Pleading for mercy in a shaking voice, Martha F. Bell testified that she was ultimately responsible for conditions at the nursing home she once ran and would accept whatever sentence a federal judge imposed on her.

An hour later, after U.S. District Judge Terrence F. McVerry ordered her to serve five years in prison and pay $50,000 in fines, Mrs. Bell insisted that she'd provided good care to residents and did not deserve jail time.

As she's done since her conviction for defrauding Medicare and Medicaid and on other charges last year, she contended yesterday that she did not receive a fair trial because the court did not permit her to introduce records and evidence. She said she would appeal.

She also blamed former employees for providing shoddy care and faking medical records, saying they duped her into believing they were carrying out her dream of operating a model facility for people with Alzheimer's disease.

"I don't believe I did anything wrong. I believe I trusted people and asked them to tell me the truth,'' said Mrs. Bell, 60, of West Mifflin. "Those people all knew how much I wanted them [to do] for the patients. They have to sleep with their consciences.''

Mrs. Bell was convicted in August 2005 of one count of health care fraud and eight counts of making false statements for her actions as founder and administrator of the defunct Ronald Reagan Atrium I Nursing and Rehabilitation Center in Robinson. The state closed the facility in 2004.

Judge McVerry also sentenced Mrs. Bell to serve three years of supervised release after prison and ordered the Atrium corporation, which she heads, to spend five years on probation and pay $490,000 in fines. He acknowledged there was little hope of collecting the corporation's fines, but said the probation period enables authorities to monitor its activities.

Weeping on the witness stand, Mrs. Bell told Judge McVerry she never meant to hurt anyone and feared developing Alzheimer's disease or a reoccurrence of breast cancer in prison. But the judge noted that she'd shown no remorse and denied her request to remain free on bail during her appeal.

Prosecutors accused Mrs. Bell and Atrium of defrauding Medicare and Medicaid of more than $7 million and making false statements to hide that fraud between 1999 and 2003. They charged that Mrs. Bell and Atrium accepted and spent money from the health care programs, then faked thousands of medical and financial records to conceal failure to provide appropriate care as required.

Mrs. Bell also was accused of diverting funds from Atrium to other nonprofit organizations that she headed to supplement her salary, which reached nearly $1 million between 1999 and 2002.

The case was the first of its kind to be prosecuted in Western Pennsylvania. U.S. Attorney Mary Beth Buchanan said she believes it has caught the attention of prosecutors and investigators around the country.

"This was a scheme that dramatically impacted people's lives,'' Ms. Buchanan said, noting testimony about how Atrium residents endured injuries, medication errors and lack of adequate food and treatments.

Mrs. Bell ran up thousands of dollars in restaurant meals and personal expenses on corporate credit cards while seeking to cut Atrium's food budget to less than $3 a person per week, Assistant U.S. Attorney Leo Dillon said. He acknowledged defense attorneys' arguments that Mrs. Bell had built a "beautiful facility'' but said greed destroyed it and harmed vulnerable residents.

"This is not just a typical white-collar case,'' he said. "People were hurt.''

The judge also chastised Mrs. Bell for falsely accusing his court of destroying evidence in her case in a letter she sent to relatives and associates, soliciting them to write letters of support for a lenient sentence.

Mrs. Bell also is scheduled to stand trial next month in Allegheny County Common Pleas Court on involuntary manslaughter and other charges in the death of former Atrium resident Mabel Taylor, 88.