Enforcement · April 7, 2026 · 8 min
American Senior Communities — 89 Facilities After the CEO’s Conviction
By Robert Benard, MS, RN, CNS, AGACNP-BC, PMHNP-BC
James Burkhart was convicted of a $19.4 million fraud scheme and his sentence was commuted by President Biden. His name has been scrubbed from CMS records. But American Senior Communities still operates 89 Indiana nursing homes — with a 2.0 staffing star average, $86.8 million in related-party costs, and one facility reporting zero bedside RN hours on 67% of days.
What this post covers
This is the final post in a four-part series on the federal healthcare fraud enforcement surge of 2026. The first post laid out the timeline. The second and third posts followed the data on Joseph Schwartz's Skyline Healthcare — where the facilities went and who is running them now.
This post looks at a different chain and a different pardon. James Burkhart, the former CEO of American Senior Communities, was convicted of a $19.4 million fraud and kickback scheme. President Biden commuted his sentence in December 2024. Burkhart himself has been fully scrubbed from CMS ownership records — he does not appear in any current ownership, CHOW, or all-owners file.
But American Senior Communities is still operating. The chain runs 89 nursing homes, all in Indiana. This post examines what the enforcement and staffing data looks like across those facilities today.
The Burkhart case
James Burkhart served as CEO of American Senior Communities, one of the largest nursing home chains in Indiana. In 2016, he was charged with leading a $19.4 million fraud and kickback scheme. The scheme involved kickbacks from vendors in exchange for contracts, with proceeds flowing through a network of related entities. Burkhart was convicted and sentenced to federal prison.
In December 2024, President Biden commuted Burkhart's sentence — making him the second nursing home operator in recent years to receive executive clemency, following President Trump's commutation of Philip Esformes's sentence in 2020 and pardon of Joseph Schwartz in November 2025.
Eighteen state attorneys general referenced both Schwartz and Esformes in a February 4, 2026 letter to CMS urging stronger enforcement against for-profit nursing home operators. The letter cited private equity ownership research estimating a 10% increase in mortality and approximately 22,000 excess deaths over 12 years in PE-owned facilities.
The pardons are bipartisan. The pattern is the same: a nursing home operator is convicted of fraud, receives executive clemency, and the facilities continue operating.
ASC today: 89 facilities, all in Indiana
American Senior Communities LLC appears in current CMS ownership records as the management entity for 89 Medicare-certified skilled nursing facilities, all located in Indiana. Burkhart's name does not appear anywhere in the current data — he has been fully removed from all ownership and management records, consistent with his conviction and CMS exclusion. The Biden commutation did not restore his ownership rights.
The chain-level numbers across all 89 facilities:
- Average CMS star rating: 3.78 out of 5
- Average staffing star rating: 2.0 out of 5
- Total CMS penalties: $140,060
- Total related-party transaction costs: $86.8 million (HCRIS Worksheet A-8)
- Average nursing staff turnover: 47.7%
- Average RN turnover: 38.9%
- Average zero-RN day percentage: 5.03%
- High-risk facilities (composite ≥ 60): 0
The headline number — 3.78 average stars — looks reasonable. None of the 89 facilities crosses the high-risk threshold on the OversightReports composite risk index. But the staffing numbers tell a different story.
The staffing picture
ASC's average staffing star rating is 2.0 out of 5 — while the overall average is 3.78. That gap matters. CMS star ratings are composites of health inspections, staffing, and quality measures. A chain can hold a reasonable overall rating while running consistently low on staffing, and the staffing number is the one that reflects day-to-day conditions for residents.
Two facilities illustrate the pattern:
Hickory Creek at Peru — CCN 155406
- CMS Stars: 3/5 (overall looks fine)
- Zero-RN Days: 67.4% — two out of every three days, this facility reported zero bedside registered nurse hours
- RN Turnover: 80.0%
- Total Staff Turnover: 71.9%
- Antipsychotic Prescribing Rate: 18.8% (above both national averages)
- Related-Party Costs: $873,764 (FY2024)
- CMS Penalties: $0
Federal law requires at least 8 consecutive hours of registered nurse coverage per day in Medicare-certified SNFs (42 CFR 483.35(b)). The OIG recommended in June 2025 that CMS use Payroll-Based Journal data to flag RN staffing violations. CMS declined, citing resource constraints.
At a facility where registered nurses are absent on 67% of days and the antipsychotic prescribing rate exceeds the national average, the clinical concern is straightforward. As I noted in my CRUSH RFI public comment: zero-RN shifts create conditions in which the clinical oversight required to evaluate PRN psychotropic medication orders may not be consistently present. That assessment comes from my experience as a practicing psychiatric NP with prescribing authority.
University Nursing Center — CCN 155200
- CMS Stars: 1/5
- Composite Risk Score: 44.1/100
- Zero-RN Days: 9.8%
- Total Staff Turnover: 63.6%
- Related-Party Costs: $456,797
- CMS Penalties: $0
The lowest-rated facility in the ASC chain. One star overall, nearly 10% zero-RN days, and over 63% staff turnover.
