Nursing a Grudge: DOJ Cracks Down on Nursing Home Cons
The Department of Justice’s 2025 Report on Combatting Elder Fraud and Abuse revealed the Department initiated 283 enforcement actions involving over 600 defendants charged with stealing or alleged to have stolen over $2 billion from over 1 million victims as well as the government.1 In 2025, the Department brought several enforcement actions against nursing homes and providers that committed fraud, provided medically unnecessary services, and/or failed to care for their residents as required by regulation.
The schemes are wide-ranging, touching on both financial frauds and risks to patients:
In June 2025, Ohio based nonprofit American Health Foundation and three affiliated nursing homes paid $3.61 million to resolve allegations it billed the government for substandard skilled nursing services. The United States alleged that the nursing homes failed to follow appropriate infection control protocols (at incredible risk to patients), did not maintain adequate staffing levels, and one of the named nursing homes “housed its residents in a dirty, pest-infested building, gave its residents unnecessary medications [and] subjected residents to verbal abuse,” among other things.
Similarly, Villa Nursing Homes agreed to pay $4.5 million to resolve allegations it failed to provide services to nursing home residents and/or provided materially and grossly substandard care services to nursing home residents.
In July 2025, the United States reported that Centers Health Care paid $6 million to resolve allegations that forty-four of its skilled nursing facilities (“SNF”) submitted cost reports to Medicare that were not accurate regarding their transactions with related organizations in violation of federal regulations. Medicare regulations require SNFs to disclose related organizations to CMS, along with other data points. The goal is to keep records on which transactions may be financially beneficial to the SNF (and hence have the potential to cloud medical judgment).
In September 2025, the United States filed sued ProMedica Health System, Inc., and HCR ManorCare alleging that the nursing homes provided non-existent, grossly substandard skilled nursing facility care, including failing to (1) provide adequate wound care; (2) maintain residents’ hygiene and provide required showers; and (3) provide residents with appropriate feeding assistance. The government also alleged that the defendants falsely documented that care services had been provided to residents when they had not. This lawsuit reinforces the Department’s focus on holding nursing home and health care fraudsters accountable in the civil arena. The case continues in litigation.
The DOJ is also taking criminal action against fraudsters targeting the nursing home population. For example, in June 2025, an Oklahoma City man was indicted for health care fraud for fraudulently billing Medicare for $3 million of face-to-face patient visits in SNFs. He either did not meet with patients face-to-face or only partially provided the services.
The DOJ is showing no signs of slowing down in 2026. In May 2026, three affiliated SNFs in Illinois paid $300,000 to resolve allegations they submitted false claims for medically unnecessary rehabilitation services. The Department’s message is clear – it “will not tolerate elder fraud and abuse and will aggressively pursue those that target older Americans[,]” including those targeting vulnerable Medicare and Medicaid beneficiaries.
This piece was written by Gia Grimm, a Senior Counsel at Joseph Greenwald Laake
1 The relevant time period is July 1, 2024, through June 30, 2025.
