Nursing Home Operator sentenced for defrauding medicaid

A South Carolina nursing home operator pleaded guilty to Defrauding $1,000,000+ from State Medicaid Program. The case is connected to nursing homes in Aiken, Bishopville, Fork, Florence, Kingstree and Fountain Inn.

Attorney General Alan Wilson announced Richard C. Cooke, 53, of Lake View, pleaded guilty in Richland County General Sessions Court on Wednesday to six indictments arising from his fraudulent activity in the operation of six nursing homes.

Cooke pleaded guilty to two indictments charging him with Forgery, a felony, and four indictments charging him with Medical Assistance Provider Fraud, a misdemeanor.

Cooke, a resident of Dillon County, was a key figure in Cooke Management Company, Inc., of Lake View, which operated the six nursing homes.

Under South Carolina Medicaid regulations, nursing homes are required to submit annual operational cost reports for their facility.

The Medicaid program pays the nursing home based on that, and on the number of Medicaid residents.

From 2009 through 2011, the six nursing homes were overpaid a total of $1,020,818.34 as a result of the fraudulent items listed on cost reports submitted to the Medicaid program.

Under the terms of a plea agreement, Cooke was required to plead guilty to the charges, to make restitution of $1,020,818.38 to the South Carolina Medicaid program, to be excluded from the Medicaid program for life, and to cooperate with the ongoing investigation by the Attorney General's office.

Cooke was sentenced by the Honorable L. Casey Manning, Circuit Judge, to 10 years on the two forgery indictments to run concurrently, suspended to five years probation.

Probation conditions include house arrest for one year and 500 hours of community service, plus full restitution.

On the four Medicaid fraud counts, Cooke was sentenced to three years on each to run concurrently, all suspended.

He presented two checks totaling $500,000.00 toward his restitution.

Attorney General Alan Wilson said after Cooke was sentenced: "Fraud committed against the Medicaid program deprives funds needed to pay for medical services, including nursing home care, for elderly citizens who can't afford it otherwise. As a result of this investigation and prosecution, the over payments will be repaid and the defendant will never again own or manage a nursing home facility. I commend the excellent work done by the State Auditor's office in uncovering this fraud, and for their cooperation, along with that of the South Carolina Department of Health and Human Services. This case shows how state agencies can work together for the benefit of South Carolina taxpayers."