When Private Equity Groups Own Healthcare Facilities And How to Hold them Accountable

By Jeffrey J. Downey, Esq.

As a trial lawyer for over 35 years, I have observed one constant in the United States Healthcare system. When private equity firms take over nursing homes and other healthcare facilities, the outcome is usually disastrous for the patients.

This article summarizes the exploits of a relatively new private equity group that has taken ownership of over 130 nursing homes in the United States. At the end of the article, I list the nursing homes currently affiliated with these entities and individuals, which include the H.C. Family Trust and the Zanziper Family Trust. Additional entities and individuals affiliated with these nursing facilities include the Portopiccolo Group LLC, Accordius Health LLC, Simcha Hyman, Naftalia Zanziper, Akiva Schonfeld and Natalie Zanziper. When preparing to file a claim against any nursing home, attorneys should undertake a Freedom of Information Act request to determine the owners and management companies affiliated with the defendant nursing home. If that request reveals that the nursing home is affiliated with above Trusts or individuals, there is a high probability that the nursing home is uninsured and undercapitalized.

I have handled other cases against nursing homes owned or managed by private equity firms. For example, HCR ManorCare was owned by the Carlyle Group. HCR was involved in a case filed by the Department of Justice alleging Medicare fraud. I represented the primary whistleblower in that case. After the DOJ intervened, ManorCare claimed that it was virtually insolvent. Manorcare had pushed much of its revenue up to the private equity firm, who also created a entity to lease the physical buildings back to the operating entity. This strategy makes it difficult to hold the individual operating entity liable, since that LLC is often undercapitalized on purpose. Much as been written about Private Equity firms taking over healthcare facilities. As President Biden observed, “as Wall Street firms take over more nursing homes, the quality in those homes has gone down and the cases have gone up.”

The New Yorker published an informative article on nursing facilities operated by private equity groups including Simcha Hyman and the Portopiccolo Group LLC. As the article points out, in a period of six years, Portopiccolo has amassed enough nursing homes to make it one of the top chains in the country. Some 16 of these facilities are operating in Virginia. Facilities affiliated with Simcha Hyman and Naftali Zanziper had received very high civil monetary penalties, with the average being five times the national average as of 2022.

You will not typically see the Portopiccolo Group listed as the owner or manager of any of these facilities, as they are operating behind the scenes. Typically, the owners are trusts and a second LLC is set up as the building owner. That building owner charges very high rents to the operating entity and the money is pushed back to the trusts, owners or holding companies. It’s your classic corporate shell game designed to evade personal responsibility and legal liability for their torts.

My first involvement with this group involved a wrongful death suit against Virginia nursing home, August Healthcare at Iliff, 8000 Iliff Dr., Dunn Loring VA 22027. My client developed a Stage IV pressure wound that became infected and caused her death. I filed suit against the operating entity, Dunn Loring VA Opco LLC, only to learn that its license had been recently transferred to Iliff Opco LLC. In short, it was now a defunct entity that was judgement proof. The case was removed to federal court in the Eastern District of Virginia, Tamara L. Kammerer, as Executory of the Estate of Mildren Poehner v. Dunn Loring VA Opco LLC, et al (Case No. 1:24 cv 1369). This chain typically uses “Opco” to designate the operating entity (licensee) and “Propco” to designate the landlord or building owner. Sometimes an additional “Holdo” is in the mix as a holding company.

As it turns out the facility was also uninsured, which is a violation of Virginia law. Pursuant to 12 VAC 5-371-160, all nursing homes licensed in Virginia “shall maintain liability insurance coverage in a minimum of $1 million and professional liability coverage in an amount at least equal to the recovery limit set forth in § 8.01-581.15 of the Code of Virginia to compensate residents or individuals for injuries and losses resulting from the negligent or criminal acts of the nursing facility. Failure to maintain minimum insurance shall result in revocation of the nursing facility’s license.” The typical modus operandi of this chain is to remove the case to federal court, disclose their lack of insurance and underfunded operating entity and seek settlements far below the fair value of the case. Since those settlements are always cloaked with confidentiality, the public never learns about these practices.

