An investigation by the Maryland Attorney General’s Medicaid Fraud and Vulnerable Victims Unit found evidence of substandard care at an Ellicott City nursing home. Investigators said the problems they discovered at the facility showed the company was breaking the law and defrauding taxpayers.

The owner of Ellicott City Healthcare Center has voluntarily agreed to have the facility monitored for three years as part of a settlement. The nursing home is owned by CommuniCare, an Ohio-based company that operates two dozen facilities in Maryland and Virginia.

Last year, the I-Team investigated the site of the Clinton Healthcare Center in Clinton, Maryland.

Demetrius Hanna of Northeast DC reached out to the I-Team after the initial report to share his experience with Communicare’s Clinton location, confirming what we’ve heard from other patients.

In late November, Hanna said he was admitted to a Washington, DC, hospital for an allergic reaction. He suffers from multiple sclerosis and has been confined to a wheelchair for three years. The hospital stay left him weak. He said staff at Howard University Hospital told him he would have to travel across the country to Clinton Healthcare Center for rehabilitation.

His fiancée Crystal Williams told the I-Team she was confused because the couple lived in Washington, D.C. “I thought, ‘Why are they sending you all the way there?'” Williams said.

The I-Team found in its investigation last year that nearly 200 Washington, D.C., residents on Medicaid are sent to Clinton each year. Experts say there are fewer long-term care options in the county. Some of those patients complained to the I-Team about the conditions that Hanna’s fiancé was also suffering from: “He didn’t bathe for a week because they kept saying they didn’t have any linens. They didn’t have any towels, no washcloths,” Williams said.

The 4 I-Team reviewed a state inspection of Clinton last summer and found similar complaints, including inadequate bathing facilities, unclean conditions and lack of or improper treatment. In total – 35 health violations, 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 many of the subpoenas are unusual, adding: “I would say I would be concerned if I were looking at it as a consumer.”

Ellis offered advice to families whose loved ones are in facilities or who are looking for one: “I always tell people before they choose a facility, take a tour…don’t tell them you’re coming. Go to the lobby, look for the survey book, and if you see 30 or 40 complaints in there, then I would probably want to talk to the facility about some of those complaints,” she said. “We’re concerned about staff and facilities. We’re concerned about problems in providing appropriate treatment, individualized care, and things like that,” Ellis explained.

The I-Team found that other facilities operated by CommuniCare in our region, including Ellicott City Healthcare Center, received multiple complaints that are higher than the state and national averages.

Zak Shirley of the Maryland Attorney General’s Medicaid Fraud and Vulnerable Victims Unit said an investigation by his office found conditions there were so bad that the state took historic action. “It’s the first time we’ve applied the False Claims Act and the worthless benefits theory to a facility in Maryland.”

His department launched a year-long investigation after inspections found numerous problems at Ellicott City Healthcare Center. Shirley said, “We had medication errors and unattended falls, which is often a sign of understaffing, because people in these facilities who are at risk of falls are usually known to be at risk and should be monitored.”

Shirley said his department used a new approach to build a case alleging the substandard care meant taxpayers who paid for the care through Medicaid were being defrauded. Shirley explained, “As we looked into this, we realized this was something that was a more systemic problem, and we believe this state is being defrauded.”

Shirley said to prove fraud, they would have to build a case over an extended period of time that included a series of violations that impacted the entire facility, with errors in multiple systems that showed the state should not pay for services that were not actually provided.

Following the state’s investigation, CommuniCare agreed to settle rather than go to trial, agreeing to pay $400,000 and voluntarily agreeing to have an independent third-party oversight agency oversee the company for the next three years at its own expense.

Shirley said, “We want to make sure that the people of Maryland get these services. Taking back a lot of money and allowing long-term care facilities to fail is not the solution. Pointing out these deficiencies and forcing them to improve and meet the standard is the solution.”

CommuniCare told the I-Team in an email, “We are committed to providing the best care possible to our residents and value and take seriously the feedback from the survey results. After reviewing the results, our team has already initiated comprehensive actions. The company has deployed new facility teams, invested millions in building renovations and made key management changes. In addition, we have implemented brand new processes to ensure each of our residents receives the best care and compassion they deserve and expect.”

Shirley could not confirm whether his office was investigating other CommuniCare facilities, but said, “I can say that we have a number of chains, nursing home chains and private facilities on our radar. We are aware of the problems across 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, 56, during a 2022 inspection. CommuniCare told the I-Team that the facility has improved significantly following renovations to the space and key leadership changes in management.

As for the Clinton Healthcare Center, the owner said it is currently compliant with state and federal regulations and that he has invested $7 million in renovations.

Improvements Hanna can’t confirm. He told the I-Team he got so fed up that he discharged himself early: “I left and discharged myself.” Regarding his complaints, CommuniCare said, “Due to HIPAA, we cannot comment on or confirm the identity of current or former residents. However, as a company, we always strive for excellence when it comes to the health and well-being of our residents.”