Articles Posted in Nursing Home Medicare Fraud

Life Care Centers of America, which operates 200 locations and is based in Tennessee, will pay $143 million to settle a False Claims Act (FCA) litigation in which it was alleged that the corporation had billed Medicare for excess treatment. According to the report of the case, this was a record FCA settlement for the nursing home industry.

The consolidated cases arose because of two whistleblower cases as well as an unjust enrichment lawsuit brought by the Department of Justice (DOJ) against the owner of Life Care. The two former employees will share $29 million in the settlement payout.

This settlement was reported to be the largest in the Justice Department’s history involving a skilled nursing home chain. The size of the settlement was based on Life Care’s ability to pay this amount.  The government, which joined in the FCA cases in 2012, alleged excessive treatment of seniors in order to maximize Medicare reimbursements.

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The nursing home real estate trust investment company, Extended Care Real Estate Trust Investments, which operated 146 skilled nursing facilities in 11 states, was found to have over-billed Medicare and Medicaid, provided substandard and essentially worthless nursing care and put in place worthless rehabilitation therapy.

Two private citizens, including the entities’ area director of rehabilitation, brought separate whistleblower lawsuits under the federal False Claims Act on behalf of the United States and themselves. It was alleged that Extended Care bilked Medicare and Medicaid for nursing services that they didn’t provide or failed to meet federal and state standards in 33 of the skilled nursing homes in multiple states. These states included Indiana, Wisconsin, Minnesota, Ohio, Kentucky, Pennsylvania and Washington.

The lawsuit alleged that Extended Care chose not to provide an adequate number of skilled nurses and sufficient catheter care and failed to prevent pressure ulcers or falls to its many residents.

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A Georgia jury has awarded $43.5 million in damages related to the abuse and neglect of an 80-year-old man, Morris Ellison. Ellison was a resident of a nursing home where the ownership held title to a string of nursing facilities in and around the state of Georgia. Ellison eventually died in this nursing home.

Along with the neglect and possible abuse, Ellison was found to have been malnourished, dehydrated and lacking sufficient nursing and medical care, all of which was a contributing factor in hastening his death. But the background of this catastrophic case was that the nursing home owners had bilked Medicare and Medicaid out of tens of millions of dollars.

In this case, the nursing home’s individual owner and his wife ran three nursing facilities or long-term care facilities in Georgia. According to newspaper reports, this couple had a net worth of almost $100 million, relying almost exclusively on Medicaid and Medicare payments to operate their nursing home empire. According to the testimony in the case, one of the nursing home directors stated that the facilities were so lacking in funds that they were unable to pay for laundry, essential supplies and personnel wages for the nursing homes. The owners were systematically draining money out of the nursing homes, which resulted in a lack of food supplies, water, medicine, personnel and basic cleaning supplies.

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