A Robinson Township nursing home under federal, state and local investigation following a resident's death also might have double-billed Medicare and Medicaid for services and supplies and diverted patient care money to augment employee salaries, according to documents filed Friday in federal court by the U.S. Attorney's Office. Federal agents already were investigating the Ronald Reagan Atrium I Nursing and Rehabilitation Center when resident Mabel Taylor, 88, an Alzheimer's patient, was locked out of the 120-bed Campbells Run Road facility in 40-degree weather on Oct. 26, 2001. Taylor later died. In February 2001, the U.S. Department of Health and Human Services' Office of Inspector General learned from a nursing home contractor that Atrium, owned by the Alzheimer's Disease Alliance of Western Pennsylvania Inc., appeared to be double-billing, according to the documents filed yesterday. Atrium officials also might have diverted patient care money from the nursing home to its other nonprofit organizations to augment the salaries received by Atrium personnel. Court papers do not identify the nonprofit organizations. If the investigation leads to criminal charges, they would be the first in the Western District of Pennsylvania dealing with substandard care, U.S. Attorney Mary Beth Buchanan said yesterday. Buchanan was not specific on the types of charges or penalties the nursing home or its officials could face. Calls to Atrium President Martha F. Bell and the center's lawyer, Lawrence G. Zurawsky, were not returned yesterday. Federal investigators want to know whether the money allegedly used to augment salaries was diverted from patient care. If it was, the government's contention that Atrium provided substandard care to residents would be bolstered, court records said. It's rare for federal officials to investigate claims of substandard care at nursing homes because there are no specific federal laws that address such allegations, Buchanan said. Federal agents also have requested patient records for a man identified as the father of Atrium President Bell. "For reasons we do not yet understand but which appear suspicious, (the facility) tried to hide the fact that he was a patient," wrote Jason Coopey, special agent with the Office of Inspector General. The U.S. Attorney's Office filing was in response to Atrium's request two weeks ago that U.S. District Judge Gary L. Lancaster quash a subpoena filed by the Department of Health and Human Services for thousands of pages of documents. Zurawsky has said the subpoena was "a blatant fishing expedition" and "oppressive." In August, federal agents asked the nursing home to provide thousands of pages of records, including files for 14 residents who lived at the facility from 1996 to the present, including those of Mabel Taylor. Investigators also want to review unusual incident reports submitted to the Pennsylvania Departments of Health and Public Welfare. The records are needed to determine whether Atrium provided patients with care that meets professional standards and whether services for which claims to Medicare and Medicaid were filed were actually provided. The records of the 14 patients represent "the most egregious cases of abuse or neglect based on allegations received," according to the documents filed yesterday. Zurawsky has said Atrium is willing to comply with requests relating to the home's ownership and its directors. But he balked at all other requests, saying patients' records are private and that meeting the request would require diverting employees from patient care to photocopying and retrieving files. In May, Allegheny County Coroner Cyril Wecht recommended prosecuting Atrium management for conspiracy to obstruct justice and neglect in Taylor's death. The offense also could warrant involuntary manslaughter charges, Wecht said. District Attorney Stephen A. Zappala Jr. has not yet decided whether to follow Wecht's recommendations. During a coroner's inquest, Atrium employees testified that Bell ordered workers to carry Taylor inside, clean the blood off her and put her into bed to make it look like she died in her sleep. The FBI, IRS criminal investigators, the state Attorney General's Office and Allegheny County police are working jointly on the Atrium investigation.

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