The head of four Central Florida daycare facilities for medically fragile children — including a location in north Lakeland — was arrested Wednesday and charged with Medicaid provider fraud.
Attorney General Ashley Moody said Orlando resident Carlos Cabrera, 53, the CEO of Angels on Earth PPEC, is facing a first-degree felony charge for “bilking Florida Medicaid out of more than $400,000″ by submitting fraudulent claims for services that were never provided.
“This defendant used vulnerable children and their families for his own financial gain by overbilling and stealing from a taxpayer-funded program,” Moody stated a press release. The case will be prosecuted by Moody’s Office of Statewide Prosecution.
Investigators also filed an emergency motion ordering SouthState Bank to freeze 16 bank accounts controlled by Cabrera and his wife Aleida D. Cabrera, 51, including a business account with $234,381 and a personal savings account with $196,456.
The news came five days after Angels on Earth abruptly closed its facilities in Lakeland, Haines City, Orlando and Melbourne — giving parents only a text message as notice.
The closure has left about 40 Lakeland families scrambling to find care for their children.
The charges were not the first for either Angels on Earth PPEC — which stands for prescribed pediatric extended care — or Cabrera, who has a lengthy history of financial troubles.
- In May 2022, the U.S. Department of Labor ordered Angels on Earth to pay $303,367 in back wages to 160 employees after an investigation found it routinely failed to pay workers for overtime.
- In January, parents filed a lawsuit alleging negligence resulting in the death of a 13-year-old boy at the company’s center in Melbourne on Nov. 30.
- In December 2021 the Florida Agency for Healthcare Administration fined Angels on Earth $500 for hiring a driver to transport children without doing a background check.
- Cabrera was arrested by Winter Park Police in 2015 and charged with DUI. He pleaded no contest to the reduced charge of alcohol-related reckless driving and was sentenced to two days in jail, 360 days of probation, substance abuse treatment, $894 fines and 100 hours of community service. His driver license was suspended for 180 days and ignition lock put on the Porsche he was driving at the time of his arrest.
- In 2013, a federal court in Orlando permanently barred Cabrera from preparing federal tax returns. A Justice Department news release alleged “total losses to the Treasury Department from Cabrera’s misconduct could be in the tens of millions of dollars” across 17,000 flawed returns he prepared in 2009 and 2010 while operating as CFG Tax LLC.
- In addition, Cabrera and his wife had foreclosures on homes they owned in 2009 and 2012. They were evicted from residential properties in 2001 and 2014. And they were sued by Rooms to Go in 2011 and Target Visa in 2010 for nonpayment of debts.
Up to 34% of billed services weren’t provided
Angels on Earth PPEC is not a typical daycare center. The children at Angels on Earth receive prescribed skilled nursing care that includes services like diapering, cleaning out tracheotomy tubes, and using feeding tubes to provide nourishment.
It is one of the few facilities in Lakeland for children with special needs and provides medical daycare, transportation from homes or schools, and therapy for disabled children for up to 12 hours a day, six days a week. It is paid for with Medicaid funds.
“Cabrera, the person responsible for all Medicaid PPEC billing, billed a nearly 100% attendance rate to get the maximum payment per patient despite knowing that not everyone attended every day,” the Attorney General’s release states.
Moody said her office’s Medicaid Fraud Control Unit determined that services were not rendered for up to 34% of the claims the Angels on Earth submitted for reimbursement.
The criminal complaint states that Angels on Earth PPEC was paid almost $4.08 million by Medicaid for all four locations, not including reimbursements for transportation services, from July 1, 2021 through Dec. 31, 2021. During that time:
- Attendance records show an average of 23 children were cared for on Saturdays;, however claims were submitted for an average of 74 children each Saturday.
- The center billed Medicaid $31,370 for 154 days of care for a child identified as “Q.F. King” even though he was marked absent for 139 of those days. The child’s mother, Angela King, told investigators she believed the attendance records were correct, since she kept him home for most of the COVID pandemic.
- Another mother, Tamyra Burnham, said she transferred her child “T.H.” to Learning Tree PPEC. After posting pictures of her child there, she allegedly “received a phone call from Carlos Cabrera, who bribed Burnham to return to Angels on Earth by paying Burnham through Cash App, check and cash, $3,000-$4,000. Burnham was paid $1,000 on March 4, 2022, $1,000 on April 27, 2022, and $500 on June 28, 2022. T.H. came home one day with $2,000 cash in his backpack because a check believed to be written by Cabrera had bounced. The payments received via Cash App were noted as ‘marketing.’ Burnham was aware other parents were receiving bribes or kickbacks to keep their children enrolled at Angels on Earth.”
