Ram Kuma Chhetris day begins and ends with a ritual that looks like work on paper but, in reality, appears to be little more than a drive-by.
Every morning at 6 a.m., the Bhutanese refugee eases his electric car into the driveway of a tidy suburban home outside Harrisburg, Pennsylvania, idles for two or three minutes while tapping on his phone, then pulls away. Every evening at 5 p.m., he repeats the same maneuver, again lingering briefly in the drivers seat before heading back to his own house a mile away.
To the states Medicaid system, those two short visits register as the bookends of an 11-hour shift caring for an elderly woman, a supposed full day of home care that, over the course of a year, unleashes roughly $82,000 in taxpayer-funded payments. According to The Daily Wire, months of surveillance footage show that, in practice, his workday often consists of no more than five minutes in a driveway.
Under Pennsylvanias expansive Medicaid rules, low-income seniors can direct government payments to relatives or friends who help them cook, clean, and handle basic in-home tasks. The program is so generous, and so loosely monitored, that home care has become the single most common occupation in the state, with about two percent of all Pennsylvanians now classified as home health aides a rate surpassed only by New York, California, and Minnesota, as reported by The Daily Wire.
The only hard requirement for getting paid is the use of a GPS-enabled phone app that confirms the aide is at the clients home when clocking in and out, a safeguard that sounds rigorous but, in practice, is easily gamed. The Daily Wires cameras captured Chhetris routine over many weeks, documenting the same slow roll into the driveway, the same brief pause, and the same unhurried departure.
One afternoon, as he pulled away, he smiled and waved before lighting a cigarette and guiding his car down the street at the unhurried pace of a man with nowhere in particular to be. To the bureaucrats in Harrisburg and Washington, however, those taps on his phone translate into 77 hours of weekly care a workload that, at Pennsylvanias average Medicaid home care rate of $20.63 an hour, yields a comfortable, government-backed income.
The brazenness of the scheme is not unique. No-show home care has become so normalized in parts of Pennsylvania that some participants barely bother to conceal it.
In August, federal Drug Enforcement Administration agents arrested a drug trafficker in the state who, while in handcuffs, asked to be released just long enough to clock out of the home health shift he was supposedly working. When agents told him that would be illegal, he appeared genuinely perplexed, responding, Everyone is doing this. If this is a problem, youll have to arrest the whole city.
Even that might not be enough: investigators have uncovered at least one home health scam that was being orchestrated from inside a prison. The house that Chhetri dutifully visits twice a day hardly resembles the residence of a struggling, infirm senior in need of taxpayer-funded assistance.
Property records show it was among the most expensive homes sold in the area in the month it changed hands, and the driveway features high-end vehicles, including a Range Rover and a custom-painted Tesla Cybertruck. On a weekday afternoon, The Daily Wire knocked on the door and was greeted by the homeowner, 34-year-old Dilu Monger, who said her aunt lives with her and receives 11 hours of home health care each day, from 6 a.m. to 5 p.m.
It was 4:50 p.m. when Monger spoke, just minutes before the supposed end of that days shift, yet she refused to allow a reporter to see either her aunt or Chhetri. She seemed puzzled that anyone would attempt an unannounced, in-person verification, explaining that government inspectors always call ahead before visiting.
Such pre-announced inspections, of course, defeat the very purpose of oversight, allowing state officials to claim that fraud is tightly controlled while, in reality, signaling to participants exactly when to stage compliance. The numbers suggest that the system is being exploited on a massive scale.
Pennsylvanias Medicaid spending on home care ballooned from $530 million in 2021 to $850 million just three years later, a staggering increase that far outpaces ordinary demographic change. When the state defines elderly as anyone 60 or older, and when families can effectively pay themselves by enrolling a not-particularly-infirm relative, the incentives for abuse are obvious.
Democrat Governor Josh Shapiro has moved to raise pay rates even further, a decision that, absent serious reform, risks drawing even more people into what has become, for some, a taxpayer-funded lifestyle rather than a genuine caregiving vocation. Earlier surveillance had already shown that when Chhetri leaves Mongers driveway, he typically returns straight to his own home.
After Monger turned the reporter away, The Daily Wire drove to Chhetris house and arrived just as he was walking from his front door to his car. Confronted with video evidence of his daily drive-throughs, he appeared at a loss for words, until his daughter, standing beside him, stepped in to explain.
