A nursing home owner won a pardon from Trump. The families of his patients got nothing.

Doris Coulson remained spirited even as her illness progressed – watching cooking shows on TV, solving crosswords and walking the halls of her nursing home to show off her granddaughter when she came to visit.

Coulson had been admitted to Hillview Post Acute and Rehabilitation Center in Little Rock, Arkansas, in January 2016, after Parkinson’s disease left her at risk of choking when swallowing. In April, the facility’s operations were taken over by Skyline Healthcare, a New Jersey-based company that purchased nursing homes across the country.

The medical records of the retired cardiology nurse, then 71, were marked “NPO” – nothing by word of mouth.

Then, in September, a nursing assistant found Coulson unconscious and hanging on the edge of her bed, her skin ashen and breathing shallow. She was taken to hospital in a coma and died a few days later. The primary cause of death was aspiration pneumonia, according to his death certificate.

“The doctors said they found scrambled eggs in his lungs,” said his daughter Melissa Coulson.

Coulson’s death and the circumstances surrounding it led his family to file a lawsuit against Skyline and its owner, New Jersey businessman Joseph Schwartz, alleging that cost cutting at Hillview had left Coulson without the care she needed. It was one of several lawsuits related to patient outcomes as Schwartz’s empire expanded and then collapsed, with much of the chain collapsing in 2018.

Schwartz did not contest the case, and a judge in 2020 awarded nearly $19 million in damages. Coulson’s family was never able to recover. Schwartz had by then given up all of his assets in Arkansas, so there was nothing left in the state that the family’s lawyer could try to seize, nor was there enough information about what assets he may have held in other states.

Coulson’s civil suit was one of several efforts to hold Schwartz accountable for what happened at his nursing homes. In perhaps the most sweeping move, federal prosecutors in New Jersey accused Schwartz of orchestrating a $39 million payroll tax scheme linked to his nursing home empire.

He pleaded guilty last April to failure to pay IRS taxes withheld from employees and failure to file a financial report for his employee benefit plan. A federal judge sentenced him to three years in prison.

But Schwartz only served three months. In November, President Donald Trump granted him a full pardon, overturning his criminal conviction — part of a series of clemency rulings during the president’s second term that have benefited well-connected defendants, including political allies with access to the White House and individuals like Schwartz who had spent hugely on lobbyists.

The emotional and financial devastation left behind Trump’s decisions is often overshadowed by the attention paid to Trump’s decisions. Few clemency decisions illustrate this more clearly than the case of Schwartz, who paid himself millions of dollars from his nursing homes while embezzling tens of millions owed to taxpayers and employees, and who failed to satisfy at least three multimillion-dollar judgments entered against grieving families.

In the Coulson case, Schwartz later claimed he never received the key documents and had confused the complaint with the same lawsuit first filed in 2017, which he thought his insurer had already handled before it was withdrawn and refiled. And he argued that the company that took over Hillside and canceled the insurance coverage – not him – was the correct defendant. He also said he was representing himself, was in poor health and was self-isolating due to the risks of COVID-19. A judge denied his request to stay the case.

Kevin Marino, an attorney representing Schwartz and Skyline, said he and Schwartz had no comment. He did not respond to a follow-up email with a detailed list of questions.

Trump has pardoned several figures in major health care fraud cases. In 2020, he commuted the 20-year federal prison sentence of Philip Esformes, a Florida nursing home mogul convicted in a scheme that prosecutors said involved about $1.3 billion in fraudulent Medicare and Medicaid claims. The White House cited allegations of prosecutorial misconduct, echoing claims by Esformes’ defense that prosecutors improperly violated attorney-client privilege in reviewing documents seized during an FBI raid. Although the appeals courts did not overturn the conviction based on this argument, Esformes had the support of two former U.S. attorneys general.

The same year, Trump commuted the sentence of Judith Negron, convicted in a $200 million Medicare fraud case. Trump’s pardon indicated that the “ends of justice” did not require him to serve another two decades in prison.

Lawyers for Esformes and Negron did not respond to requests for comment.

