Nurses Sue Ohio Staffing Firm Over Hefty Quitting Fees

Two nurses and a licensed physical therapist (PT) originally from the Philippines have filed a proposed class action lawsuit against an Ohio staffing firm, claiming its contracts and practices amount to trafficking and fraud, among other allegations.

The lawsuit claims that Cincinnati-based Health Carousel, which recruits and hires healthcare workers primarily from the Philippines to work in the U.S., employs its workers in “essentially indentured servitude.”

“Health Carousel mandates that its workers not leave the company for years unless they pay the company tens of thousands of dollars,” a complaint filed on behalf of Novie Carmen, RN, Kersteen Flores, RN, and licensed PT Jerlin Amistoso states. “And the company follows through on its threats by suing workers who dare to leave anyway.”

Earlier this month, a Bloomberg investigation first shed light on the case and Carmen, the original nurse behind it.

“I was basically trapped,” Carmen told Bloomberg. “Duped.”

According to the Bloomberg report, Carmen borrowed money from her boyfriend to help pay the $20,000 “quitting fee” and break ties with Health Carousel.

Carmen, Flores, and Amistoso now claim in their lawsuit that Health Carousel knows its workers must partake in lengthy orientation sessions and work overtime, but that the company doesn’t count those hours toward their required commitment period. The lawsuit adds that, “to make these workers feel even more vulnerable,” Health Carousel isolates them and prohibits them from discussing their pay and working conditions with others.

According to the complaint, Health Carousel maintains its scheme through defrauding the federal government, which approves its visa petitions without knowing it routinely fails to pay workers the wage it promises, and defrauding the workers themselves — who are unexpectedly subject to harsh employment terms, difficult workplace conditions, long work requirements, and stringent rules.

The complaint adds that Health Carousel continues to profit from its alleged scheme because healthcare facilities at which workers are placed pay the company more than what it pays its workers, and the company recoups even more money from workers who leave before the company determines they have completed their commitment period.

The lawsuit seeks to end what it claims are Health Carousel’s illegal practices and to compensate victims through forced labor claims under federal and state law, claims under the Racketeer Influenced and Corrupt Organizations Act and Ohio’s Corrupt Practices Act, and claims under the Fair Labor Standards Act.

Ultimately, Carmen, Flores, and Amistoso allege their circumstances aren’t unique. The Cincinnati Enquirer reported that at least 20 nurses in Pennsylvania alone, where Carmen was placed at a hospital by Health Carousel in 2018, have paid high financial penalties in recent years, according to the lawsuit.

Of Health Carousel, the Enquirer reported that the staffing firm has made the Deloitte Cincinnati 100 list of the region’s largest privately held companies for the past 5 years. “In the latest ranking, the company dropped from 39 to 45 on the list, reporting a revenue of $288 million in 2020,” the Enquirer wrote. “It hauled in $301 million in 2019.”

Legal counsel for Carmen, Flores, and Amistoso did not immediately provide additional comment on the case.

A spokesperson for Health Carousel, which has denied the allegations against it in court documents, told MedPage Today in an email that, “Unfortunately, we cannot comment on the specifics of ongoing litigation, but we are confident we will be successful in this matter.”

The spokesperson also pointed to a statement posted on the company’s website that includes the following: “For our part, ensuring the health, safety and well-being of every one of our nurses is the core of our business. To imply otherwise, based on activists intent on exploiting and twisting the experiences of a few, is disheartening and damaging. But more than that, it is simply inaccurate and a grave insult to the millions of people worldwide who continue to be victimized by traffickers.”

The company also posted a list of answers to frequently asked questions, one of which includes information on why nurses have to reimburse expenses when they break a contract. To that end, Health Carousel states in part that, “Requiring repayment of invested expenses and other damages if an employee does not fulfill a service obligation is not a ‘quitting fee’ or a penalty. Rather, it is a customary, reasonable and fair practice that many employers use in a range of industries and occupations to recoup investment in tuition reimbursement, relocation expenses, signing bonuses and more.”

Health Carousel added that the expenses it expects healthcare professionals to reimburse should they not complete their contracts “approximates or underestimates” its upfront investment on their behalf. “For example, when healthcare professionals do not complete the commitment period in the contract, the nurse retains his or her permanent resident visa to work in the United States, but Health Carousel suffers a financial loss because it cannot earn back the money it had advanced for their recruitment, credentialing, sponsorship, relocation and resettlement, and employment,” the company stated.

Trump’s pardons included healthcare execs behind massive frauds

At the last minute, President Donald Trump granted pardons to several individuals convicted in huge Medicare swindles that prosecutors alleged often harmed or endangered elderly and infirm patients while fleecing taxpayers.

“These aren’t just technical financial crimes. These were major, major crimes,” said Louis Saccoccio, chief executive officer of the National Health Care Anti-Fraud Association, an advocacy group.

The list of some 200 Trump pardons or commutations, most issued as he vacated the White House this week, included at least seven doctors or health care entrepreneurs who ran discredited health care enterprises, from nursing homes to pain clinics. One is a former doctor and California hospital owner embroiled in a massive workers’ compensation kickback scheme that prosecutors alleged prompted more than 14,000 dubious spinal surgeries. Another was in prison after prosecutors accused him of ripping off more than $1 billion from Medicare and Medicaid through nursing homes and other senior care facilities, among the largest frauds in U.S. history.

“All of us are shaking our heads with these insurance fraud criminals just walking free,” said Matthew Smith, executive director of the Coalition Against Insurance Fraud. The White House argued all deserved a second chance. One man was said to have devoted himself to prayer, while another planned to resume charity work or other community service. Others won clemency at the request of prominent Republican ex-attorneys general or others who argued their crimes were victimless or said critical errors by prosecutors had led to improper convictions.

