 to settle civil claims of healthcare fraud and kickbacks. They deny wrongdoing and say they didn't contribute to the settlement.
