A Pediatric Nursing Home Admitted Years of Neglect. Now It Owes Medicaid $1.3 Million.

Albany, New York — New York Attorney General Letitia James says a pediatric skilled nursing facility in Albany will pay $1.3 million after state and federal investigators found years of resident neglect, chronic understaffing, and false certifications tied to Medicaid billing.

The settlement, announced Tuesday, resolves allegations against St. Margaret’s Center, a not-for-profit facility that serves chronically ill and disabled children along with other residents insured by Medicaid. Investigators said the facility certified from 2018 through 2023 that it was meeting state and federal nursing home standards while failing to provide the level of care those standards require.

Officials said the problems went beyond paperwork. According to the attorney general’s office, the facility repeatedly operated without enough staff and in one inspection failed to supervise three children, creating what regulators described as immediate jeopardy to resident health and safety. Investigators also said some residents did not receive proper respiratory care, and one resident missed anti-seizure medication twice.

The case adds to a growing enforcement push around nursing home compliance and resident safety. As federal auditors are now reviewing whether nursing homes inflated their staffing hours, state and federal investigators are also taking a harder look at whether facilities that bill Medicaid are actually meeting the care standards they certify.

Facility was placed in special federal watch program

The attorney general’s office said CMS temporarily placed St. Margaret’s in the Special Focus Facility program, a designation reserved for some of the country’s poorest-performing nursing homes. Investigators said the facility also lacked an effective compliance program, which helped lead to false claims submitted to Medicaid for payment.

Under the settlement, St. Margaret’s admitted wrongdoing and agreed to pay $1.3 million. Of that amount, $707,200 will go to New York state and $592,800 will go to the federal government. The U.S. Department of Health and Human Services Office of Inspector General will monitor the facility for five years.

The case began after whistleblowers filed a complaint under the federal and New York False Claims Acts. James said it is the fifth nursing home her office has held accountable for resident mistreatment and neglect, part of a broader effort that has stretched from before the pandemic through the years after it.