Nick Shirley Exposes New York's Phantom-Patient Daycares

True to his usual approach, Nick Shirley arrived in New York City with public records and a camera, and left claiming he had uncovered over $190 million in fraud involving social adult daycare centers, home care companies, and the pharmacies connected to them. He published his full investigation last week. It only took him a few days to find what New York’s agencies have ignored for years, which is not surprising.

According to Nick’s investigation, social adult daycares in Flushing, a neighborhood in New York City, bill Medicaid for more than 90% of Medicaid-eligible seniors there. This would mean either Flushing has the most active elderly population in the country, or many of these seniors are just names on paperwork. That seems suspicious.

Nick revealed that the scheme is surprisingly simple. An operator starts a social adult daycare, and recruiters visit elderly residents, many of whom are Korean and Chinese immigrants, offering them cash to add their names to a list. The center then bills Medicaid for each person every day, whether they attend or not. Some seniors do come for activities like tai chi and ping pong, which helps make the operation look legitimate, while most listed people are not actually there. Shirley points out that these seniors are not committing fraud; they are being used as cover. He uses stronger language for the operators, calling them organized “Korean and Chinese mafias” who take advantage of a program meant to help the elderly, a claim that goes beyond what prosecutors have said so far.

At one center, Shirley arrived with records showing nearly 7,900 members and about $12.9 million billed in just one year. He asked the staff if the center really had seven thousand people. The staff member admitted it did not and then asked Shirley to leave. With about $1,600 billed per name, someone was profiting from thousands of seniors who could not be found.

What made this investigation different was who joined Shirley: Dr. Mehmet Oz, the administrator in charge of Medicare and Medicaid across the country. He walked the neighborhood himself. In one apartment, he found three medical equipment companies registered to a single unit with no inventory. He described this as a major warning sign and estimated that similar setups could make millions each month. Oz said that social adult daycares in Queens alone have billed $2.1 billion over three years.

The surprising thing for Albany is that none of this was hidden. Since 2021, New York’s Department of Health has referred 387 of these centers for investigation and sent about a third to the attorney general. Billing in Flushing rose by 390 percent from 2018 to 2024, while the number of eligible seniors only increased by twenty percent. In February, federal prosecutors charged two men from Flushing in connection with two daycares and a pharmacy that allegedly took about $120 million from Medicare and Medicaid, with kickbacks paid in cash and supermarket gift cards. Even after the scheme was documented, referred, and prosecuted, the number of centers continued to grow.

For years, the scheme was so profitable that no one in power seemed willing to stop it. It took an independent journalist with a camera to investigate where regulators would not. This week, Vice President JD Vance said that other journalists could learn from this example; more details on that follow.

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For nearly a year, officials in the states Nick Shirley investigates have called him a conspiracy theorist. On Wednesday, he sat at the witness table before the Senate Homeland Security and Governmental Affairs Committee, which held a hearing called, without irony, “Exposing Fraud in America.”

Shirley explained to the senators how he uncovered fraud, showing them his work from empty daycare centers in Minnesota to hospices in Los Angeles and adult daycares in Queens. He said the fraud became so widespread because no one had really investigated it before. He described the Quality Learning Center in Minnesota, which received millions in child care funding despite having no children present. Senator Joni Ernst brought up this case during her questions, pointing out the center received about $10 million in taxpayer money while remaining empty. She reminded everyone, “if you can’t find waste, fraud and abuse in Washington, you’re not looking.”

Governor Tim Walz once called Shirley a white supremacist and a delusional conspiracy theorist. Since then, Walz dropped his re-election bid, and the Minnesota fraud cases Shirley exposed have led to guilty pleas and new indictments. Governor Gavin Newsom also mocked Shirley with an AI-generated image, shortly before California moved forward with a bill critics call the Stop Nick Shirley Act. According to Shirley, more than thirty fraud bills have been introduced in Congress since his first Minnesota video, along with a new federal task force and a Treasury effort to prevent improper payments.

The Government Accountability Office estimates that the federal government loses between $233 billion and $521 billion to fraud each year. Paul suggested a simple solution, similar to what banks already do: verify who is getting the money before sending it.

A year ago, Shirley was an independent journalist visiting buildings that agencies had approved for years. On Wednesday, the United States Senate asked him to share what he discovered. Most of the officials who tried to discredit him over the past year were not there to hear his response.

Vice President JD Vance, who President Trump chose to lead the federal government’s fight against fraud, spent part of this week publicly thanking Nick Shirley and telling the national press it should be embarrassed, read below.

Vance posted his message after Shirley released his New York investigation last week. He wrote that the administration owes Shirley a debt of gratitude for exposing one of the country’s worst fraud cases, and said that a good press corps should learn from citizen journalists rather than trying to silence them. The task force JD Vance leads uses Shirley’s videos to launch raids, make indictments, and freeze funding. Since Shirley’s first Minnesota video, the administration has frozen $260 million in Medicaid payments to the state, suspended hundreds of high-risk hospices in Los Angeles, and created a national enforcement division that has established over a billion dollars in fraud in its first weeks.

The idea of “trying to silence them” is not just talk. It refers to real people. In California, lawmakers pushed a bill so clearly aimed at Nick Shirley that it’s nicknamed the Stop Nick Shirley Act. In the media, NPR had to run corrections on a report about Shirley’s work, including one that admitted it had wrongly quoted him. The news outlets that tried to fact-check Shirley often ended up correcting themselves.

In an interview with Shirley this spring, Vance predicted that prosecutions would increase within months, and that has happened. The Justice Department charged the Minneapolis daycare operator from Shirley’s first video, then charged fifteen people in a Minnesota health care scheme that prosecutors called the largest autism fraud ever prosecuted. This month, two former Minnesota daycare operators pleaded guilty.

The label of “conspiracy theorist” was never going to last. A year ago, the governor of Minnesota called Shirley a white supremacist, and the governor of California mocked him with an AI-generated image. This week, the Vice President thanked him by name and pointed to the convictions that followed his reporting.

There is now a clear record of progress in the fight against fraud, and much of it started with one person knocking on doors that officials had chosen to ignore. Vance is right that the rest of the media could learn from this. Whether they will is another matter.