Trump commuted the sentence of former nursing home magnate Philip Esformes in late December. He was serving a 20-year sentence for bilking $1 billion from Medicare and Medicaid. An FBI agent called him “a man driven by almost unbounded greed.” Prosecutors said that Esformes used proceeds from his crimes to make a series of “extravagant purchases, including luxury automobiles and a $360,000 watch.”

Esformes also bribed the basketball coach at the University of Pennsylvania “in exchange for his assistance in gaining admission for his son into the university,” according to prosecutors.

Fraud investigators had cheered the conviction. In 2019, the National Health Care Anti-Fraud Association gave its annual award to the team responsible for making the case. Saccoccio said that such cases are complex and that investigators sometimes spend years and put their “heart and soul” into them. “They get a conviction and then they see this happen. It has to be somewhat demoralizing.”

Tim McCormack, a Maine lawyer who represented a whistleblower in a 2007 kickback case involving Esformes, said these cases “are not just about stealing money.”

“This is about betraying their duty to their patients. This is about using their vulnerable, sick and trusting patients as an ATM to line their already rich pockets,” he said. He added: “These pardons send the message that if you are rich and connected and powerful enough, then you are above the law.”

The Trump White House saw things much differently.

“While in prison, Mr. Esformes, who is 52, has been devoted to prayer and repentance and is in declining health,” the White House pardon statement said.

The White House said the action was backed by former Attorneys General Edwin Meese and Michael Mukasey, while Ken Starr, one of Trump’s lawyers in his first impeachment trial, filed briefs in support of his appeal claiming prosecutorial misconduct related to violating attorney-client privilege.

Trump also commuted the sentence of Salomon Melgen, a Florida eye doctor who had served four years in federal prison for fraud. That case also ensnared U.S. Sen. Robert Menendez (D-N.J.), who was acquitted in the case and helped seek the action for his friend, according to the White House.

Prosecutors had accused Melgen of endangering patients with needless injections to treat macular degeneration and other unnecessary medical care, describing his actions as “truly horrific” and “barbaric and inhumane,” according to a court filing.

Melgen “not only defrauded the Medicare program of tens of millions of dollars, but he abused his patients — who were elderly, infirm, and often disabled — in the process,” prosecutors wrote.

These treatments “involved sticking needles in their eyes, burning their retinas with a laser, and injecting dyes into their bloodstream.”

Prosecutors said the scheme raked in “a staggering amount of money.” Between 2008 and 2013, Medicare paid the solo practitioner about $100 million. He took in an additional $10 million from Medicaid, the government health care program for low-income people, $62 million from private insurance, and approximately $3 million in patients’ payments, prosecutors said.

In commuting Melgen’s sentence, Trump cited support from Menendez and U.S. Rep. Mario Diaz-Balart (R-Fla.). “Numerous patients and friends testify to his generosity in treating all patients, especially those unable to pay or unable to afford healthcare insurance,” the statement said.

In a statement, Melgen, 66, thanked Trump and said his decision ended “a serious miscarriage of justice.”

“Throughout this ordeal, I have come to realize the very deep flaws in our justice system and how people are at the complete mercy of prosecutors and judges. As of today, I am committed to fighting for unjustly incarcerated people,” Melgen said. He denied harming any patients.

Faustino Bernadett, a former California anesthesiologist and hospital owner, received a full pardon. He had been sentenced to 15 months in prison in connection with a scheme that paid kickbacks to doctors for admitting patients to Pacific Hospital of Long Beach for spinal surgery and other treatments.

“As a physician himself, defendant knew that exchanging thousands of dollars in kickbacks in return for spinal surgery services was illegal and unethical,” prosecutors wrote.

Many of the spinal surgery patients “were injured workers covered by workers’ compensation insurance. Those patient-victims were often blue-collar workers who were especially vulnerable as a result of their injuries,” according to prosecutors.

The White House said the conviction “was the only major blemish” on the doctor’s record. While Bernadett failed to report the kickback scheme, “he was not part of the underlying scheme itself,” according to the White House.

The White House also said Bernadett was involved in numerous charitable activities, including “helping protect his community from COVID-19.” “President Trump determined that it is in the interests of justice and Dr. Bernadett’s community that he may continue his volunteer and charitable work,” the White House statement read.

Others who received pardons or commutations included Sholam Weiss, who was said to have been issued the longest sentence ever for a white collar crime — 835 years. “Mr. Weiss was convicted of racketeering, wire fraud, money laundering, and obstruction of justice, for which he has already served over 18 years and paid substantial restitution. He is 66 years old and suffers from chronic health conditions,” according to the White House.

John Davis, the former CEO of Comprehensive Pain Specialists, the Tennessee-based chain of pain management clinics, had spent four months in prison. Federal prosecutors charged Davis with accepting more than $750,000 in illegal bribes and kickbacks in a scheme that billed Medicare $4.6 million for durable medical equipment.

Trump’s pardon statement cited support from country singer Luke Bryan, said to be a friend of Davis’.

“Notably, no one suffered financially as a result of his crime and he has no other criminal record,” the White House statement reads.

“Prior to his conviction, Mr. Davis was well known in his community as an active supporter of local charities. He is described as hardworking and deeply committed to his family and country. Mr. Davis and his wife have been married for 15 years, and he is the father of three young children.”

CPS was the subject of a November 2017 investigation by KHN that scrutinized its Medicare billings for urine drug testing. Medicare paid the company at least $11 million for urine screenings and related tests in 2014, when five of CPS’ medical professionals stood among the nation’s top such Medicare billers.