Trump also named Benjamin Landa, owner of a retirement home as ambassador to Hungary. The appointment remained in effect even as a facility Landa co-owns faces a federal audit alleging there were more than $31 million in overpayments to Medicare. Landa is suing the administration to block reimbursement. An attorney for Landa did not respond to a request for comment but has previously denied his client’s wrongdoing, saying in a statement that the issues identified in the audit occurred during the COVID-19 pandemic, when nursing homes were in the midst of a crisis and the company was committed to taking over patient care.

Schwartz’s case was highlighted by far-right activist and Trump ally Laura Loomer, who had previously worked on other issues alongside lobbyists hired by Schwartz to advance his cause in Washington. Loomer published a series of messages on

She also accused the judge of anti-Semitism against Schwartz, who is Jewish, even though she presented no evidence. She also said Schwartz was “in very poor health” and that prison would be a “death sentence,” although the judge found no evidence that Schwartz was unfit for prison.

Versions of Loomer’s account surfaced in the White House’s explanation of the pardon. A White House official said in response to questions from ProPublica that Schwartz “relied on a third-party entity” to handle the tax returns, that he paid restitution, that no funds were used for personal enrichment, that the sentence was exceptionally harmful to a 65-year-old man in deteriorating health, and that it was “an example of excessive prosecution.”

But those claims are contradicted by the court filing and Schwartz’s own guilty plea, in which he admitted responsibility for unpaid payroll taxes. Although he repaid $5 million, it only covered a fraction of what he owed. Federal prosecutors said that under Schwartz’s plea deal, the IRS could have pursued the remaining balance — an effort that now appears much less likely after the pardon. And his three-year sentence falls in the middle of the range recommended by federal sentencing guidelines.

Asked about these statements and their consistency with the legal file, the White House did not respond.

Schwartz’s faith also became part of the Trump administration’s public celebration of the decision. Alice Marie Johnson, who advised the White House on clemency, wrote online that the pardon meant Schwartz could now join his family for Shabbat, and weeks later he attended the pardon ceremony. Hanukkah Party at the White House.

Schwartz paid more than $1 million to lobbyists to lobby the White House, Justice Department and Congress on his behalf — including for his efforts to obtain a pardon — according to lobbying disclosure forms. The White House has insisted that paid lobbyists have no influence over pardons.

Loomer said she was not paid for her advocacy. She said she learned about Schwartz’s case during a group discussion with members of an Orthodox Jewish outreach movement, who asked her to look into the issue. She also highlighted her influence within the Trump administration, citing several instances in which she publicly urged the president to take specific actions. She said Schwartz approached her at the Hanukkah party to thank her.

Melissa Coulson said Trump’s pardon of Schwartz reinforced her belief that justice was not applied equally.

“Apparently he has money somewhere,” Coulson said.

His lawyer hopes to find him.

From the outside, Schwartz’s operations don’t look like a business empire. The headquarters of Skyline’s growing nursing home network was a second-floor office above a pizzeria in Wood-Ridge, New Jersey.

Schwartz entered the nursing home business in the late 2000s and created Skyline to acquire and operate skilled nursing facilities, initially in New Jersey and Pennsylvania. He sold a company Florida-based insurance company in 2015 for $22 million, allowing it to quickly expand Skyline. In 2017, Skyline and related companies controlled by Schwartz cared for about 15,000 residents in about 100 facilities across 11 states.

In a 2017 deposition in a wrongful death lawsuit in Philadelphia, Schwartz defended the care at his facilities as “superb” while distancing himself from day-to-day operations by saying he relied on facility administrators and nursing directors. The lawsuit was settled without Schwartz admitting wrongdoing.

In his deposition, Schwartz downplayed reports of staffing shortages and unpaid bills as mere business “disagreements.” Asked about the facility’s one-star ratings of federal staff from 2010 to 2014 – the lowest possible rating in the Centers for Medicare & Medicaid Services’ five-star system – Schwartz said he remembered getting “a good rating” and that his nursing homes had done their best to staff as much as possible, insisting that they were “very, very, very, very, very compliant” and that residents were “happy and satisfied.”

