Medicaid on hold at 4 NJ families
Owners to be suspended after guilty plea to fraud
By: Amanda Wallace
NorthJersey.com
USA Today Network - New Jersey
..... The owners of four skilled nursing facilities in North Jersey will be suspended from New Jersey Medicaid starting in May after a guilty plea by parent company KBWB Operations and this former CEO Kevin Breslin to federal health care fraud and tax conspiracy charges in January, [2025] the Office of the State Comptroller said Monday. [02/10/2025]
.....
In January, 92025] KBWB Operations LLC and Breslin, of KBWB-atrium, pleaded guilty to health care fraud and tax conspiracy in an alleged scheme to divert millions of dollars in Medicaid and Medicare funds away from nursing facilities in Wisconsin for personal and other purposes. At one time, the state comptroller said, Breslin and KBWB operated about a dozen facilities in New Jersey and several others in Wisconsin and Michigan.
.....
After this guilty plea, in a letter dating February 6, [2025] the comptroller notified Little Falls-based KBWB Operations, doing business as Atrium Health and Senior Living, as well as Breslin and the other owners of KBWB Operations that, as of May7, [2025] they and their four New Jersey facilities will no longer be permitted to provide services to Medicaid beneficiaries or receive Medicaid funds as long as KBWB-Atrium and Breslin are the owners. Aside from Breslin, the owners who received suspension notices form the state comptroller were William G, Burris Jr., William G Burris III, Mary Theresa Khawly, Elia Zois and Vincent Tufariello.
..... The affected facilities were the Avalon Rehab and Care Center in Wayne, Atrium Post Acute of Wayne, Atrium Senior Living of Park Ridge and Atrium Post Acute Care of Park Ridge.
..... These facilities may remain in the Medicaid program if the current owners disassociate form them entirely, which the comptroller said means they "divest ownership or the facilities are placed under the control of a receiver or other independent party so that the suspended individuals have no access to authority over Medicaid funds,"
..... This action marks only the latest attempt to remove nursing home owners from Medicaid due to evidence of fraud or irresponsible management, the comptroller's report said. the comptroller has taken action against the owners and administrators of seven other New Jersey nursing homes over about the last 12 months.
..... For example, the owners and operators of South Jersey Extended Care, the state's worst-rated nursing home, improperly funneled millions of dollars of Medicaid funds into their own business and personal charities, "leaving residents to live in a dismal, understaffed, and under-resourced facility."
.....
"Again and again, we are seeing owners and operators of medicaid-funded nursing homes in New Jersey engaging in massive fraud. That's causing real harm to the vulnerable resident who rely on Medicaid. The fraud is also wasting taxpayer dollars," said acting State Comptroller Keven Walsh. "This is a systematics problem, and it needs to be treated as one."
.....
The December [2024] report made several recommendation to the Department of Human Services, the Department of Health and the Legislature to protect the integrity of Medicaid, the comptroller said.
..... Breslin and KBWB are scheduled to be sentenced in May , [2025] the comptroller said. The owners of the affected facilities have a right to challenge their suspension and disqualification from Medicaid.