Luigi Mangione, the accused killer who reportedly targeted UnitedHealthcare CEO Brian Thompson, is now under scrutiny for his family’s nursing home empire, Lorien Health Services. While Mangione’s alleged motives may stem from his disdain for private insurers, Lorien—a chain founded by his wealthy grandparents—has faced its own controversies, including federal citations for abuse and mismanagement in its Maryland facilities.
Nursing Home Violations
Lorien Health Services operates nine for-profit facilities marketed as luxurious, family-oriented care centers. Despite this image, federal inspections have revealed troubling issues. The Lorien Nursing and Rehab Center in Bel Air has faced repeated allegations of mistreatment, with the Department of Health and Human Services (HHS) issuing a critical report in April 2024.
One incident, dated August 24, 2023, involved a geriatric nursing assistant (GNA) who threw a call bell at a resident needing help and warned them not to use it again. On the same day, the same GNA allegedly handled another resident roughly, causing the patient pain. Though the GNA was fired, the investigation revealed systemic issues, including a failure to ensure staff completed annual abuse training.
The Bel Air location has received 24 health citations over six years—nearly triple the national average. Lorien’s Columbia facility also paid a $24,680 fine in July for extensive health and safety violations, including cases where patients were left distressed due to neglect, such as a resident being left naked and unattended when another patient entered the room.
In another violation, Lorien Health Services paid $55,192 in fines in June after an unlicensed employee impersonated licensed nursing staff, submitting fraudulent claims to Medicare and Medicaid.
Public Relations Amid Controversy
Lorien’s CEO, Lou Grimmel Sr., defended the company, emphasizing its long-standing commitment to care and innovation. He argued that the fines were minor compared to those of similar facilities and maintained that Lorien’s reputation remains strong, with the company ranked among the top 19% of nursing homes in the U.S. News & World Report’s 2025 list.
Mangione’s grandmother, Mary, who left the family a $30 million trust, was not implicated in any federal investigations. However, public interest in Lorien’s practices has surged following Mangione’s alleged manifesto and apparent disdain for both the insurance and nursing home industries.
Mangione’s Manifesto and Motive
Police have linked Mangione’s writings to his actions, with his manifesto decrying the “greed” of private insurers and referring to them as “parasites.” He accused the industry of prioritizing profits over clients’ well-being. Notably, the bullets used in the attack on Thompson bore the words “deny,” “depose,” and “defend,” echoing the title of the book Delay, Deny, Defend, which criticizes the insurance industry’s handling of claims.
Brian Thompson, as head of UnitedHealth Group’s insurance division, oversaw operations for the largest private insurer in the U.S., a company often criticized for denying claims and putting profits ahead of customer care.
Broader Implications
Mangione’s alleged actions and the controversies surrounding Lorien Health Services have cast a spotlight on systemic issues within both the insurance and elder care industries. While investigators continue to examine Mangione’s motivations, his family’s troubled nursing home empire further complicates the narrative, suggesting a personal and financial connection to the very systems he appeared to despise.
