This is stunning in its scope and made me wonder in what other developed country is it even possible for a citizen to defraud its government of over 1 billion dollars?

The skilled nursing system in this country is broken, with no meaningful oversight other than an annual inspection which everyone knows is coming. Lengths of stay are unnecessarily long and the quality of care is unbelievably sub par. Despite all of this, fraud at this level is pretty astounding, and should serve as a wake up call for the government to more aggressively monitor all facilities, or outsource monitoring from the States to private agencies.