Shady Deals in the Nursing Home Industry

Levin and Associates had an interesting article in The Senior Care Investor discussing the bankruptcy and sale of IHS to THI and eventually Fundamental long Term Care Holdings LLc, owned and operated by Murray Forman and Leonard Grunstein.  Below are excerpts from the article:

Very few people remember what happened a little more than seven years ago, but in early
2003, an unknown entity (at least to the senior care world) stepped in at the last minute and snatched the remaining assets of a bankrupt Integrated Health Services (IHS) from the presumed
buyer, literally on the steps of the court house. Trans Healthcare Inc. (THI) thought it had the deal wrapped up for $97.5 million, but an entity called Abe Briarwood, backed by Cammeby’s
International, swooped in for $114 million in cash and was willing to assume the post-petition Medicaid and Medicare billing liabilities, something that made the court very happy.

We are certain that the founder of Cammeby’s, one Rubin Schron, had no idea where this initial acquisition would take him in the rough and tumble skilled nursing industry....  And, most certainly, he never thought he would now be in court pitted against a man he trusted with everything. After Cammeby’s made the winning bid at the 11th hour, THI at first tried to fight it, but then the two sides settled their differences when Cammeby’s hired THI to run the newly acquired IHS assets.  Then, in May 2004, we caught wind of an acquisition offer that was brewing for the former Mariner Health Care from none other than Cammeby’s, but under the name National Senior Care, and separate from its Integrated Health.  The purchase price for Mariner was just under $1.0 billion, and when you capitalized the lease payments, the total transaction value increased to about $1.25 billion. This resulted in a price per bed of $38,800 and a 9.2x multiple of annualized EBITDAR.  The
deal closed at the end of 2004, but perhaps the most longlasting impact on the target entity, which some time later had a name change to Sava SeniorCare, was the role that Mr. Schron’s attorney, Leonard Grunstein, came to play.
There were really two sets of problems that began to emerge. One was what transpired with the original acquisition of the Integrated Health assets and the role of Trans Healthcare, which eventually came to be known as Fundamental Long Term Care when Fundamental purchased the assets of THI, the sale of which some claim was under duress and fraudulent.  There is a separatelawsuit filed on July 1, 2010, against Leonard Grunstein, his brother Harry, Murray
Forman alleging, among other things, fraudulent conveyance, unjust enrichment, legal malpractice, fraud, breach of fiduciary duty, breach of lease agreements, tortious interference and aiding and abetting fraud. The lawsuit was filed by Allen Bodner and DMV Funding LLC and is seeking no less than $150 million in damages and no less than $300 million in punitive damages.
According to the complaint, Bodner owned 100% of DMV which purchased Cammeby’s loan to the Abe Briarwood/IHS deal, and there are 30 more pages as to what transpired among the various parties. The long and short of the complaint was that the plaintiffs believe they got screwed, to
put it bluntly, by people who were partnering with them and advising them
.
The more interesting lawsuit, but sort of related, was filed on June 22, 2010, with Rubin Schron and his various holdings as the plaintiffs against a similar cast of characters including Leonard Grunstein, Murray Forman, the law firm Troutman Sanders, and the various Sava and Mariner
affiliates. To fully appreciate how unusual this lawsuit is, one must always keep in mind that Leonard Grunstein was Rubin Schron’s attorney. ....Mr. Grunstein did much of the legal work involved in the Mariner acquisition and subsequent Opco and Propco set-ups that evolved over time.
The relationship between Mr. Schron and Mr. Grunstein dates back to the 1980s, and according to the complaint, he apparently has referred to himself as Mr. Schron’s “general counsel.” According to the complaint, Mr Schron relied on legal advice from his attorney who began to organize things to the benefit of the attorney, and on financial advisory services from Mr. Forman, who was allegedly in cahoots with Mr. Grunstein. Mr. Schron never wanted to have anything to do with operating the nursing facilities; he just wanted a steady, but increasing, rental stream from the
real estate. In the case of the Mariner acquisition, according to the complaint, Mr. Schron put all the money up and ended up owning the real estate in Propco, while Grunstein/Forman retained ownership of the operating entity created to run the facilities, and all the excess cash flow, plus they received a small share of Propco—all without investing any of their own money.  In addition, according to the complaint filed, Mr. Schron was charged $14 million for financial advice in the Mariner deal by MetCap Advisory Services, which was 25% owned by Mr. Grunstein and 25% owned by Mr. Forman.   Other allegations in the nearly 100-page complaint include loans made to Opco that were never paid back to Mr. Schron, distributions taken by the Grunstein/Forman group
totaling more than $70 million, Grunstein billing Schron for non-existent legal work, and for allegedly not giving Schron the final closing documents for the original Mariner acquisition.
One also needs to remember that all of this recent legal action is on top of several issues earlier this year, when Mr. Grunstein and Mr. Forman sued Mr. Schron for more than $100 million for allegedly misappropriating significant sums of money from various partnerships in which they all had a stake.