The collapse was rapid. Skyline facilities failed to pay for food and medical supplies and reduced nursing home staff hours. At the same time, Schwartz began siphoning money from multiple sources — overcharging Medicaid and withholding millions of dollars in payroll taxes from workers’ paychecks, but never sending the money to the IRS, he later admitted. Additionally, Schwartz paid himself $5 million for what a federal prosecutor described as a “ghost employee” at some of his facilities.

As conditions in the homes deteriorated, health officials in at least six states, from Nebraska to Massachusetts, seized or transferred control of its facilities or relocated residents. In South Dakota, a vice president who oversaw 18 nursing homes owned by Schwartz began sending increasingly desperate emails to state health officials, according to court records.

Debbie Menzenberg wrote in the emails that Schwartz’s son Louis, a Skyline executive, called her to say the state “needs to do something – there is no money – he told me to fire the residents???”

Then Menzenberg’s emails to the state became more urgent:

“I need water paid for at Bella Vista and Pr Airie Hills today or it will be SHUT DOWN – Skyline is QUIET!!!

“A disconnection notice arrived today for Pierre on May 8 electric.”

“I NEED HELP !!!!”

“CEOs know what’s going on!!! »

Neither Menzenberg nor Louis Schwartz could be reached for comment.

A group of employees at Skyline nursing homes across the country then filed a lawsuit alleging that Skyline withheld more than $2 million in health insurance premiums from more than 1,000 workers’ paychecks but failed to provide coverage. That left some of its employees with denied health insurance claims and mounting medical bills.

Schwartz did not defend the claim, and an attorney for the employees asked a judge to grant a default judgment of $2.4 million. The case remains pending in New Jersey federal court.

One of the plaintiffs in the lawsuit, an activities director at an Arkansas nursing home, said she was left with more than $50,000 in medical bills after back and neck surgery. She said she couldn’t pay her bills and the debt ultimately destroyed her credit.

“They withheld over $1,000 from my paycheck to pay my insurance premiums and did nothing with them except run away with them,” said the employee, Margaret Gates.

Under Schwartz’s ownership, residents suffered – and some died.

In a lawsuit against Schwartz, Zelma Grissom’s family said living conditions at Hillview, the same facility where Doris Coulson lived, left residents without even basic care. The mother-of-six had entered the facility after brain surgery left her unable to move on her own and reliant on staff to turn her back to bed.

Grissom’s son, LeVester Ivy, said Hillview appeared to be chronically understaffed. One day, Ivy said, a wound care nurse called the family into her mother’s room and showed them a serious pressure sore that had developed after Grissom was not turned regularly. Surgeons had to cut away the infected tissue, leaving a large open wound. After that, he said, his health deteriorated.

“She started getting infection after infection,” Ivy recalls.

During a late-night ambulance transfer, he said, a paramedic quietly told him how his mother had arrived. “She pulled me to the side and told me how dirty and nasty she was, how wet she was,” Ivy said.

The family’s lawyers said she died of sepsis from bedsores that Hillview caregivers allowed to become infected.

In February 2023, a judge ordered Schwartz to pay $15.7 million to Grissom’s family after neither Schwartz nor any representative contested the family’s wrongful death claim. Schwartz later tried to overturn the decision, citing poor health, lack of notice and the fact that he was only an investor with no role in the operations, but a judge rejected his attempt.

Ivy said the family sued Schwartz because “we didn’t want anyone else to go through the things we had to go through.” Schwartz did not pay the judgment, and the family’s attorney said in an interview that he did not have enough information about Schwartz’s assets to try to recover the money.

The suffering described in cases like Coulson and Grissom’s was not part of the tax case against Schwartz that landed him in prison. But it weighed on proceedings when he appeared for sentencing in federal court in Newark, New Jersey, last April. Schwartz had pleaded guilty to withholding $39 million in payroll taxes from his employees and failing to send the money to the IRS.