Related-party costs across 89 facilities
ASC's 89 facilities reported $86.8 million in total related-party transaction costs on HCRIS cost reports (Worksheet A-8). Related-party transactions are payments from facilities to commonly owned entities — management companies, therapy vendors, real estate holding companies, and other affiliates.
The largest single-facility figure:
Allisonville Meadows — CCN 155786
- Related-Party Costs: $4,298,146 (FY2024)
- CMS Stars: 2/5
- Composite Risk Score: 39.8/100
- CMS Penalties: $11,190
- Antipsychotic Prescribing Rate: 17.5% (above national average)
$4.3 million in related-party costs at a 2-star facility. As I noted in my CRUSH RFI public comment, related-party transactions are disclosed annually on federal cost reports but not systematically monitored at the chain level. The CRUSH RFI (Section II.A) specifically asks about monitoring these figures at scale. When you add them up across all 89 ASC facilities, $86.8 million is flowing to related parties in a single reporting year.
Related-party transactions are not inherently fraudulent. But Burkhart's original conviction involved kickbacks from vendors — payments flowing from facility operations to related entities in exchange for contracts. That is exactly the kind of pattern that chain-level related-party monitoring is designed to detect.
The top 10 ASC facilities by composite risk
No ASC facility crosses the high-risk threshold (composite ≥ 60). The highest-risk facilities are in the 35–47 range. Here are the top 10, with links to each facility page:
| Facility | Stars | Risk | Fines | Zero-RN% | Related-Party | Turnover |
|---|---|---|---|---|---|---|
| North Park Nursing | 2 | 47.0 | $38,288 | 0.0% | $585,014 | 52.3% |
| Community Nursing & Rehab | 2 | 44.9 | $0 | 10.9% | $613,064 | 62.1% |
| University Nursing Center | 1 | 44.1 | $0 | 9.8% | $456,797 | 63.6% |
| Rosewalk Village | 2 | 42.3 | $0 | 16.3% | $882,070 | 56.5% |
| Allisonville Meadows | 2 | 39.8 | $11,190 | 0.0% | $4,298,146 | 50.0% |
| Columbia Healthcare | 2 | 39.4 | $0 | 0.0% | $785,030 | 54.1% |
| Hickory Creek at Rochester | 2 | 39.0 | $14,901 | 3.3% | $885,346 | 58.3% |
| Harcourt Terrace | 4 | 38.6 | $0 | 19.6% | $762,570 | 33.3% |
| Hickory Creek at Peru | 3 | 37.8 | $0 | 67.4% | $873,764 | 71.9% |
| Riverwalk Village | 3 | 36.5 | $0 | 10.9% | $1,115,795 | 55.0% |
Full data for all 89 ASC facilities is available on OversightReports.com.
What this series showed
Four posts. Two convicted nursing home operators pardoned by two different presidents. One chain that collapsed and scattered its 56 facilities across 11 successor operators. One chain that survived its CEO's conviction and kept operating 89 facilities. A former CFO still listed in an active management role. A family member still holding an ownership stake.
None of this required investigative journalism or FOIA requests. Every data point in this series came from public CMS files — ownership records, Change of Ownership records, penalty data, staffing data, quality measures, and cost reports. The data is collected by the federal government, published quarterly, and available to anyone willing to work through the files.
OversightReports.com exists to make that process unnecessary. The platform covers all 14,713 Medicare-certified skilled nursing facilities, drawing from 18 federal data sources. Every facility page linked in this series shows the same data that informed these posts — and anyone can verify the numbers.
What happens next: June 24, 2026
On June 24, 2026, CMS will begin publishing facility-level civil money penalty data on Care Compare for the first time. That will be the first time families can see which facilities have been fined, and how much, without using a tool like this one. A post on that data will follow in real time.
In the meantime, the CRUSH rulemaking continues. 768 comments were submitted to the public docket. If CMS convenes Technical Expert Panels, commenters are drawn from the public record. I submitted one of those comments, covering zero-RN days, antipsychotic prescribing gaps, related-party transactions, and ownership transparency — the same data points that ran through every post in this series. The full text is published here.
Source index
All primary sources referenced in this post:
Government documents
- Federal Register: CRUSH RFI (91 FR 9803)
- Regulations.gov: CRUSH docket CMS-2026-0826
- OIG: CMS Use of Staffing Data (OEI-04-22-00550, June 2025)
- 42 CFR 483.35(b): RN staffing requirement
OversightReports.com facility pages
- Hickory Creek at Peru (155406) — 67.4% zero-RN days, 18.8% antipsychotic rate
- University Nursing Center (155200) — 1-star, lowest-rated ASC facility
- Allisonville Meadows (155786) — $4.3M related-party costs
- North Park Nursing (155148), Community Nursing & Rehab (155029), Rosewalk Village (155329), Hickory Creek at Rochester (155430), Harcourt Terrace (155149), Riverwalk Village (155106), Columbia Healthcare (155224)
Robert Benard's submissions
- CRUSH RFI public comment (March 30, 2026)
- Letter to HHS OIG Deputy Inspector General Ann Maxwell (March 23, 2026)
News coverage
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