The purpose of this article is to educate the public about this nursing home chain and provide attorneys with a blueprint for holding the principals and owners accountable. Upon learning that the nursing home operating entity was uninsured and defunct, I filed a Motion to Amend. The Court granted my Motion to Amend. The Amended Complaint included the two Trusts that are the purported owners of the facility: the H.C. Family Trust and Zanziper Family Trust. I included additional theories of joint venture and the added the remedy of piercing the corporate veil. In federal court, unlike some state courts, a Plaintiff does not have to wait to receive a judgment before it can develop discovery supporting this remedy. I also issued a corporate designee notice to obtain information that will support my new theories of recovery. Defendant has filed a Motion for a Protective Order which I have opposed.

This litigation is ongoing and I will update my website with future decisions in this case. Attorneys encountering facilities owned by this chain should consider similar theories of recovery. Attorneys should also consider including some of the care providers and the administrator as individual defendants in the case. Staff members working in these facilities likely do not realize they are working without insurance coverage.

A list of nursing homes affiliated with this chain is set forth below.

Affiliated Nursing Facilities

Abingdon VA Opco LLC

600 Walden Road

Abingdon, VA 24210-2356

Accordius Health at Aberdeen LLC

915 Pee Dee Road

Aberdeen, NC 28315

Accordius Health at Clemmons, LLC

3905 Clemmons Rd

Clemmons, NC 27012

Accordius Health at Nans Pointe LLC

200 West Constance Road

Suffolk, VA 23434

Accordius Health at Salisbury, LLC

635 Statesville Boulevard

Salisbury, NC 28144

Accordius Health at Wilmington, LLC

820 Wellington Avenue

Wilmington, NC 28401

Accordius Health at Winston Salem, LLC

911 Brian Center Lane

Winston-Salem, NC 27106

Accordius Health at Gastonia, LLC

416 N Highland Street

Gastonia, NC 28052

Accordius Health at Concord LLC

515 Lake Concord Rd NE

Concord, NC 28025

Accordius Health at Hendersonville, LLC

200 Heritage Circle

Hendersonville, NC 28791

Accordius Health at Scotland Manor, LLC

920 Jr. High School Road

Scotland Neck, NC 27874

Accordius Health at Roanoke, LLC

324 King George Avenue SW

Roanoke, VA 24016

Accordius Health at Greensboro, LLC

1201 Carolina Street

Greensboro, NC 27401

Accordius Health at Asheville, LLC

500 Beaverdam Road

Asheville, NC 28804

Accordius Health at Rose Manor, LLC

4230 N Roxboro Road

Durham, NC 27704

Accordius Health at Mooresville LLC

752 E. Center Avenue

Mooresville, NC 28115

Accordius Health at Rutherford LLC

188 Oscar Justice Road

Rutherfordton, NC 28139

Accordius Health at Statesville LLC

520 Valley Street

Statesville, NC 28677

Accordius Health at Creekside Care LLC

604 Stokes Street E

Ahoskie, NC 28910

Accordius Health at Wilson LLC

1804 Forest Hills Rd W

Wilson, NC 27893

Accordius Health at Wilkesboro LLC

1000 College Street

Wilkesboro, NC 28697

Annandale VA Opco LLC

Leewood Healthcare

7120 Braddock Road

Annandale, VA 22003-6007