And don’t forget that all three of them were defendants together when the Department of Justice charged them all with accepting kickbacks from Omnicare in return for pharmacy contracts. Without admitting guilt, they settled and agreed to pay the federal government $7.8 million
and $6.1 million to certain states.

Over the past two years the owners of Sava (Mariner) have been trying to sell off various pieces of the company (or the whole thing), notably the portfolio of mostly leased assets in California, but with little success. The obvious problems were pricing and financing.  Currently, Sava is the seventh largest skilled nursing company in the country with 184 facilities and 21,279 skilled
beds, and it is larger than half of the publicly traded skilled nursing companies.   Still, we believe that selling the assets is a real outcome, especially for Mr. Schron who we assume wants to be done with his relationship with his former attorney and financial advisor, and may even want to be out of the skilled nursing real estate business altogether. The other side, however, may
still not want to give up their cash cow, but the courts and the credit markets may make the decision for them.

THI Indicted in New Mexico

Finally an Attorney General has indicted THI entities for resident abuse and neglect.   It is about time.  Hopefully, this will open the flood gates for other state attorney generals to investigate and indict these entities who have shown a pattern of neglect and careless indifference to their residents. See indictments here and here.   The indictments have a lot of factual information showing the lack of care provided to a vulnerable adult. 

Murray Forman and Leonard Grunstein own and operate Fundamental Long Term Care Holdings which own, operate, and control the hundreds of THI facilities in the U.S. managed by Fundamental Clinical Consulting (the successor company to indicted THI of Baltimore Management).

The pattern of poor care and careless indifference by Fundamental in their THI facilities is well known in the nursing home industry.  Hopefully, these indictments will change their policies and procedures but it is doubtful.

 

 

More Details to OmniCare Kickback Scheme

The Chicago Tribune had an article about new details in the OmniCare kickback scheme that included many of the country's for profit nursing home chains.  Omnicare — which supplies medicine to roughly 1.4 million nursing home residents in facilities across the U.S. and enjoys an 85 percent share of this market.  Court documents add new details to a whistle-blower lawsuit alleging that the giant pharmaceutical firm Omnicare Inc. paid kickbacks to Illinois' most prominent nursing home families.

The new filing, which contains 164 pages of internal company records and other documents, is intended to bolster pending civil allegations that Omnicare significantly inflated the purchase price it paid in 2004 for a pharmacy company purportedly controlled by Chicago nursing home operators Philip Esformes and his father, Morris Esformes.

Omnicare's $32 million purchase of that company, Total Pharmacy, included roughly $16 million that was a kickback to secure long-term pharmacy contracts with nearly three dozen nursing homes the Esformeses operated or controlled

The new documents include copies of handwritten notes from a March 2004 meeting at Morris Esformes' Lincolnwood headquarters between Omnicare CEO Joel Gemunder and Morris Esformes to discuss the sale of Total Pharmacy to Omnicare.   Gemunder offered to pay $15 million for Total Pharmacy if three-year contracts were in place with Esformes-controlled homes, $20 million if there were five-year contracts and $25 million if there were 10-year contracts. In the final sale, Omnicare paid the $25 million and let Total Pharmacy keep $7 million worth of accounts receivable, making the sale worth $32 million.