- Funds deposited into Medicaid EFT account were “transferred into the other accounts and co-mingled with business and personal expenditures.”
In addition, the complaint says a review of the Cabreras’ bank account records from July 1, 2021, through Aug. 31, 2022, showed: “several large purchases from Beverly Hills Jewelry, Watch and Loan, approximately $430,000, Jacob and Company, approximately $509,000, and Kirk Jewelers, $52,708.68. Records obtained from the three businesses revealed that firearms (handguns, rifles, and shotguns), jewelry, watches, sports memorabilia, and artwork were purchased with funds obtained fraudulently from the Medicaid program.”
“The overall pattern of billing and submitting claims to Medicaid, despite children being absent, demonstrates an intent to maximize billing without regard for accuracy,” the attorney general’s release states.
What Cabrera said to LkldNow
Cabrera told LkldNow on Tuesday – before his arrest — that he had a major medical emergency on Thursday evening that sent him to the hospital until Sunday. Texts and emails were sent out at 5:28 p.m. on Friday to parents about a temporary closure.
“As you all know, we are a family business and due to a sudden family emergency we made the difficult decision to suspend operations temporarily,” a text message read. “We will be arranging times for families to pick up and personal belongings and/or medications from the centers. We appreciate your patience in this trying time and look forward to providing services again in the near future.”
Cabrera said Tuesday that they planned to reopen on Monday – although that now seems doubtful. A follow-up phone call after his arrest was answered by an answering service and he did not return a message seeking comment.
Some parents took to a Facebook page over the weekend and were baffled that one man’s hospitalization could close four daycare centers.
“I can tell you that I was serious enough that they thought I was not going to make it at one point,” Cabrera said in Tuesday’s telephone interview. “We reached out to the case coordinators, letting them know that this was very temporary and we are hoping to be reopened next Monday.”
State business records show Angels on Earth PPEC was founded in August 2018. Ownership is listed as 34% owned by Aleida D. Cabrera; 33% by her mother, Julia Erbiti, 77, of Orlando; and 33% by Maria A. Delgado, 61, of Orlando. Carlos Cabrera is listed as the administrator in charge of day-to-day business operations and daughter Arielle Cabrera, 26, of Orlando is the financial officer.
The court documents state that Aleida and Carlos Cabrera had “no previous experience as a Medicaid provider and no experience operating a prescribed pediatric extended care facility.”
Other past and current businesses owned by the principals of Angels on Earth PPEC include:
- Angels Medical Supplies, Inc. (2020-2022)
- Hello Medical Equipment Inc. (2021-2022)
- Hello Home Health Inc. (2021-2022)
- Super Economy Insurance, Inc. (1992-1998)
- C A & A Premium Finance, Inc. (1995-1996)
- CFG Tax LLC (2011-2013)
- Golden Family Adult Day Care LLC (2016-2017)
Death of a child
Cabrera said the facilities’ closures were not related to the death of a 13-year-old boy in the care of Angels on Earth PPEC’s Melbourne facility in late November.
A lawsuit filed in Brevard County Court by the boy’s family states that “staff left Tarionn Jackson-Hanner unsupervised for an extended period” and left a surgical glove within his reach. “On November 30, 2022, as a result of the acts and omissions of Angels on Earth and its staff, Tarionn Jackson-Hanner choked and died on the aforementioned glove,” the lawsuit alleges.
Tiffany Baugher, a spokesperson for the District 18 Medical Examiner’s Office in Brevard County, said a report on Tarionn’s death had not been finalized. Tod Goodyear, a spokesman for the Brevard County Sheriff’s Office, said their report has also not been finalized because they are waiting to hear from the Medical Examiner’s Office.
Tarionn’s mother, Kiyonna Durham, took to Facebook on Feb. 22 to decry her son’s treatment and the cold way she said their family has been treated. She described Tarionn as a non-verbal, special needs child who was fed through a G-tube. She said he “required constant care around the clock, which I constantly emphasized repeatedly throughout his time attending.”
“The disturbing part of this horror story is that to date we still have no answers as to what really happened to our son in his last hours leading up to his death,” Durham wrote on Facebook. “All we know is upon arrival of the EMS to the PPEC & Medical Day, a latex glove was retrieved from our son’s esophagus, (per the EMS & Hospital report & the Homicide Detective) that apparently this competent skilled nursing facility had no clue was there (according to the 911 call) and no clue how my son got to the glove to swallow it.”