Bay Pointe Rehabilitation and Nursing LLC

1148 First Colonial Rd

Virginia Beach, VA 23454

Beck Mayfield KY Opco LLC

500 Beck Lane

Mayfield, KY 42066

Birchwood Nursing and Rehabilitation, LLC

106 Padgett Street

Clinton, KY 42031

Blue Ridge Rehabilitation and Nursing LLC

94 South Avenue

Harrisonburg, VA 22801

Boulder City NV Opco LLC

601 Adams Blvd

Boulder City, NV 89005

Brookhaven MS Opco LLC

524 Brookman

Brookhaven, MS 39601

Brynwood Operations LLC

1656 S. Jefferson Street

Monticello, FL 32344

Canton MS Opco LLC

1145 E. Tisdale

Canton, MS 39046

Covington TN Opco, LLC

1992 Hwy 51 S

Covington, TN 38019

Carolina Pines at Asheville, LLC

91 Victoria Road

Asheville, NC 28801

Carthage Opco LLC

112 Healthcare Drive

Carthage, TN 37030

Carolina Pines at Greensboro

109 S. Holden Road

Greensboro, NC 27401

The Citadel Virginia Beach, LLC

340 Lynn Shores Dr

Virginia Beach, VA

Citadel Mooresville LLC

550 Glenwood Drive

Mooresville, NC 28115

The Citadel Salisbury LLC

710 Julian Road

Slaisbury, NC 28147

Collierville Nursing and Rehabilitation, LLC

490 West Poplar Avenue

Collierville, TN 38017

Clarksdale MS Opco LLC

701 US Highway 322

Clarksdale, MS 38614

CV Louisville Opco, LLC

D/b/a Sycamore Heights Health and Rehabilitation

2141 Sycamore Avenue

Louisville, KY 40206

CV Louisville Opco, LLC

D/b/a Sycamore Heights Health and Rehabilitation

2141 Sycamore Avenue

Louisville, KY 40206

Daytona Beach FL Opco LLC

1001 South Beach Street

Daytona Beach, FL 32114

Depaul VA Opco LLC

6403 Grandby St

Norfolk, VA 23505

Douglas MI Opco LLC

243 Wiley Rd.

Douglas, MI 49406-5108

Down East Living & Rehab Center, LLC

38 Carters Road

Gatesville, NC 27938

Eastover Opco LLC

2616 E. 5th Street

Charlotte, NC 28204

Eastland Opco LLC

5939 Reddman Road

Charlotte, NC 28212

Farthing Mayfield KY Opco LLC

402 W. Farthing Street

Mayfield, KY 42066

Fulton Nursing and Rehabilitation, LLC

1004 Holiday Lane

Fulton, KY 42041

Glasgow KY Opco LLC

1002 Glenview Drive

Glasgow, KY 42141

Glen Oaks Operations LLC

1100 Pine Street

Clearwater, FL 33756

Greenville KY Opco LLC

515 Greene Drive

Greenville, KY 42345

Henrico VA Opco LLC

1503 Michaels Road

Henrico, VA 23229

Heritage Park Operations LLC

37135 Coleman Avenue,

Dade City FL 33525

Hopkinsville KY Opco LLC

950 Highpoint Drive

Hopkinsville, KY 42240

Jasper FL Opco LLC

427 15th Ave. NW

Jasper, FL 32052

JAX FL Opco LLC

8700 A C Skinner Parkway

Jacksonville, FL 32256

Jeffersontown Opco LLC

3500 Good Samaritan Way

Jeffersontown, KY 40299

Key West FL Opco LLC

5860 College Road

Key West, FL 33040

Knoxville Opco LLC

3300 Broadway NE

Knoxville, TN 37917

Lake Mariam FL Opco LLC

1801 N. Lake Mariam Drive

Winter Haven, FL 33884

Lake City FL Opco LLC

1270 SW Main Boulevard

Lake City, FL 32025

Lake Placid Operations LLC

125 Tomoka Boulevard South

Lake Placid, FL 33852

Las Vegas NV Opco LLC

2860 E Cheyenne Ave

North Las Vegas, NV 89030

Leitchfield KY Opco LLC

718 Goodwin Lane

Leitchfield, KY 42754

Longwood Operations LLC

1520 S. Grant Street

Longwood, FL 32750

Loudon Opco LLC

1520 Grove Street

Loudon, TN 37774

Lecanto FL Opco LLC

1900 West Alpha Court

Lecanto, FL 34461