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Diversion

Healthcare-7
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Kevin Breslin was CEO of KBWB-Atrium and was responsible for all operations of the company and its 23 skilled nursing facilities. The primary source of income for KBWB-Atrium was Medicare and Medicaid reimbursements. From January 2015 through September 2018, KBWB-Atrium billed Medicare for more than $189 million in supposed nursing care and supplies and received more than $49 million in payments. It billed Medicaid for more than $218 million and received more than $93 million in payments. But most of those charges and funds never went to actual patient care at KBWB-Atrium.

Breslin created a health care fraud scheme that involved unlawfully diverting more than $37 million in Medicare and Medicaid funds to him and KBWB-Atrium’s executives for their own personal use. Instead of being used for the operation, management, maintenance, and care of the residents of the KBWB-Atrium Wisconsin skilled nursing facilities. Priority was made for distributions and guaranteed payments to KBWB-Atrium’s owners regardless of KBWB-Atrium’s financial situation. The diversion of funds led to inadequate care of residents, including a shortage of clean incontinence briefs, inadequate wound care supplies, inadequate cleaning supplies, and a lack of durable medical equipment and repository supplies.

Patients and the US taxpayer weren’t the only victims here. Breslin failed to pay third-party administrators monies deducted from KBWB-Atrium employees’ paychecks for insurance premiums and 401(k) plan contributions. And also directed that income taxes and employment taxes withheld from KBWB-Atrium Wisconsin employees’ paychecks not be paid over to the Internal Revenue Service (IRS). 

In 2018, under Breslin’s direction KBWB-Atium borrowed money from a company called MidCap Financial, supposedly to expand its nursing home empire across the country. But once again, Breslin diverted those funds to the company executives. Even as bills for essentials went unpaid, putting Atrium on the path to ruin.

On January 24, 2025, Breslin pled guilty to health care fraud.

Great job by the Department of Health and Human Services in this case.

Today’s Fraud of The Day is based on article “N.J. healthcare facility, CEO plead guilty to fraud, tax conspiracy” published by US News on January 24, 2025.

The Justice Department announced on Friday that a health care company and its CEO pleaded guilty to one count of fraud and one count of tax conspiracy. KBWB Operations LLC and its CEO Kevin Breslin, of Hoboken, N.J., entered guilty pleas to the single count of health care fraud and one count of tax conspiracy related to the operation of numerous skilled nursing facilities.

The case is related to investigations in which Breslin was accused of diverting Centers for Medicare and Medicaid Services funds meant for the operation and management of facilities for personal expenses and other uses.

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