LOS ANGELES — Federal regulators inspected multiple suites at Merabi Professional Medical Plaza in Los Angeles between 2021 and 2025 and found nearly 400 violations at 75 companies. The three-story, 32,000-square-foot stucco and glass office building houses 89 licensed hospice companies alongside a salon, a law office, a modeling agency, and a realty corporation.

State auditors consider geographic clustering of hospice agencies in one location a major red flag for potential fraud, according to a 2022 California State Auditor's report. Seventy-two of the 89 registered hospices in the building have at least three of the six potential fraud warning signs identified by auditors.

A 2022 California State Auditor's report listed low patient counts, high rates of terminally ill patients later discharged alive, excessive billing, and staff shared across multiple companies as warning signs for potential hospice fraud.

Federal inspection records documented several practices. One inspection cited a nurse who reported that a patient's family was satisfied with care despite indications that no one from the hospice ever visited the patient. A federal inspection of a patient's chart listed medications for malaria and diabetes even though the patient told inspectors he was not taking either drug.

At one hospice in the building, a social worker wrote about a family's grief when their loved one passed but there was no evidence the patient was actually dead. "This particular building I noticed, I'm like, 'dang, how can there be that many licensed and certified hospices in this tiny little building?'" said Sheila Clark, a patient advocate.

California Attorney General Rob Bonta pledged enforcement action against potential hospice fraud. "We're committed to tackling the issue until we root it out and extinguish all fraud," Bonta said.

Centers for Medicare and Medicaid Services Administrator Mehmet Oz outlined stricter oversight measures. "I want to make it clear, we're not going to pay you money just because you sent me a piece of paper with a bill on it. We're going to check to make sure that's legitimate, and that document is evidence that you actually performed something that's helpful to the American people. Or you're not getting money from us," Oz said.

Los Angeles County experienced a 1,500% increase in the number of hospice companies countywide since 2010, according to the 2022 California State Auditor's report. The county had six times more hospice providers than the national average relative to the county's elderly population.