Sometimes he just goes and does it, she conceded, referring to the quick clock-in and clock-out, though she insisted that at other times he spends more time at the house. She added that the client is not disabled but has diabetes, a condition that, while serious, hardly explains the need for 77 hours a week of paid in-home supervision.
Pressed further, Chhetri claimed that he sometimes leaves the clients home to go shopping for her, but the surveillance footage tells a different story: he is seen pulling into the driveway just before 5 p.m., never opening his car door, and then driving away with no groceries in sight, either then or during his equally brief morning visits. Scenes like this are not confined to Pennsylvania.
Thirty-three states operate similar Medicaid programs that bill the federal government for personal services, a category distinct from traditional nurse-provided home health and specifically designed to allow payments to family members with no medical training. The potential for conflict of interest is built into the model: relatives are paid to attest to their own diligence, and clients have every reason to look the other way.
Yet the problem appears especially acute among Bhutanese refugee communities clustered in Pennsylvania and Ohio, where word has spread that the system is both lucrative and easy to manipulate. Attempts to tighten oversight have run into resistance from those benefiting from the status quo, who often cloak their objections in the language of privacy and personal freedom.
In Ohio, one lawmaker proposed breadcrumb tracking, a system that would record an aides GPS location throughout the shift rather than just at clock-in and clock-out. That provision was stripped from a broader anti-fraud bill that ultimately passed with bipartisan support, illustrating how even modest reforms can be watered down under pressure from interest groups and activists.
Even if such tracking had been adopted, many aides already have workarounds. One Bhutanese immigrant in Harrisburg described a common tactic: The caregiver leaves one phone at home and takes another phone with them. Someone who stayed at the home simply clocks in and out for them on the app. They still get paid while doing absolutely nothing.
If the aide lives with the client, the GPS safeguard collapses entirely, since the system cannot distinguish between genuine caregiving and mere cohabitation. The home care agencies the for-profit companies that bill Medicaid and then pay the aides are fully aware that the caregivers arent working, but they help them do it anyway because they are in on the scam, the immigrant said.
At 77 hours a week, federal and state taxpayers are effectively paying about $82,600 a year for one refugee to watch a friend with diabetes, with the agency typically skimming roughly a quarter of the hourly rate before overtime. Because the job often consists of little more than being at home with family, it is easy to rack up hours that would be impossible in a traditional workplace.
While taxpayers foot the bill, some beneficiaries live conspicuously well. Monger, whose aunts care is ostensibly the reason for Chhetris 11-hour days, appears to enjoy a jet-setting lifestyle.
Social media shows her on frequent trips to Nepal where a round-trip ticket runs about $2,000 as well as vacations to Aruba and Disney World. The older woman often pictured with Chhetri, presumably the aunt, hardly appears homebound either; she is seen at Hershey Park amusement park, with Chhetri tagging along, despite the narrative that she requires near-constant in-home assistance.
When confronted on August 14, Chhetri said he is employed by Gaunley Home Care, a company that, according to Medicaid records, collects about $150,000 a month from 25 clients. The firm is owned by another Bhutanese man, Biras Adhikari, who lives in Ohio and holds additional jobs.
In a phone interview, Adhikari said that just three days after the confrontation, Chhetri abruptly resigned without explanation. Adhikari acknowledged that the system has serious vulnerabilities, even as he insisted he is doing everything right.
He said home care companies rely on GPS-based Electronic Visit Verification (EVV) and quarterly client satisfaction check-ins to guard against fraud, but conceded that these measures are weak when most clients are related to their aides. If we are doing everything right on our side, like punch-in and punch-out from the location and submitting the timesheet, and the client is saying they are receiving the service and everything, there is no way for us to find out, he said.
I think thats the lawmakers job to find those loopholes and try to prevent it, he added, effectively shifting responsibility back to the state. His proposed fix is to remove the family connection altogether.
What government should do, they should eliminate the family caregivers, he said. I would support that.
In his view, if an elderly person knew a stranger would be dispatched to cook and clean, she would only tell a doctor she was unable to perform those tasks if it were genuinely true, rather than as a pretext to secure a paycheck for an unemployed relative. If that stranger failed to show up, Adhikari argued, the client would have no incentive to lie on the quarterly quality survey.
On [the] quarterly quality survey you dont lie, you know?, he said. Yet even that reform might not be enough, because the latest evidence suggests that some home health companies themselves may be entangled in the fraud, whether through negligence or complicity.
