STATE OF NEW YORK: COUNTY OF MONROE CITY COURT: CITY OF ROCHESTER ‘THE PEOPLE OF THE STATE OF NEW YORK -against- FELONY COMPLAINT BERTHA GRANDERSON AND MELINDA JONES, Defendants. STATE OF NEW YORK) COUNTY OF MONROE) SS.: CITY OF ROCHESTER) Special Investigator Arthur Vasile, employed at the Office of the New York State Attorney General’s Medicaid Fraud Control Unit (MFCU), 144 Exchange Boulevard, Suite 600, Rochester, New York, deposes and says, based upon personal knowledge and upon information and belief, the sources of which are (i) my review of the business and other records of the Maxim Health Care and of the New York State Department of Health, including Medicaid paid claim data, (ii) my review of the business records of Sonic Restaurant and ‘Tim Hortons Restaurant and (ii) an interview with the defendants BERTHA GRANDERSON and MELINDA JONES, that in the City of Rochester, County of Monroe, State of New York, BERTHA GRANDERSON and MELINDA JONES acting in concert, committed the crimes of: 1) Grand Larceny in the Fourth Degree, a class E felony in violation of section 155.30 (1) of the Penal Law of the State of New York; in that from on or about and between September 1, 2014 to April 25, 2015, defendant, acting in concert with another, and with intent to deprive another of property and appropriate the same for herself and a third person, wrongfally took, obtained and withheld property valued in excess of one thousand dollars ($1,000) from an owner thereof, to wit: the State of New York; and 2) Falsifying Business Records in the First Degree, a class E felony, in violation of section 175.10 of the Penal Law of the State of New York; in that from on or about and between September 1, 2014 to April 25, 2015, defendant, acting in concert with others, and with intent to defraud which included an intent to aid and conceal the commission of another crime, to wit: larceny, caused false entries in the business records of an enterprise; to wit: Maxim Health Care, and 3) Offering a False Instrument for Filing in the First Degree, a class E felony, in violation of section 175.35 of the Penal Law of the State of New York; in that from on or about and between September 1, 2014 to April 25, 2015, defendant, acting in concert with another, knowing that a written instrument contained false information, with intent to defraud the state, offered and presented it to a public office and publicservant with the knowledge and belief that it would be filed with, registered and recorded in, and otherwise become a part of the records of such public office and public servant. The above-listed crimes were committed as follows: defendant GRANDERSON, while employed as a personal care attendant by Maxim Health Care, and providing self-directed care to Medicaid recipient DJ., under the Consumer-Directed Personal Assistance Service Program (CDPAP), at 106 Turpin Street in Rochester, New York, on or about and between September 1, 2014 to April 25, 2015, with intent to defraud, submitted time sheets to Maxim for CDPAP services, which falsely represented that GRANDERSON had provided personal care attendant services to said Medicaid recipient D.J. Defendant JONES signed off on and approved the time sheets as the “self-directing other” for her husband Medicaid recipient DJ. As a result of the false entries and false timesheets, the defendants knowingly caused Maxim, located at 151 State Street, Rochester, New York, to submit claims to the New York State Medicaid program, which falsely represented that defendant GRANDERSON provided certain personal care attendant services to Medicaid recipient D.J., which did not occur. In reliance upon these false representations, the State of New York paid Maxim approximately $2,379.61, to which it was not entitled. Your deponent and Steven Sachman, Special Auditor Investigator (SAI) in the Office of the Attomey General, Medicaid Fraud Control Unit, reviewed and analyzed records furnished by Maxim, Sonic Restaurant, Tim Hortons Restaurant, and the New York State Department of Health. In conducting this review, approximately 34 of the defendant's CDPAP time sheets from Maxim and defendant GRANDERSON’S employee time records from Sonic Restaurant and Tim Hortons Restaurant for the above time period of her employment were analyzed and revealed that the defendant submitted time sheets to Maxim indicating that she performed 149 hours of services for Medicaid recipient D.J. while she was present and working at various times at Sonic Restaurant and Tim Hortons Restaurant during those same hours. S.A.[. Sachman’s review revealed that Maxim based upon the defendant's false time sheets, submitted Medicaid billing submissions to the State of New York for 149 hours of care services which the defendant claimed to have worked for Medicaid recipient D.J. for a total reimbursement amount of $2,379.61, to which Maxim was not entitled. In turn, Maxim paid defendant GRANDERSON a total of $1,490 in wages to which she was not entitled, for hours when the above employment records revealed that the defendant was not present at the above Medicaid recipient’s home. On each of the above 34 Maxim time sheets signed by both defendants is an attendant attestation above the attendant signature with the purported signature of Bertha Granderson and a supervisor attestation above the supervisor signature with the purported signature of Melinda Jones. Included in the attendant attestation are the following provisions: 1) “by my signature... attest that I have accurately recorded and signed this time shieet...” 2) “Social Services Law 366- b provides that any person who, with intent to defraud, presents payment for a false or fraudulent claim and knowingly submits false information...is guilty of a class “A” misdemeanor. 1 understand that recording time I did not work may result in termination of my employment, repayment to Maxim Health Care Services for fraudulently billed hours, and/or criminal prosecution.” Included in the supervisor attestation is the following provision: 1) “I understand that falsification of time sheets...may result in termination of my attendants, repayment toMaxim Health Care Services for fraudulently billed hours, and...I may also be subject to criminal prosecution.” 5 When defendant GRANDERSON was interviewed, she admitted that she falsely completed Maxim Timesheets and stated to your deponent that she worked at Sonic Restaurant and Tim Hortons during the time she also worked as a CDPAP aide for D.J. The defendant told your deponent her mother MELINDA JONES signed the time sheets even though the defendant id not work because the defendant needed the money. The defendant stated to your deponent that she knew D.J. was on Medicaid and knew the Maxim timesheets were used to bill Medicaid, When the defendant JONES interviewed, she identified to your deponent her signature and the signature of her daughter Bertha Granderson on Maxim CDPAP timesheets for the care of her relative D.J. The defendant admitted that she knew her daughter Bertha was putting hours on her Maxim timesheets for care for D.J. when Bertha was working at Sonic Restaurant and Tim Hortons. The defendant stated to your deponent that she knew her relative D.J. was on Medicaid and knew the Maxim timesheets were used to bill Medicaid. Richard Lundy, an employee of Maxim, informed your deponent that the employee hours on the timesheets submitted by the defendant were used to submit claims to the New York State Medicaid program for payment. FALSE STATEMENTS MADE HEREIN ARE PUNISHABLE AS A CLASS “A” MISDEMEANOR PURSUANT TO §210.45 OF THE PENAL LAW. Dated: April 20, 2016 4 /} 4 f f j > if [ ihe e ancl ARTHU eid New York State Attorney General’s Office