DOJ ProMedica Nursing Home Lawsuit: Allegations and Facilities

The U.S. Department of Justice has intervened in a False Claims Act whistleblower suit against ProMedica Health System and its HCR ManorCare subsidiary, accusing them of billing Medicare and Medicaid for “grossly substandard” care at four nursing homes between 2017 and 2023. The DOJ ProMedica nursing home lawsuit was filed in the U.S. District Court for the Eastern District of Pennsylvania on September 2, 2025, in a 157-page complaint. ProMedica, a Toledo-based nonprofit, has called the case “without merit” and said it will fight the claims.¹²

The case began as a qui tam action. A relator named Compton filed the original sealed complaint in 2016, and the government’s decision to intervene nearly a decade later signals it believes the allegations have merit and will now lead the prosecution. The case is captioned United States, et al., ex rel. Compton v. HCR ManorCare, Inc., et al., No. 16-cv-0851. The investigation was run jointly by the DOJ’s Civil Division Fraud Section, the U.S. Attorney’s Office for the Eastern District of Pennsylvania, and the HHS Office of Inspector General.¹

What the Government Alleges

The complaint says the four facilities violated the Nursing Home Reform Act and then submitted claims to Medicare and Medicaid for care that was either never delivered or so deficient it was effectively no care at all.

On the ground, the allegations describe residents going without basic services. Staff failed to develop or follow individualized care plans. Residents did not receive adequate wound care and developed preventable pressure ulcers. Required bathing and showers were skipped. Residents were not helped to eat, and many lost significant weight.¹

The DOJ ties those failures to management choices. The complaint alleges ProMedica executives pushed administrators to admit more residents and expand capacity even after state regulators warned that the facilities were substandard. Administrator bonuses were reportedly tied to policies that incentivized keeping staffing low, and administrators who missed admission targets were reprimanded.³

The complaint’s sharpest allegation is that staff falsified records to cover the gaps. Employees documented services as delivered when they were not, in some cases attributing care to workers who were not on shift. Those records, the government says, were then used to support the bills sent to Medicare and Medicaid.³¹

Assistant Attorney General Brett A. Shumate said the lawsuit “sends a clear message that we will pursue health care providers who fail to meet their legal obligations,” and that the alleged care placed residents at “serious risk of harm.”⁴

The Four Facilities Named

The complaint focuses on four skilled nursing facilities ProMedica owned and controlled from 2018 to 2023:

ProMedica Skilled Nursing and Rehabilitation – Pottstown, in Pottstown, Pennsylvania
ProMedica Skilled Nursing and Rehabilitation – Riverview, in South Point, Ohio
ProMedica Skilled Nursing and Rehabilitation – Greenville East, in Greenville, South Carolina
ProMedica Skilled Nursing and Rehabilitation – Imperial, in Imperial, Virginia

At its peak, ProMedica operated more than 200 nursing facilities. These four were among 147 skilled nursing homes ProMedica transferred to a Welltower–Integra Health joint venture in late 2022 when it exited the nursing home business.⁵

The Legal Theory

The case rests on the False Claims Act, the federal government’s main tool for recovering money lost to fraud. In healthcare, the FCA reaches providers who bill Medicare or Medicaid for services never provided, or for care so deficient it amounts to no real service.

The DOJ is leaning on two theories that federal courts in the Eastern District of Pennsylvania have already accepted in similar nursing home cases. The first is the “worthless services” doctrine: care so grossly negligent that it provides no real benefit is treated as no care, and billing for it is fraudulent. The second is “implied false certification”: by submitting a claim, a facility implicitly certifies compliance with the Nursing Home Reform Act’s care requirements, and a facility that knows it fell far short and bills anyway has made a false certification.⁶

Both theories have to clear the FCA’s materiality bar, which the Supreme Court called “demanding” in Universal Health Services, Inc. v. United States ex rel. Escobar in 2016. Courts in this district have found that failures to feed, bathe, and medically treat residents go to “the very essence of the bargain” between nursing homes and the government, satisfying that standard.⁶

ProMedica’s Response

A ProMedica spokesperson called the DOJ’s suit “without merit” and said the company would “vigorously defend against it.”²

Much of ProMedica’s public defense turns on timing. The underlying whistleblower complaints were filed in 2016 and 2017, before ProMedica owned HCR ManorCare. ProMedica and the real estate investment trust Welltower jointly acquired HCR ManorCare in a $4.4 billion deal that closed in July 2018, taking the regional Ohio health system national.⁷

ProMedica says it bought HCR ManorCare to ensure continuity of care, made “substantial investments to further elevate the high-quality of care” during its ownership, and maintained “an impressive compliance record” until the facilities were divested.⁴ The DOJ’s complaint, however, covers conduct running through 2023, which sits squarely inside ProMedica’s ownership period.

Where the Case Stands and What’s at Stake

The DOJ filed its complaint in intervention on September 2, 2025, and the case is in early stages. No trial date, settlement, or ruling on the merits has been reported. The government has said its damages run into the millions but has not publicly disclosed specific monetary demands. Under the False Claims Act, the government can seek treble damages, three times what it was defrauded, plus civil penalties for each false claim submitted. The DOJ has emphasized that the claims are allegations only and that no liability has been determined.¹

A Broader Federal Push

The ProMedica case fits a pattern of aggressive federal enforcement against nursing home operators. False Claims Act recoveries reached a record $6.8 billion in fiscal year 2025, with $5.7 billion tied to healthcare, and the DOJ opened 401 new independent investigations that year rather than waiting for whistleblowers.³ In a closely related case in the same court, the DOJ in June 2025 reached a $3.61 million settlement with the American Health Foundation and three of its nursing homes over similar allegations of grossly substandard care between 2016 and 2018, along with a five-year Corporate Integrity Agreement with the HHS Office of Inspector General. Deputy Assistant Attorney General Brenna Jenny said the DOJ “will not tolerate nursing homes — or their owners or managing entities — abdicating these responsibilities and seeking taxpayer funds to which they are not entitled.”⁸

1
U.S. Department of Justice. United States Intervenes and Sues ProMedica Health System Inc. and Its Affiliates for Providing Grossly Substandard Nursing Home Services
2
Skilled Nursing News. DOJ Sues ProMedica Alleging Substandard Nursing Home Care
3
Healthcare Dive. Department of Justice Sues ProMedica Over Nursing Homes
4
13ABC (WTVG). DOJ Sues ProMedica for Substandard Nursing Home Services
5
McKnight’s Senior Living. Justice Department Sues ProMedica Affiliates Alleging Grossly Substandard Nursing Home Services
6
Center for Medicare Advocacy. Nursing Home Motion Denied
7
Welltower. Welltower and ProMedica Health System Complete Acquisition of Quality Care Properties and HCR ManorCare
8
U.S. Department of Justice. Ohio-Based Nonprofit and Affiliated Nursing Homes Agree to Pay $3.61M to Resolve False Claims Act Allegations