To demonstrate his transparency, Adhikari provided The Daily Wire with Chhetris EVV documentation the GPS logs that the government relies on to verify an aides presence. Those records revealed that Chhetri was billing the government for caring for a second client across town during the same hours that both he and Monger said he was being paid to watch her aunt.
On paper, he was clocked into two 77-hour-a-week jobs simultaneously, a schedule that would yield roughly $160,000 a year in taxpayer-funded income. In reality, surveillance showed his car parked at his own home for much of the day, suggesting he was not meaningfully present at either location.
The EVV logs for the second client, a 45-year-old woman named Suk Tamang, showed clock-ins from the GPS coordinates of her house at the exact times when The Daily Wire had eyes on Chhetri across town. The simplest explanation is that he left a phone tied to his account at Tamangs residence, allowing her to clock in and out on his behalf.
Tamang would, of course, know that her aide was not actually there, yet she never reported any problem, and whatever she told a doctor to qualify for a taxpayer-funded aide was plainly inconsistent with her ability to function without one. The GPS reports list a phone number for Tamang the only practical way for the government to contact her short of a home visit but that number does not belong to her.
Instead, it is tied to a felon convicted of welfare fraud who is connected to a senior Gaunley official. The biography of that man, Chida Nanda Kafley, says he worked in refugee resettlement and that since 2013, Chida has served as a Case Manager/Area Manager in home care, even though public records show that in 2022 he was convicted of felony food stamp fraud.
(After a year of probation, prosecutors removed the felony under a program called Accelerated Rehabilitative Disposition.) Simultaneously, Kafley works as a realtor for Ghimire Homes, a nearly all-Bhutanese real estate agency.
That makes him a colleague of Deepesh Pradhan, the man who runs Gaunley Home Cares Harrisburg office. While Adhikari oversees the company from Ohio, Pradhan dispenses hundreds of thousands of Medicaid dollars as a side gig, even as he also works at Ghimire Homes.
The Daily Wire called and texted the phone number listed in Tamangs EVV records, but no one answered and the voicemail box was full. Adhikari said he would send staff to interview Tamang and, if they confirmed that she lied about Chhetris presence, he would terminate her as a client.
But the identity of the Gaunley official tasked with policing timesheets raised even more troubling questions: it was none other than Dilu Monger, the homeowner whose aunt was the other client Chhetri was pretending to care for. Mongers husband, Roshan Bhai, is responsible for training home care aides in Harrisburg, working as a contractor for Gaunley and other firms.
Adhikari claimed he did not realize that the address flagged by The Daily Wire belonged to two of his own employees. He said Gaunley has never had a client at Mongers address, so if Chhetri is clocking in for a shift there as both he and Monger indicated then the aunt must be enrolled with another home care company.
Monger and her husband did not respond to inquiries, leaving unanswered how they could simultaneously serve as gatekeepers for the system and beneficiaries of its apparent abuses. If Dilu is involved I think they should be prosecuted. Ill support that 100%. Ill be ready to give all the information from my agency because personally, Im not involved in all of this, like what my staff does, Adhikari said.
He also conceded that the fact that GPS records show Chhetri clocking in at Tamangs house while he was definitively elsewhere means he cannot be sure any of his aides are actually working. Im very confused myself, Adhikari said.
Maybe the state can implement more rules for our agencies Give us tools that we can determine if our employees are actually the ones who are punching in and punching out. Yet the inherent difficulty of monitoring what happens inside private homes, combined with the ingenuity of those determined to exploit the system, suggests that no technological fix will be foolproof for long.
After Chhetri quit, Adhikari said Gaunley assigned a new aide to care for Tamang. Fresh surveillance of her house, however, showed no one entering at the designated clock-in time.
Adhikari explained that the new aide is Tamangs stepdaughter, who lives with her a scenario that renders most verification measures moot, even if the relative performs little or no actual service. Pressed on whether the only real solution might be to dismantle the entire industry of taxpayer-funded personal care, Adhikari did not dismiss the idea.
I think they can do that too, he said. For conservatives who believe in limited government, personal responsibility, and the dangers of expansive welfare programs, the spectacle of luxury cars, overseas vacations, and idle driveways funded by Medicaid underscores a deeper truth: when government tries to replace family duty and private charity with open-ended entitlements, it often ends up subsidizing fraud, eroding work ethic, and betraying the taxpayers it is supposed to serve.
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