The new court filing also includes other handwritten notes taken two days after the meeting that allegedly show Morris Esformes agreed to backdate nursing home pharmacy contracts "in order to avoid the appearance of impropriety," according to the lawsuit.

Philip and Morris Esformes, who are listed as part-owners of 28 nursing homes in Illinois and Florida, and had ties to others in Missouri, have not been charged with any crime in the sale of Total Pharmacy.

The whitsle blowers include two industry insiders: pharmacy executive Maureen Nehls, who served as vice president of pharmacy operations for Total Pharmacy, and former health care dealmaker Adam Resnick, a consultant to Total Pharmacy at the time of the sale.

The Tribune in April reported that the Esformeses were embroiled in what prosecutors called a "horrific" patient-brokering scheme in which unsuspecting nursing home residents were shuttled to and from a local psychiatric hospital for unnecessary treatments. 

Government authorities in Boston have won settlements in federal court based on Resnick's information about other deals involving Omnicare and separate East Coast nursing home chains including Mariner and SavaSeniorCare owned and operated ath time by Murray Forman and Leonard Grunstein.

The False Claims Act allows private citizens to file lawsuits against companies and individuals defrauding the government and recover funds on the government's behalf.


 

Punitive Damage Verdict Against SavaSeniorCare

Congratulations to Jay Reinan who recieved a verdict and an Order allowing for punitive damages against SavaSeniorCare et al.  The case is Reigel v. SavaSeniorCare L.L.C and related companies.

On the claim of wrongful death, the jury awarded Plaintiff $75,000.00 in compensatory losses and $150,000.00 in punitive damages, for a total wrongful death verdict of $225,000.00. After reducing the punitive damages to the amount of the compensatory damages pursuant to the Court’s Order of June 16, 2010, the total wrongful death award is $150,000.00.  Total interest on the wrongful death claim is $51,151.71. The total judgment on the wrongful death claim is $201,151.71.

As to the extreme and outrageous conduct claim, the jury awarded $125,000.00 in compensatory damages and $100,000.00 in punitive damages.  Three years, four months and 24 days of pre-judgment interest on $225,000.00 at 9.0% per annum, compounded annually equals $76,727.56. The total judgment on the extreme and outrageous conduct claim is $301,727.56.

Total judgment in favor of the Plaintiff and against all Defendants shall enter in the amount of $502,879.26.

$114 million Verdict in Default Case against THI

Juanita Jackson became a resident of IHS of Florida, Auburndale, in March 2003 for short term rehabilitation. Her family planned for her to regain her strength so her children could resume caring for her at home.  Trans Healthcare Inc. and Trans Healthcare Management operated the nursing home at that time.  These companies are part of the corporate maze of sham LLCs that were created by Murray Forman and Leonard Grunstein and others to shield them from accountability.  The company is now known as Auburndale Oaks Healthcare Center.

Ms. Jackson was at risk for falls, but the facility did not take proper preventative measures to ensure she would be safe from falls. Within two weeks of her admission, she fell. She suffered a closed head trauma and fractured her upper arm, which she never fully recovered from. Due to short staffing Ms. Jackson didn't get turned enough and developed numerous pressure ulcers. They didn't give her enough to eat and drink, causing her to become malnourished and dehydrated. She was also overmedicated during her stay. Ms. Jackson was left to lie in bed so long that she developed contractures, where the muscles shrivel up, making movement even more difficult. Ms Jackson's family removed her from the nursing home in May 2003, but she died several weeks later.

Suit was filed July 2004. In May 2009, Plaintiff's Motion to Amend to Add Claim for Punitive Damages was granted. After years of delay and obstruction from the corporate defense lawyers causing unnecessary litigation costs, and days before a Pre-Trial Conference, defense counsel moved to withdraw from the case. In June the Court allowed defense counsel to withdraw.  Defendants chose not to hire counsel for trial.  The insurance money probably ran out--why else would they abandon the case after defending it for years? 

Later, Defendants declined to defend themselves, and accepted default as to liability.  The only issue at trial was the amount to compensate the family and punish the corporate owners who mismanaged the facility.  The owners have probably bled all the assets out of the companies--where did all the money go?

