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Nursing home mogul Philip Esformes sentenced to 20 years for $1.3 billion Medicaid fraud

David Jackson and Mario Ariza, Chicago Tribune on

Published in Business News

CHICAGO -- Former Illinois and Florida nursing home mogul Philip Esformes wept and pleaded for mercy Thursday before being sentenced to 20 years in prison for what the U.S. Justice Department called the largest single health care bribery and kickback scheme in American history.

A separate hearing will be held in November to determine the amount of money and property Esformes may be required to forfeit.

Esformes, who once controlled a network of more than two dozen health care facilities that stretched from Chicago to Miami, garnered $1.3 billion Medicaid revenues by bribing medical professionals who referred patients to his Florida facilities then paid off government regulators as vulnerable residents were injured by their peers, prosecutors said.

He housed elderly patients alongside younger adults who suffered from mental illness and drug addiction -- sometimes with fatal results. In Esformes' Oceanside Extended Care Center in Miami Beach, "an elderly patient was attacked and beaten to death by a younger mental health patient who never should have been at (a nursing facility) in the first place," prosecutors wrote in a pre-sentencing memo.

As he handed down the sentence, Judge Robert N. Scola Jr. said the length and scope of Esformes' criminal conduct were "unmatched in our community. ... Mr. Esformes violated the trust of Medicare and Medicaid in epic proportions."

But Scola meted out a punishment significantly less than the 30 years prosecutors requested, saying Esformes also had an extraordinary history of helping people in need. Attorneys for Esformes had described him as a selfless philanthropist who had donated more than $15 million to synagogues, schools and needy individuals, often anonymously.

 

Said Scola: "I think he should get some consideration for his philanthropy, although it's dangerous to say because he was stealing money from Medicare, so people might say he was giving that money to charity. But the vast majority of the money he made, he made legitimately. More importantly he was a true friend to people known and unknown to him, and that is worthy of mitigation."

In arguing for a 30-year sentence, prosecutors said his yearslong bribes-for-patients schemes involved the corruption of medical professionals and government regulators, and entailed grievous injuries to a massive number of elderly patients.

"Miami is the epicenter of health care fraud, there was no one like Philip Esformes, he was king," prosecutor Allan J. Medina told the judge in court Thursday.

Many of his younger, drug-addicted patients spent the daylight hours wandering the streets of Miami while he collected government payments for services that were never delivered, prosecutors said.

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