Legal Teams and Fallout
The Justice Department’s Ben Young and Susan Gillin led the charge for the government, pursuing the claims under the False Claims Act—a legal weapon often used in cases of healthcare fraud that allows whistleblowers to bring suits on behalf of the government.
American Health Foundation turned to Michael Ferrara of Dinsmore & Shohl LLP for its defense in the high-profile case.
A Warning Shot for the Industry
Though the case ends with a settlement rather than a trial, its message reverberates across the elder care industry: billing Medicare and Medicaid for care that’s dangerously inadequate—or imaginary—comes with a high price tag and even higher reputational cost.
The agreement arrives amid growing scrutiny of long-term care facilities nationwide, particularly in the wake of COVID-19, which exposed systemic vulnerabilities in the sector. The DOJ emphasized that the settlement aims to protect both public funds and the lives of those in care homes who can’t always speak for themselves.
With no admission of guilt but a sizable payout, American Health Foundation exits the courtroom—but not the shadow of controversy.