Lance Reins and Blair Mendes of Wilkes & McHugh tried the matter for two days before a Polk County, Florida jury and presented live testimony from three former employees, the family and a physician expert. The jury entered a $114 million verdict with Trans Health Management, Inc. and Trans Healthcare, Inc. each bearing 50% liability. The Plaintiffs elected damages in accordance with Florida law which reduced the award to $110 million.

The verdict is believed to be the largest awarded by a Polk County jury and followed allegations that Jackson’s treatment at the facility was the cause of her death and that she was injured after falling and then received other injuries from “pressure sores, overmedication, malnourishment, and dehydration,” said The Ledger.

 

 

Another Lawsuit involving Forman and Grunstein

According to the AmLaw Daily, another disgruntled investor has filed a civil suit against Troutman Sanders, real estate partner Leonard Grunstein, and corporate partner Lawrence Levinson.   Also named as defendants are Murray Forman, an investment banker and business partner of Grunstein's, Harry Grunstein, the lawyer's brother, along with several entities created and controlled by the defendants that operate and control nursing home and health care investments.
The action comes after the three were named as defendants in a civil suit filed in state court in Manhattan by New York real estate investor Rubin Schron.

In this latest lawsuit, filed in New York State Supreme Court, plaintiff Allen Bodner accuses the defendants of legal malpractice and breach of fiduciary duty as part of a scheme to divest Bodner and a company he controlled of an interest in a lucrative health care and real estate venture.

Bodner's 54-page complaint claims Grunstein, the former head of Troutman's real estate capitalization and investment practice groups, "accounted for a substantial portion of the revenues of Troutman's New York office, much of which was attributable to the legal representation of Rubin Schron and companies associated with him."   Grunstein served as his attorney and was the "mastermind" and "legal architect" behind a series of transactions named in the complaint. Bodner further claims that Grunstein concealed his "conflicting personal financial interests" in several of those transactions, which allowed Grunstein and the other defendants to misappropriate "the real estate and health care assets" that were under the control of Bodner and his holding company.

According to a letter filed by Coles in the Schron suit, several firms have lined up advisory roles as the litigation expands. Arent Fox, Latham & Watkins, Atlanta's Arnall Golden Gregory, and New York's Brodegaard & Simone are representing several companies named as defendants in the dueling civil suits. Grunstein's brother, Harry, who now lives in Israel, has retained New York's Davidoff Malito & Hutcher, while Troutman and Levinson have turned to New York's Friedman Kaplan Seiler & Adelman.
 

What a Tangled Web They Weave

Nursing home partners in the ownership and operation of hundreds of nursing homes are fighting and suing each other for the fraud they have perpetuated for the last decade.   New York real estate investor and nursing home owner/operator Rubin Schron is suing his partners (in fraud) Troutman Sanders, Leonard Grunstein, and Murray Forman.  See Complaint here.

Schron accuses Troutman, Grunstein, and Murray Forman of breaching their fiduciary duties to benefit themselves at Schron's expense, according to this report by Bloomberg.  The Am Law Daily reported on federal charges against Schron, Grunstein, and Forman over their involvement in a $50 million kickback scheme with nursing homes and pharmaceutical providers. In February all three reached a $14 million civil settlement with federal prosecutors in Boston. 

"This case is about the systemic exploitation by self-interested attorneys and bankers of clients who entrusted them to devise and implement the terms of complex business deals that these defendants arranged and advocated for their clients," states Schron in his 97-page complaint.  Grunstein served as principal outside legal adviser to the real estate investor and his companies from the 1980s until late last year. The suit accuses Grunstein of causing "hundreds of millions in dollars of damages" to Schron.  Also named as defendants are Grunstein's brother and business associate, Harry Grunstein, and Troutman M&A and project finance partner Lawrence Levinson. 

"Grunstein facilitated his tortious conduct by his association with these firms," states Schron's complaint. "Grunstein frequently used their letterhead for his schemes, and he was assisted by the active complicity of several partners, including defendant Levinson. In reward for facilitating Grunstein's misdeeds, these law firms received tens of millions of dollars in legal fees from Schron and the Schron Entities."

