Complaint Review: Americare - Brooklyn New York

Company Profile:

The Companies: The Americare companies are a network of for-profit healthcare companies. Americare Certified Special Services Inc. ("ACSS") is a certified home health agency (CHHA) and Americare, Inc. ("Americare") is a licensed home care services agency (LHCSA) [1].

ACSS Principals: Martin "Elly" Kleinman is the President, CEO, and sole shareholder[2] of ACSS. Jack Meth and Faivish Pewzner are the Vice Presidents[3].

Americare, Inc Principals: Martin "Elly" Kleinman is the President and CEO of Americare, Inc. Jack Meth, Faivish Pewzner, and David Helfgott are the Vice Presidents. George Stern is the Executive Director[4]. 

Claim to Shame:

In October 2005, ACSS, Americare, MartinKleinman, and their employee Diane Ahearn entered into a $1.2 million settlement agreement resolving allegations against them for their role in subjecting 17 mentally-disabled residents of the Leben Home for Adults to unnecessary prostate surgeries [5].

Leben Home had contracted with ACSS and Americare to perform home health and nursing care services at the facility[6]. Diane Ahearn, an ACSS employee and "medical director" at Leben Home, took responsibility for
scheduling home health aides, acting as a liaison between LebenHome and home health aides, and acting as a liaison between nurses and doctors providing care to residents[7]. Ahearn scheduled appointments for residents with the doctor performing the unnecessary surgeries, and signed transfer forms for residents sent "to other facilities, including Parkway Hospital, where the unnecessary surgeries were performed." [8]

According to the plaintiffs, Ahearns close relationship with physicians allowed her to secure the physician approvals necessary for additional Leben House residents to receive services from Americare and ACSS, thus increasing the companies revenues [9].

According to the facts of the case, as set forth in Judge Nina Gershons July 29th, 2005 order, Ahearn accepted monetary payments from several doctors, including the doctor performing the unnecessary surgeries [10]. Ahearn was involved in obtaining the residents signatures for those surgeries [11]. The residents signed blank consent forms, with the area indicating the procedure being consented to left blank [12]. Diane Ahearn agreed to a stipulation that she would never again be employed by, or work as an independent contractor for, any health care facilities
serving individuals with developmental disabilities [13].

Additional settlements Since the Leben Home settlement, Americare has reached two multi-million dollar settlements with the Office of the Attorney General (OAG) in the span of three years.

On November 21, 2005, ACSS agreed to a $7 million settlement with theNew York State Attorney General Medicaid Fraud Control Unit in response to allegations that ACSS improperly billed Medicaid
for unnecessary medical services and personal care that were rendered to residents in adult
homes [14].

On August 21, 2008, three years after ACSS' first settlement with the OAG, the company agreed to an $8 million settlement to resolve new allegations of improper Medicaid payments to ACSS.
According to the OAG settlement agreement, ACSS billed Medicaid for home health services that were provided by unqualified home health aides. 

Financials:

ACSS and Americare, Inc. had a combined profit of more than $9 million in 2008, and more than 90 percent of ACSS funding came from Medicaid[15]. Between 2001 and 2007, ACSSs Medicaid revenue grew a stunning 788% to $173 million. [16]. 

Spending Habits:

Between 2001 and 2010, Martin Kleinman made at least $32,275 in political contributions, and between 2007 and 2010 Favish Pewzner made at least $9,950 in political contributions. David Helfgott contributed at least $8,250 between 2006 and 2007 [17]. 


Background Check:

Martin Kleinman, President and CEO of both ACSS and Americare, Inc. faced allegations of sexual harassment from a former employee, Selene Lookfong [18]. 

Current Status:

Business as usual  
 

[1] http://www.americareny.com. Retrieved 1/13/2010.

[2] Clement Bowen et. al. vs.
Jacob Rubin d/b/a Leben Home for Adults, et al. 01-cv-0070. P. 1-2.

[3] Kleinman: 2008
ACSS settlement. Meth and Pewzner obtained from Mayors Office of Contracts.
NYC Vendor Search. Retrieved 1/14/2010.

[4] Kleinman: 2008
ACSS settlement. Meth,Pewzner, Helfgott and Stern obtained from Mayors Office
of Contracts. NYC Vendor Search.Retrieved 1/14/2010. Although the NYC Vendex
indicates that David Helfgott is the CEO of ACSS, the 2008 ACSS settlement
has Kleinman listed as the CEO. There is no other documentation available that
assigns Helfgott another title.

[5] Order Approving
Settlement Agreement and Releases of Claims, Approving Amendment to the
Memorandum of Understanding, and Authorizing Payment of Settlement Proceeds
Into the CLC Pooled Trust 2, 10/28/2005; Amendment to Memorandum of
Understanding, 10/20/2005

[6] Order (denying Americare
defendants motion for summary judgment), 7/29/2005, p. 2

[7] Id., pp. 3-4

[8] Id., p. 4

[9] Plaintiffs Memorandum in
Opposition to Defendants Motion for Summary Judgment, 12/3/2004, p. 7

[10] Order (denying Americare
defendants motion for summary judgment), 7/29/2005, p. 5

[11] Id., p. 6

[12] Id., p. 6

[13] Stipulation and Order,
10/28/2005

[14] Office of the Attorney
General,"Attorney General Cuomo Announces $24 Million Medicaid Fraud
Settlement with Three Home Health Agencies," December 17, 2009.

[15]

[16] Analysis of Certified Home Health Agency Cost Reports as obtained from the New York State
Department of Health.

[17] Federal Election Commission (FEC) Campaign Finance Reports, Retrieved 1/13/2010 and the New York State Board of Elections. Campaign Financial Disclosure Reports. Retrieved
1/13/2010.

[18] Selene Lookfong vs. Americare Certified and Eli Kleinman. Complaint Number 41045/2007. Date
Filed: November 1, 2007.

 More to come.