MARGARET GATHMAN v. CARE ONE MANAGEMENT, LLC (L-5015-17, BERGEN COUNTY AND STATEWIDE)

CourtNew Jersey Superior Court Appellate Division
DecidedFebruary 22, 2022
DocketA-2904-19
StatusUnpublished

This text of MARGARET GATHMAN v. CARE ONE MANAGEMENT, LLC (L-5015-17, BERGEN COUNTY AND STATEWIDE) (MARGARET GATHMAN v. CARE ONE MANAGEMENT, LLC (L-5015-17, BERGEN COUNTY AND STATEWIDE)) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
MARGARET GATHMAN v. CARE ONE MANAGEMENT, LLC (L-5015-17, BERGEN COUNTY AND STATEWIDE), (N.J. Ct. App. 2022).

Opinion

NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.

SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION DOCKET NO. A-2904-19

MARGARET GATHMAN,

Plaintiff-Appellant,

v.

CARE ONE MANAGEMENT, LLC, ELIZABETH STRAUS, and THOMAS MCKINNEY,

Defendants-Respondents. ______________________________

Argued December 15, 2021 – Decided February 22, 2022

Before Judges Sumners and Firko.

On appeal from the Superior Court of New Jersey, Law Division, Bergen County, Docket No. L-5015-17.

R. Armen McOmber argued the cause for appellant (McOmber McOmber & Luber, PC, attorneys; Lauren M. Hill, of counsel and on the briefs; Peter D. Valenzano and R. Armen McOmber, on the briefs).

Michael J. Dee argued the cause for respondents (O'Toole Scrivo, LLC, attorneys; Thomas P. Scrivo and Michael J. Dee, of counsel; Nicole M. DeMuro, on the brief). PER CURIAM

Plaintiff Margaret Gathman appeals the Law Division's summary

judgment order dismissing with prejudice her first amended complaint alleging

that defendants Care One Management, LLC (Care One), Thomas A. McKinney,

and Elizabeth Straus terminated her employment in violation of the

Conscientious Employee Protection Act (CEPA), N.J.S.A. 34:19-1 to -14, and

common law under Pierce v. Ortho Pharm. Corp., 84 N.J. 58 (1980). We reverse

and remand for trial because we agree with Gathman that there are genuine

issues of material facts regarding the reasons for her termination, and that she

can decide prior to trial whether she wants to pursue her CEPA or Pierce claim.

I

In this appeal, our recitation of the facts is derived from the evidence

submitted by the parties in support of, and in opposition to, the summary

judgment motion, viewed in the light most favorable to the non-moving party,

Gathman, and giving her the benefit of all favorable inferences. Globe Motor

Co. v. Igdalev, 225 N.J. 469, 479 (2016) (citing R. 4:46-2(c)).

Care One is a management company providing services to various

post-acute nursing and assisted living facilities on the east coast, including

approximately thirty facilities in New Jersey. Gathman was initially employed

A-2904-19 2 by Care One in 2005, as a Regional Business Office Manager. After rising to

the position of Assistant Regional Controller, she resigned for personal reasons

in July 2012.

In the spring of 2015, Gathman was contacted by Care One's Chief

Strategy Officer, Timothy Hodges, about meeting with Straus, Care One's

Executive Vice President, to discuss returning to the company. According to

her, Hodges sought her out because of her past "success[] turn[ing] facilities

around and collect[ing] the monies that the company needed to operate, put[ting]

systems in place[,] and [doing] training on a broad scale." After meeting with

company executives, Straus, Michael Shea, Controller, Daniel Straus, Chairman

and Chief Executive Officer, and Alberto Lugo, Executive Vice President and

General Counsel, Gathman returned to Care One as Director of the Shared

Business Office on August 19, 2015.

A month or so later, Gathman discovered the company was exposed to

liability for violating the law by not returning overpayments. She discovered

that overpayments and security deposits owed to Medicare, Medicaid, and other

entities and individuals for residents who died were overdue. In one case, she

determined that $50,000 in a resident's personal needs checking account in one

of their facilities was illegally retained for over a year after the resident died.

A-2904-19 3 Although funds needed to be returned, she believed it was not a "number one

priority" at the time because she was more focused on the "tremendous amount

of outstanding receivables."

