CHICAGO — A former Illinois and Florida nursing home mogul wept and pleaded for mercy last week before being sentenced to 20 years in prison for what the U.S. Justice Department called the largest single health care bribery and kickback scheme in American history.

A hearing will be held in November to determine the amount of money and property that Philip Esformes may be required to forfeit.

Esformes, who once controlled a network of more than two dozen health care facilities that stretched from Chicago to Miami, garnered $1.3 billion Medicaid revenues by bribing medical professionals who referred patients to his Florida facilities then paid off government regulators as vulnerable residents were injured by their peers, prosecutors said.

He housed elderly patients alongside younger adults who suffered from mental illness and drug addiction — sometimes with fatal results. In Esformes' Oceanside Extended Care Center in Miami Beach, "an elderly patient was attacked and beaten to death by a younger mental health patient who never should have been at (a nursing facility) in the first place," prosecutors said.

As he handed down the sentence Thursday, Judge Robert N. Scola Jr. said the length and scope of Esformes' criminal conduct were "unmatched in our community. ...Mr. Esformes violated the trust of Medicare and Medicaid in epic proportions."

But Scola meted out a punishment significantly less than the 30 years prosecutors requested, saying Esformes also had an extraordinary history of helping people in need.

Attorneys for Esformes had described him as a selfless philanthropist who had donated more than $15 million to synagogues, schools and needy individuals, often anonymously.

Said Scola: "I think he should get some consideration for his philanthropy, although it's dangerous to say because he was stealing money from Medicare, so peoplemight say hewas giving that money to charity. But the vast majority of the money he made, he made legitimately. More importantly he was a true friend to people known and unknown to him, and that is worthy of mitigation."

In arguing for a 30-year sentence, prosecutors said his years-long bribes-forpatients schemes involved the corruption of medical professionals and government regulators, and entailed grievous injuries to a massive number of elderly patients.

Prosecutor Allan J. Medina told the judge Thursday that many of Esformes' younger, drug-addicted patients spent the daylight hours wandering the streets of Miami while he collected government payments for services that were never delivered.

"Phillip Esformes used deceptive and calculated means to orchestrate a fraud of the magnitude that we have not seen before," Medina said. "People who needed to get better, who wanted to get better, they had no shot."

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