## Facts

- Tri-Lakes Medical Center (Tri-Lakes) was a community hospital in Mississippi overseen by a board of trustees.
- David Chandler served as chairman of Tri-Lakes’s board and worked closely with Raymond Shoemaker, the hospital’s chief operating officer (and later CEO).
- Earnest Levi Garner owned nurse-staffing businesses that provided temporary nurses to area hospitals, including Tri-Lakes.
- The government presented evidence that Chandler agreed to steer or influence Tri-Lakes nursing contracts to Garner’s staffing company in exchange for kickbacks of $5 per nursing-hour billed.
- Chandler sought increased business for Garner’s company by pressing Shoemaker to expand the contracts awarded to Garner.
- During the course of the scheme, Chandler authorized a $50,000 raise for Shoemaker.
- After Tri-Lakes was sold and Chandler left the board, Shoemaker became CEO. Shoemaker then met with Chandler and Garner to discuss compensation for Shoemaker’s participation in the arrangement.
- Chandler and Shoemaker spoke privately, and Chandler conveyed Shoemaker’s payment demand to Garner. The three reached an understanding that Chandler would pay Shoemaker $2,000 per month from Chandler’s kickback stream.
- Chandler paid Shoemaker $12,000 over six months.
- A federal grand jury in the Northern District of Mississippi charged Shoemaker and Garner in a multi-count indictment that included conspiracy and substantive counts tied to the bribery/kickback conduct, including a conspiracy count alleging a plan to violate the federal Anti-Kickback Statute, 42 U.S.C. § 1320a-7b(b)(2).
- A jury found both defendants guilty on all counts. Post-trial, the district court granted judgments of acquittal and, in the alternative, new trials on several counts (including the Anti-Kickback conspiracy count), while leaving other guilty verdicts in place.
- The government appealed the post-trial acquittals and new-trial orders; Shoemaker cross-appealed the denial of his post-trial motions on the counts that remained.

## Issues

1. Whether the district court erred by granting judgments of acquittal (and, alternatively, new trials) on multiple counts based on its view that the evidence was insufficient, including on the theory that Chandler was not an “agent” or sufficiently influential decisionmaker for purposes of the charged bribery/kickback offenses.
2. Whether the district court abused its discretion in granting new trials under Federal Rule of Criminal Procedure 33 based on the weight of the evidence.
3. Whether Shoemaker was entitled to acquittal or a new trial on the counts where the district court denied his post-trial motions (including claims framed as insufficient evidence and asserted trial-error grounds).

## Decision

- The Fifth Circuit vacated the district court’s judgments of acquittal and its alternative grants of new trials on the counts challenged by the government.
- The court held that the district court applied the wrong approach to sufficiency review by reweighing evidence and drawing inferences against the verdict rather than viewing the evidence in the light most favorable to the government.
- The court rejected the district court’s narrowed view of Chandler’s role, concluding that the evidence permitted a reasonable jury to find Chandler had enough authority or influence in the hospital’s affairs for the statutes at issue and for the conspiracy theory the jury accepted.
- The Fifth Circuit affirmed Shoemaker’s convictions on the counts that had remained intact after the district court’s post-trial rulings, finding the evidence sufficient and finding no reversible error that required a new trial.
- The case was remanded with instructions to reinstate the jury’s verdicts and for sentencing.

## Legal Principles

- In reviewing a judgment of acquittal, an appellate court evaluates whether any rational juror could find the elements proved beyond a reasonable doubt when the evidence and reasonable inferences are taken in the prosecution’s favor.
- A district court may not grant a Rule 29 acquittal by substituting its own view of witness credibility, the weight of evidence, or competing inferences for those of the jury.
- A new trial under Federal Rule of Criminal Procedure 33 is reserved for the “interest of justice” and is not a vehicle for a trial judge to overturn a verdict simply because the judge would have reached a different result on the evidence.
- For federal program bribery and related theories, the term “agent” and the concept of decisionmaking authority can be satisfied by evidence of functional authority or influence within the federally funded organization, not only by proof of formal power to execute contracts.
- Conspiracy liability may be proven through circumstantial evidence showing an agreement to pursue an unlawful objective and knowing participation, including evidence of coordinated conduct and payments tied to the flow of business.

## Conclusion

United States v. Shoemaker held that the district court went beyond its proper post-verdict role when it set aside guilty verdicts in a hospital staffing kickback case by reweighing evidence and narrowing Chandler’s authority in ways the jury was not required to accept. The Fifth Circuit reinstated the verdicts by vacating the acquittals and new-trial orders, affirmed Shoemaker’s remaining convictions, and sent the case back for reinstatement of the jury’s determinations and for sentencing.


United States v. Shoemaker, 746 F.3d 614 (2014)