A couple of months later, Gathman determined she had to give attention

to refunding overpayment as well as improving the collection of money owed to

Care One. The failure to return overpayments to the federal government posed

a liability to the company under Section 1128J(d) of the Patient Protection and

Affordable Care Act, 124 Stat. 119 (2010).1 In January, February, and March

of 2016, Gathman issued reports regarding the extent of the unreturned

overpayments and liability to her supervisor, Shea. During a meeting, Shea

stated that Care One's management team would not be pleased about this

problem, and she should create a plan––without having to hire additional staff–

–to tackle the issue before presenting it to management. According to Gathman,

1 Section 1128J(d) of the Affordable Care Act, which took effect on March 23, 2010, requires a person who "has received an overpayment" from the federal government to report and return the overpayment and to provide, in writing, a reason for the overpayment. 42 U.S.C. § 1320a-7k(d)(1). The overpayment must be reported and returned within sixty days after the date on which the overpayment is "identified" or, if applicable, the date any corresponding cost report is due, whichever is later. Id. § 1320a-7k(d)(2). The requirement to report and return an overpayment within this deadline is defined as "an obligation" within the meaning of the False Claims Act, 31 U.S.C. §§ 3729-3733. Id. § 1320a-7k(d)(3).

A-2904-19 4 she kept senior management, including Straus and Lugo, abreast of her progress

on the retained funds via monthly meetings and written progress reports, and

expressed concern over the company's non-compliance in returning them,

estimated to be as much as $13 million with further investigation needed to settle

the actual amount.

In April 2016, Shea was terminated from Care One. Lugo, who informed

Gathman that Shea's termination had "to do with th[e] whole credit mess[,]"

stated she would now report to him and Straus.

On August 4, Straus advised Gathman that she was being considered for

the position of Vice President of Finance. The day before, Gathman emailed

McKinney, Lugo, Straus, Hodges, and others a report (August 3 report)

providing that she had returned "large sums of money," identified as "true

credits" owed to Medicare, Medicaid, individuals, and entities, which were

unlawfully held by Care One. Credits totaling approximately $3 million had

been returned in the first six months of 2016, roughly $500,000 a month.

Because Care One's monthly revenue for New Jersey facilities was roughly $30

to $32 million a month, Gathman believed returning the owed funds at that rate

would not "have a drastic impact on [the company's] cash flow [and] it would

help [the company] to get compliant within a year, year and a half."

A-2904-19 5 On August 12, 2016, McKinney, Senior Vice President and Deputy

General Counsel, delivered a letter––signed only by him—to Gathman stating

she was terminated that day because "of certain things that have come to light

recently, the organization has lost confidence in [her] ability to effectively

perform in [her] role" and her position was eliminated due to restructuring. In

Free access — add to your briefcase to read the full text and ask questions with AI

Related

McDonnell Douglas Corp. v. Green
411 U.S. 792 (Supreme Court, 1973)
Texas Department of Community Affairs v. Burdine
450 U.S. 248 (Supreme Court, 1981)
St. Mary's Honor Center v. Hicks
509 U.S. 502 (Supreme Court, 1993)
Maimone v. City of Atlantic City
903 A.2d 1055 (Supreme Court of New Jersey, 2006)
Ballinger v. Delaware River Port Authority
800 A.2d 97 (Supreme Court of New Jersey, 2002)
Shelcusky v. Garjulio
797 A.2d 138 (Supreme Court of New Jersey, 2002)
Pierce v. Ortho Pharmaceutical Corp.
417 A.2d 505 (Supreme Court of New Jersey, 1980)
Zive v. Stanley Roberts, Inc.
867 A.2d 1133 (Supreme Court of New Jersey, 2005)
Young v. Hobart West Group
897 A.2d 1063 (New Jersey Superior Court App Division, 2005)
Dzwonar v. McDevitt
828 A.2d 893 (Supreme Court of New Jersey, 2003)
Abbamont v. Piscataway Township Board of Education
650 A.2d 958 (Supreme Court of New Jersey, 1994)
Romano v. Brown & Williamson Tobacco
665 A.2d 1139 (New Jersey Superior Court App Division, 1995)
Klein v. UMDNJ
871 A.2d 681 (New Jersey Superior Court App Division, 2005)
Hancock v. Borough of Oaklyn
790 A.2d 186 (New Jersey Superior Court App Division, 2002)
Young v. Schering Corp.
660 A.2d 1153 (Supreme Court of New Jersey, 1995)
Massarano v. New Jersey Transit
948 A.2d 653 (New Jersey Superior Court App Division, 2008)
Brill v. Guardian Life Insurance Co. of America
666 A.2d 146 (Supreme Court of New Jersey, 1995)

Cite This Page — Counsel Stack

Bluebook (online)
MARGARET GATHMAN v. CARE ONE MANAGEMENT, LLC (L-5015-17, BERGEN COUNTY AND STATEWIDE), Counsel Stack Legal Research, https://law.counselstack.com/opinion/margaret-gathman-v-care-one-management-llc-l-5015-17-bergen-county-and-njsuperctappdiv-2022.