An investigation by the Maryland Attorney General’s Medicaid Fraud and Vulnerable Victims Unit found evidence of substandard care at a nursing home in Ellicott City. Investigators said problems they found inside the facility showed the company was violating the law and defrauding taxpayers.
The owner of the Ellicott City Healthcare Center voluntarily agreed to have that facility monitored for three years as part of a settlement. The nursing home is owned by CommuniCare, an Ohio-based company that operates 2 dozen facilities in Maryland and Virginia.
Last year, the I-Team investigated its Clinton Healthcare Center location in Clinton, Maryland.
Demetirus Hanna of Northeast D.C. reached out to the I-Team after its first report to share his experiences with CommuniCare’s Clinton location confirming what we heard from other patents.
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In late November, Hanna said he was hospitalized in D.C. after an allergic reaction. He's living with multiple sclerosis and for three years has relied on a wheelchair to get around after the hospitalization left him weak. He said staff at Howard University Hospital told him he was going across state lines to Clinton Healthcare Center for rehabilitation.
His fiancee Crystal Willaims told the I-Team she was confused since the couple lived in D.C.
"I was like, well, why are they sending you all the way down there?” Williams said.
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The I-Team found in its investigation last year that close to 200 D.C. residents on Medicaid are sent to Clinton each year. Experts said there are fewer long-term care options in the District. Some of those patients complained to the I-Team about conditions inside, which Hanna's fiance said they also experienced.
“He didn't take a bath for a week because they kept saying that they didn't have any laundry. They had no towels, no washcloth,” Williams said.
The News4 I-Team reviewed a state inspection of Clinton from last summer and found similar complaints including the minimal bathing, unclean conditions and missed or wrong treatments. In all, the I-Team found 35 health citations. That's twice the state average and four times the national average.
Stevanne Ellis worked as Maryland's Long-Term Care Ombudsman for more than 20 years, advocating for nursing home residents and their families. She said the number of citations is unusual, adding, "I would say that I would be concerned if I were a consumer looking at that."
Ellis offered advice for families who have loved ones in facilities or who are looking for one.
"I always tell people before you choose a facility, go take a tour… don't tell them you're coming. Go into the lobby, look for the survey book, and if you see 30 or 40 complaints in the survey, then I would probably want to talk to the facility about some of those complaints,” she said.
“We're concerned about staffing and facilities. We're concerned about issues with giving proper treatment, individualized care, those sorts of things," Ellis explained.
The I-Team found other facilities operated by CommuniCare in our region have had multiple citations that surpass state and national averages, including Ellicott City Healthcare Center.
Zak Shirley with the Maryland Attorney General's Medicaid Fraud and Vulnerable Victims Unit said an investigation by his office found conditions were so bad there that the state took historic action.
“It's the first time that we've used the False Claims Act and the theory of worthless services, for a facility in Maryland," he said.
His unit started a years-long investigation following inspections that found numerous problems at the Ellicott City Healthcare Center.
"We had medication errors, unwitnessed falls, which is often a sign of understaffing because people in those facilities who are fall risks are usually known for risks and should be monitored," Shirley said.
Shirley said his unit used a new approach to build a case saying the substandard care meant taxpayers who paid for the care through Medicaid were being defrauded.
“When we started looking at this, we realized, we have something here, this is a more systemic issue and we think that this state is being defrauded," Shirley said.
Shirley said that to prove fraud, they had to build a case over time that included a series of violations that impacted the entire facility, with failures through multiple systems that showed the state should not be paying for services that were not actually being provided.
After the state's investigation, instead of going to court, CommuniCare settled. The company agreed to pay $400,000 and voluntarily agreed to a third party independent oversight for the next three years at their cost.
"We want to make sure that the services are there for the people of Maryland, and taking back a bunch of money and causing long-term care facilities to fail is not the answer. Pointing out those failures and forcing them to get better and meet the standard is," Shirley said.
CommuniCare told the I-Team in an email:
“We are committed to providing the highest quality of care for our residents and value the feedback from survey results and take them seriously. After reviewing the findings, our team has already initiated comprehensive action. The company has introduced new facility teams, spent millions in physical renovations within the buildings, and made key management changes. Additionally, we implemented brand new processes to ensure that each one of our residents receive the highest quality of care and compassion they deserve and have come to expect.”
Shirley couldn't confirm whether or not his office was investigating any other CommuniCare facilities but said, "I will say that there are a number of chains, nursing home chains and private facilities that are on our radar. We're aware of problems throughout the system."
CommuniCare also operates five facilities in Virginia, including Mount Vernon Healthcare Center in Alexandria. The I-Team found it had the highest number of health violations with 56 from an inspection in 2022.
CommuniCare told the I-Team that the facility has significantly improved after renovating the space and making key leadership changes with management.
As for Clinton Healthcare Center, the owner said it's currently in compliance with state and federal regulations and that it has invested $7 million in renovations.
Those are improvements that Hanna cannot attest to.
He told the I-Team he got so fed up that he checked himself out early.
“I left, I signed myself out," he said.
As for his complaints, CommuniCare said: “Due to HIPAA we cannot comment on, or confirm identity of current or past residents. However, as a company we always strive for excellence when it comes to the health and wellbeing of our residents.”
This story was shot by News4's Jeff Piper, Steve Jones and Lance Ing, and edited by Steve Jones.
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