The investigation never made it possible to determine where the money had gone. Prosecutors said they were unable to establish that Schwartz used the money to live a lavish lifestyle. But they said they never conducted a forensic accounting of his finances, which moved money through more than 200 bank accounts. They said they believed Schwartz still controlled more than $50 million in assets.

His lawyers argued that his actions were not an attempt at personal enrichment but the result of a businessman who expanded too quickly, fell behind on his bills and then made a series of financial decisions — some of them, admittedly, criminal. But, they claimed, he was just trying to save his business.

Schwartz apologized for his conduct and told U.S. District Judge Susan D. Wigenton that he “always tried to live the right way” and set a good example. But he admitted that he had failed to do so in this specific case.

Wigenton said she didn’t understand why prosecutors agreed to a sentence of just one year and one day. Even years after the investigation began, she noted, it was still unclear where much of the money had gone. And because many of the letters submitted on Schwartz’s behalf described him as a brilliant businessman, Wigenton said “the number of layers and corporations and LLCs that were created” made it difficult to view him as someone who had been misled or confused.

“Not a single asset is in your name,” she said. “Not one.”

Wigenton said the case was not just an abstract tax matter, citing the collapse of Skyline nursing homes and the harm caused to patients. She said there needed to be a deterrent in sentencing.

The judge sentenced Schwartz to three years in prison and ordered him to pay $5 million in restitution — the amount he paid himself as a ghost employee — which he did. The remaining taxes were not part of the criminal sentence because prosecutors said they were used to fund his bankrupt business rather than for his personal enrichment. They said the IRS could try to recover the rest through civil action.

Trump’s pardon erased Schwartz’s federal prison sentence — and likely any effort by the IRS to recover the rest of the stolen taxes. But that did not affect a separate conviction in the state of Arkansas for Medicaid fraud and tax evasion, in which Schwartz admitted to submitting false and misleading information that inflated Medicaid rates paid to his facilities in the state.

A Little Rock judge had sentenced Schwartz to a year in state prison, concurrent with his federal sentence. Arkansas Attorney General Tim Griffin, who had heralded Schwartz’s conviction as a landmark achievement, made clear after Trump’s pardon that the prosecution had autonomy.

Schwartz, Griffin said at the time, I owed Arkansas State nine months in prison and $1.8 million in restitution. A Griffin spokesperson said last week that after making some payments — on time — Schwartz owes the state about $1.2 million, which must be fully repaid by April 2027.

One of the lobbyists Schwartz hired, Joshua Nass, worked to try to reduce Schwartz’s sentence in Arkansas. Nass declined to comment. He was later accused of trying to extort $500,000 from a client and his son. Although the victims are not identified in the case, the circumstances match those of Schwartz.

Nass was released from federal prison after posting $5 million bond. He doesn’t has not yet responded to the accusation. Prosecutors said in a court filing that they were negotiating a plea deal with Nass that could resolve the case without a trial.

Schwartz showed up at an Arkansas prison on Dec. 29, creating an opportunity for attorneys representing families who won their cases against him. At the height of Skyline’s expansion, the company controlled nearly one in 10 nursing home beds in the state. But by the time the families won their case, Schwartz had abandoned or sold its Arkansas facilities, leaving no clear assets for the lawyers to exploit.

Because Schwartz was back in state custody, attorneys could serve him with court papers and ask a judge to compel him to answer questions about his finances under oath — requiring him to disclose his bank accounts, businesses and other assets and turn over his financial records. These procedures are often the first step in tracing money and identifying assets that could be used to satisfy a judgment. From there, lawyers could ask courts in other states to recognize and enforce Arkansas judgments so they can pursue assets located elsewhere.

John Landis, an attorney with Reddick Law who represents the Coulson and Grissom families, said he and another attorney representing another client with a judgment against Schwartz contacted the state prison system to arrange Schwartz’s depositions. But the window proved too brief. The Arkansas Parole Board released Schwartz after just three weeks.

Before they could ask a single question, they no longer had the ability to follow the money.