Cabrera said he couldn’t comment on the case.
“We have an attorney working with us on that — I really can’t comment on it,” Cabrera said. “But that’s definitely not true.”
LkldNow then asked, “So a child did not die in the care of Angels on Earth in Melbourne?”
Cabrera answered, “No.”
Michael Haggard, one of the family’s attorneys, was angered Wednesday.
“It is outrageous that someone like Carlos Cabrera could be in charge of Tarionn’s health in the state of Florida,” Haggard said in an email to LkldNow. “Tarionn would still be with his family if the most minimum of standards were followed in his case.”
Few options for special needs parents
Sarah Frederick, who runs a Facebook page for parents of special needs students, was outraged on Wednesday.
“For Mr. Cabrera to allegedly steal $400k off the backs of our most vulnerable community members is disgusting!” Frederick wrote in a Facebook message to LkldNow. “He took advantage of desperate parents and disabled children who couldn’t speak for themselves because he knew he could!!”
She explained that they simply can’t enroll their children in their neighborhood daycare center or call a teenage babysitter to come watch their child after school.
“Unfortunately, they’re not skilled or capable enough to handle such medically fragile kiddos,” Frederick wrote. “Angels on Earth checked off all those boxes! They provided daily transportation, medical daycare with skilled staff, many types of therapies and so much more. These parents and children finally found their ‘home’ away from home and a place to belong.”
“To find out most of those services weren’t happening is gut-wrenching to say the least!” she continued. “I’m glad our attorney general is taking this matter seriously and I hope for every child and parent affected by Mr. Cabrera, justice is served!”
A Google search shows only one other PPEC facility in Lakeland: Pediatric Health Choice on Lakeland Hills Boulevard.
Lakeland has a public school that provides similar care, but only until school lets out at 3 p.m. Doris Sanders Learning Center is an educational center school, serving students from 5 to 22 years old. Their classes focus on independent functioning and self-help, social and behavioral needs, and communication skills.
Some students receive physical and occupational as well as speech/language therapy. They participate in activities including: leisure and productivity in the home, community and school settings, social interaction, communication, personal care, health, safety routines, and mobility within familiar environments.
Polk County’s Exceptional Student Education Department serves more than 18,000 students from preschool through 22 years old. They include students with various disabilities, as well as gifted learners.
None of the district’s three center schools for special needs students provides after-school care. The other two are Jean O’Dell Learning Center in Bartow, and Karen M. Siegel Academy in Lake Alfred.
Polk County Public Schools Superintendent Frederick Heid said the teachers and paraeducators at the schools are simply exhausted at the end of the day after working with children beginning at 7:30 a.m. until 3 p.m.
“It’s a daunting,” Heid said of caring for profoundly handicapped students. “Unfortunately, this closure was sudden and came with zero warning. We are working quickly to identify a contact for these locations to see what we may be able to accommodate. But we need specific information pertaining to each child’s needs in order to do so. This will take some time to scale but we are willing.”
Heid said the district is willing to provide care for the 40 or so students served by the facility and were also rushing to find places for them.
One parent, before learning of Cabrera’s arrest, praised Angels on Earth and the care they have provided to their children.
Jea Negron of north Lakeland said her 10-year-old daughter has been diagnosed with a host of issues, including Autism Spectrum Disorder, Posttraumatic Stress Disorder, chronic skin-picking, disruptive mood dysregulation disorder, attention deficit hyperactivity disorder, reading and writing impairment, developmental disorders of speech and language and generalized anxiety disorder.
“She started at PPEC 8 months ago. Thank God — it’s the best place she’s ever been,” Negron said. “I have lived in Puerto Rico, Pennsylvania, Ohio, Illinois and now Florida. My daughter has NEVER been anywhere so good. My girl has several diagnoses and they have honored her name in our lives… Angels on Earth.”
Negron said on Wednesday after news of Cabrera’s arrest that the employees who worked with her daughter truly were angels and that her daughter was depressed that the facility was closed.
“I need to call the psychiatrist,” she said. “She needs her (prescribed pediatric extended care). She does not tolerate sudden changes in routines. She has been crying for days and she almost doesn’t even want to talk. She just says that she wants to go to PPEC. In the end, it is very sad because those who suffer are children like my daughter.”
Heid said if parents are reaching out for assistance, they should contact Assistant Superintendent for Learning Support Tammy Cassels at tammy.cassels@polk-fl.net or 863-535-6488.
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