MILLEDGEVILLE, GA — Multiple wrongful death lawsuits filed against UnitedHealthcare subsidiary Optum allege the company systematically discouraged nursing homes from transferring residents to hospitals in an effort to reduce costs, resulting in preventable deaths across several states, according to a report by The Guardian and legal filings reviewed by Satterley & Kelley, PLLC.
The lawsuits paint a disturbing picture of an insurance-driven protocol that allegedly placed cost containment above patient safety. Among the cases cited are those of 70-year-old Mary Grant, a Cleveland, Ohio, nursing home resident, and Cindy Deal, who resided in a Georgia nursing home — both of whom died after facilities allegedly followed Optum directives to avoid hospital transfers.
How the System Allegedly Worked
According to a lawsuit filed by former Optum nurse practitioner Maxwell Ollivant, who worked in the Tacoma, Washington, area, nursing home patient charts contained large red "STOP" signs directing staff to contact Optum before calling an independent primary care physician when a resident's condition deteriorated. Ollivant alleges that he and fellow employees were instructed to reprimand nursing home staff whenever a patient was transported to a hospital without first contacting Optum's hotline.
In one case described in Ollivant's legal filing, a nursing home resident exhibiting classic stroke symptoms — including drooling, unresponsiveness, and listing to one side — was sent directly to a hospital, where she was admitted to the intensive care unit for intra-brain bleeding. Rather than commending the quick action, Ollivant's manager reportedly sent an email complaining that the facility had bypassed Optum's protocol, according to court documents. The manager subsequently met with the nursing home's director of nursing to retrain staff on the company's preferred procedures.
UnitedHealthcare has denied wrongdoing in all of the pending cases, maintaining that its programs are designed to improve resident care by reducing unnecessary hospitalizations, as reported by The Guardian.
The Deaths at the Center of the Lawsuits
In the Ohio case, Mary Grant sustained a head injury after a nursing home employee accidentally knocked her from her wheelchair onto a cement floor approximately two years ago, according to her family's wrongful death lawsuit. The following day, a nurse discovered Grant with dangerously low oxygen levels and covered in vomit — symptoms consistent with internal brain bleeding after a traumatic head injury.
Rather than arranging immediate hospital transport for imaging, the nurse contacted the Optum hotline, as per facility protocol, according to court filings. The Optum representative determined a transfer was unnecessary and recommended the resident be monitored, medicated, and given a chest X-ray. Internal logs reportedly noted that "the goal is to treat in place." Grant died the next day. Her family's lawsuit alleges Optum was acting not as an independent medical professional but as "an insurance adjuster" that preemptively denied necessary care.
In Georgia, resident Cindy Deal suffered an apparent seizure in 2022, becoming unresponsive and foaming at the mouth, according to her family's legal filing. The facility nurse contacted Optum, whose representative allegedly instructed the nursing home to medicate Deal rather than transport her to a hospital. Deal subsequently died.
Federal regulations require nursing homes to arrange for immediate transfer to a hospital when a resident's medical needs exceed the facility's capability. The allegations in these lawsuits raise fundamental questions about whether insurance company protocols are interfering with that obligation.
CMS Inspection History
One of the Georgia facilities connected to these lawsuits, Chaplinwood Nursing Home in Milledgeville, holds a 3-out-of-5-star overall rating from the Centers for Medicare & Medicaid Services, according to CMS records. While the facility's health inspection score is average at 3 stars, its staffing and quality of care ratings each sit at just 2 out of 5 stars — below the national average.
The 100-bed nonprofit facility has accumulated 22 deficiencies across 8 inspections documented in the CMS database. During its most recent inspection on September 17, 2023, surveyors cited the facility for five deficiencies, two of which were classified at the "G" severity level, indicating actual harm to residents. These included failures to ensure areas were free from accident hazards with adequate supervision, and failures to develop and implement complete care plans meeting all resident needs.
The same inspection also cited the facility for failing to protect residents from abuse and neglect, and for not ensuring a safe, clean, and homelike environment — both at the "D" severity level, indicating potential for more than minimal harm. The pattern of staffing and supervision deficiencies documented by CMS is particularly relevant given that the broader Optum lawsuits center on whether nursing home staff had adequate support and authority to make independent decisions about emergency hospital transfers.
Ownership & Operations
Chaplinwood Nursing Home is classified as a nonprofit facility under CMS records. The broader lawsuits against Optum span multiple ownership types and states, suggesting the alleged protocol of discouraging hospital transfers was applied across the company's nursing home partnerships regardless of individual facility ownership structure. The cases raise industry-wide questions about the role third-party insurance protocols play in overriding clinical judgment at the point of care.
Resources for Families
Families who are concerned about the care their loved ones are receiving in Georgia nursing homes, or who believe a facility is prioritizing insurance company directives over resident safety, have several avenues for reporting and support.
The Georgia Long-Term Care Ombudsman can be reached at 1-888-454-5826. Ombudsman advocates investigate complaints, help resolve care disputes, and can intervene on behalf of residents whose rights may be violated.
The National Long-Term Care Ombudsman Resource Center maintains a hotline at 1-800-677-1116 and provides information at [ltcombudsman.org](https://ltcombudsman.org).
Families should document any concerns in writing, including dates, staff interactions, and specific incidents. If a resident is in immediate danger, call 911 — federal law guarantees a resident's right to emergency medical treatment regardless of any insurance company protocol.
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