The complaint further claims that Grunstein and Forman brought investment opportunities to Schron that they themselves took stakes in without contributing cash or assuming risk. Schron claims that he alone bore the risk from these transactions, with Grunstein and Forman later becoming involved in a series of deals in the nursing home business that drew the attention of federal prosecutors.

The trio have been caught up in a tangle of litigation. Grunstein and Forman filed suit against Schron in March, claiming he misappropriated funds from entities created by the two business partners and failed to keep and maintain audited financial statements.  "Underlying all of the claims in this action is Schron's pattern of betraying the trust placed in him," state Grunstein and Forman in their 38-page complaint,. Grunstein and Forman are seeking $100 million in damages from Schron, several of his relatives, and their affiliated holding companies. 
 


 

Omega Healthcare

Modern Healthcare has an article about real estate investment trust Omega Healthcare exercising its option to acquire 63 long-term-care facilities from affiliates of CapitalSource, a Chevy Chase, Md.-based commercial lender, for about $295 million.

It is unclear which nursing homes were purchased.  Omega is involved in several different nursing home chains including Fundamental Long Term Care Holdings owned by Murray Forman and Leonard Grunstein.

Sava Senior Care owners sue each other

Another lawsuit involving nursing home owners and operators Murray Forman, Leonard Grunstein, and Rubin Schron.  Forman and Grunstein are accusing Schron of  treating their company as "his personal piggy bank" and looted it for more than $100 million.   Rubin Schron first fattened his piggy bank in 2006, with $40 million that he claimed was repayment of a capital contribution from CAM-Elm Co., his family-owned business that's majority owner of plaintiff SMV Property Holdings.

Schron took $66 million more in 2008 and 2009 to recoup money he lost in personal investments, including rate swaps with Citibank, shareholders say in New York County Court.  Schron's eight children were majority owners of CAM-Elm, giving them the right to remove their father from his position, but since they did not, the plaintiffs say, they are suing them too.

"Schron is not content with the substantial economic returns that he, his family, and his companies have "legitimately" earned. Instead, Schron has resorted to theft, improper accounting manipulation, and more, against those who trusted him and relied on him," the complaint states.

Schron has also accused Leonard Grunstein and Murray Forman of "stealing from the company," so they added a defamation charge to the claims of misappropriation.   Of course, truth is the ultimate defense to defamation.

The plaintiffs seek an accounting and $105 million in damages and want Schron booted from his position and new managers appointed.  See full Complaint here.

Another Sava Senior Care Lawsuit

The West Virginia Record had an article recently about the lawsuit against another Sava Senior Care facility owned and operated by Murray Forman and Leonard Grunstein and others.  Defendants include six companies, an individual and multiple unknown individuals and entities for negligence in a nursing home. Canyon Sudar Partners, SVCare Holdings, Sava Senior Care, SSC Equity Holdings, SMV Management Company, SMV Huntington and Unidentified Entities 1 through 10 are the companies named in the law suit. Huntington Health and Rehabilitation Administrator, Annica Stansberry, and John Does 1 through 10 were also named in the suit.

Faith Cole claims Ruth Haynie was a resident of Huntington Health and Rehabilitation from Sept. 20 until Nov. 1, according to a complaint filed Feb. 25 in Cabell Circuit Court. Cole claims the defendants were aware of Haynie's medical condition and the care she required, but that during her stay, Haynie experienced falls, a fracture and a subdural hematoma.

Cole claims the defendants owed a duty to residents to exercise reasonable care in providing oversight and management of the nursing home.

The defendants breached their duty by failing to properly manage, operate and/or control the nursing home in a manner that a reasonably careful person/corporation would have provided.

Cole is seeking compensatory damages. She is being represented by James B. McHugh and Michael J. Fuller Jr.

 

Poliakoff & Associates, P.A., is one of South Carolina’s most respected and distinguished law firms. The Poliakoff firm began nearly 60 years ago by three attorney brothers: Matthew, J. Manning, and Bernard. With a history of believing the justice system...More...