United States of America v. Northern Adult Daily Health Care Center

CourtDistrict Court, E.D. New York
DecidedAugust 16, 2021
Docket1:13-cv-04933
StatusUnknown

This text of United States of America v. Northern Adult Daily Health Care Center (United States of America v. Northern Adult Daily Health Care Center) is published on Counsel Stack Legal Research, covering District Court, E.D. New York primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States of America v. Northern Adult Daily Health Care Center, (E.D.N.Y. 2021).

Opinion

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK ------------------------------------x

UNITED STATES OF AMERICA and NEW YORK STATE ex rel. ORLANDO LEE, MELVILLE LUCKIE and LUZ GONZALEZ, MEMORANDUM & ORDER 13—CV—04933(EK)(RER) Plaintiffs,

-against-

NORTHERN METROPOLITAN FOUNDATIONN FOR HEALTHCARE, INC., NORTHERN MANOR MULTICARE CENTER, INC. and NORTHERN MANOR ADULT DAY HEALTH CARE PROGRAM,

Defendants.

------------------------------------x ERIC KOMITEE, United States District Judge: Relators filed this qui tam action in 2013 against several affiliated companies (collectively, “Northern” or Defendants). Northern operated an adult day healthcare center in Park Slope, Brooklyn, along with other facilities. The Relators allege that at the Brooklyn facility, Northern discriminated against non-Russian registrants on the basis of national origin and provided all its registrants substandard care.1 After the federal and New York State governments declined

1 New York regulations define a “registrant” of an adult day health care program as a person: “(1) who is not a resident of a residential health care facility; is functionally impaired and not homebound; and requires supervision, monitoring, preventative, diagnostic, therapeutic, rehabilitative or palliative care or services, but does not require continuous 24-hour-a-day inpatient care and services; (2) whose assessed social and health care needs can satisfactorily be met in whole or in part by the delivery of appropriate services in the community setting; and (3) who to intervene, the case proceeded to discovery, which began in January 2017 and closed in October 2017. A bench trial commenced on June 21, 2021.

This Order memorializes certain of the Court’s pre- trial rulings on Defendants’ motions in limine. These rulings precluded relators from introducing (i) documents they obtained from the New York State Department of Health in March 2021 — more than three years and four months after the close of discovery, and only three months before trial; and (ii) testimony from a former dietician at Northern named Leslie Rosen, whose name Relators disclosed to Defendants in April 2021 (again, long after discovery had closed) despite having had the name in their possession all along. I explain those decisions, among certain other evidentiary-related issues, more fully here. Background

A. Department of Health Witness

In August 2019, almost twenty-two months after the close of discovery, the parties filed a proposed joint pretrial order (“JPTO”). ECF No. 117. In that document, the Relators indicated — for the first time — their intention to call a witness from the New York State Department of Health (“DOH”). According to Relators, this witness (who remained unnamed) would

has been admitted to adult day health care program based on an authorized practitioner’s order and the adult day health care program’s interdisciplinary comprehensive assessment.” 10 N.Y.C.R.R. § 425.1. provide testimony going to the “materiality” element of a claim under the federal False Claims Act and its New York State analogue. See Universal Health Srvs. v. United States ex. rel. Escobar, 136 S. Ct. 1989 (2016) (in False Claims Act cases, “a

misrepresentation about compliance with a statutory, regulatory, or contractual requirement must be material to the Government's payment decision in order to be actionable”). Specifically, the DOH witness would testify that “discriminatory treatment of Medicaid beneficiaries is material to the State’s decision to reimburse claims for payment.” Relators’ Br. at 5, ECF No. 125; see also Proposed Joint Pretrial Order, ECF No. 117 (DOH witness would testify to “how racial, religious and ethnic discrimination is viewed by the agency”). After the Defendants objected, I directed the Relators to provide a more detailed summary of the DOH witness’s expected testimony, see June 9, 2020 Min. Entry, ECF No. 143, and to make

efforts to identify the particular witness whom the Relators intended to call, see Oct. 13, 2020 Min. Entry, ECF No. 147. Relators ultimately reported, however, that their efforts to secure a DOH witness had been unsuccessful. Dec. 11, 2020 Tr. 10:14-18, ECF No. 209 ([Relators’ Counsel]: “I think I should tell you that [the Department of Health’s] position is because of COVID and other things, they really can’t afford or don’t want to have someone come down and testify.”). B. Department of Health Documents and Summary Damages Chart

Also in the JPTO, Relators also indicated their intent to call a summary witness named Sanjay Shah. They advised that Mr. Shah, a certified public accountant, would testify to a damages calculation under Fed. R. Evid. 1006 (Summaries to Prove Content). In October 2019, in anticipation of this testimony, Relators filed the first iteration of a proposed trial exhibit setting out Mr. Shah’s damages calculation under Rule 1006. Relators’ Calculation of Damages Br. at 1, ECF No. 124. This first summary chart, which provided no indication of what records it purported to summarize, showed a grand total of approximately $1.78 million in damages. Relators’ Calculation of Damages Chart, ECF No. 124-1. This figure apparently represented the total Medicaid billing for non-Russian registrants between 2008 and 2012, the period alleged in the complaint. See id. (cover letter indicating that “[t]here were

13,210 days that minority registrants were discriminated against . . . .”). It emerged later that the Relators’ asserted damages derived from two different theories of liability — first, that Defendants discriminated against non-Russian registrants, and second, that Defendants violated what the Relators termed the “medical model” qualifications for Medicaid-funded adult daycare. After the Court asked, at an April 2, 2020 conference, which proportion of their asserted damages derived from which theory, the Relators submitted a revised summary chart in May 2020. That chart not only broke down the damages calculation

according to the applicable theory, however; it also substantially expanded the quantum of damages sought. The May 2020 summary chart showed approximately $2.1 million in billing for minority registrants (under the discrimination theory) and $37.1 million in billing for all registrants (under the “medical model” theory for substandard care). ECF No. 137-2. The total billing for minority registrants increased because, it appears, Relators increased the total number of days billed per each non- Russian registrant by over 2,000 days, without explanation. To compile the damages summary on the discrimination theory, Mr. Shah had to identify registrants as Russian or non- Russian. To that end, he relied on documents the Defendants had

produced in discovery — namely, Medicaid claims data and registrants’ enrollment records. Relators’ March 19, 2020 Br. at 2-3, ECF No. 160. In these records, some — but not all — of the registrants had self-identified their ethnicities. The Relators had not, however, received enrollment records for all registrants, apparently because some such records had been water-damaged in the warehouse where the Defendants were storing them. Id. For registrants for whom Mr. Shah had no enrollment record, he counted registrants with non-Russian “sounding” last names toward the damages figure. See June 8, 2021 Conf. Tr. 46:17-20. Defendants objected to this on the basis that Shah was conducting a “sur-name analysis,” which is generally

considered to be expert testimony. Defendants’ Oct. 22, 2020 Letter, ECF No. 148 3-4. The Relators informed the Court at a December 2020 conference that they planned to subpoena additional damages- related documents from the DOH. At the time, trial was scheduled for April 19, 2021.

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United States of America v. Northern Adult Daily Health Care Center, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-of-america-v-northern-adult-daily-health-care-center-nyed-2021.