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This archive displays posts tagged as relevant to fraud involving skilled nursing facilities. You may also be interested in our pages:

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Watch: Jessica Moore Discusses Assisted Living Facility Safety on Tampa’s ABC Action News

Posted  09/4/20
wheelchair in the hospital lobby
Constantine Cannon has been following the impact of COVID-19 on nursing homes and assisted living facilities.  Residents and workers at nursing homes make up a disproportionate share of U.S. coronavirus deaths, and the pandemic has imposed unique burdens on the industry. Florida recently implemented standards that will allow visitors in to long-term care facilities, if those facilities meet specific criteria. ...

Whistleblowers Are Critical to Exposing Fraud in the Murky World of For-Profit and Private-Equity Nursing Home Operations

Posted  07/17/20
By Jessica T. Moore
person following a trail of money
The settlement of a fraud case against 27 skilled nursing facilities controlled by private owners demonstrates “the power of whistleblowers to shine a light on improper business practices and obtain significant recoveries on behalf of United States taxpayers.”  (U.S. Attorney Nick Hanna, C.D. California.)  The government’s recognition of the contributions of whistleblowers in the False Claims Act case against...

July 13, 2020

The owner and operator of a skilled nursing facility has agreed to pay $1 million to settle allegations of submitting false claims to Medi-Cal in violation of the California False Claims Act.  According to the Attorney General, Legacy Post-Acute Rehabilitation Center (Legacy) failed to provide the minimum number of nursing hours required for the level of care that it billed for.  AG CA

July 13, 2020

Longwood Management Company and 27 affiliated skilled nursing facilities have agreed to pay $16.7 million to resolve allegations raised by whistleblowers Judy Boyce, Benjamin Monsod, and Keith Pennetti in two separate qui tam filings, that six Longwood facilities knowingly submitted false claims to Medicare.  Between 2018 to 2012, Longwood allegedly pressured its rehabilitation therapists to increase the amount of therapy provided to Medicare Part A patients, regardless of medical necessity, so it could claim Ultra High levels of service, which are reimbursed at the highest rate.  As part of the settlement, Longwood will enter into a five-year Corporate Integrity Agreement, and Boyce, Monsod, and Pennetti will share a $3 million award.  DOJ; USDC CDCA

July 8, 2020

A Florida-based nonprofit that provides hospice care, palliative care, and other services to the elderly, has agreed to pay $3.2 million to resolve its liability under the False Claims Act.  According to former Director of Hospice Care, Margaret Peters, Hope Hospice knowingly submitted false claims to Medicare, Medicaid, and TRICARE for medically unnecessary but highly reimbursed general inpatient (GIP) hospice services over a five year period.  For blowing the whistle on the alleged fraud, Peters will receive a 19% share of the settlement.  USAO MDFL

Under Cover of Pandemic, Nursing Home Residents Illegally Evicted

Posted  06/26/20
By Jessica T. Moore
wheelchair in the hospital lobby
“It felt opportunistic, where some homes were basically seizing the moment when everyone is looking the other way to move people out.”  (Laurie Facciarossa Brewer, long-term care ombudsman in New Jersey).  With nursing homes involved in more than 40% of coronavirus deaths, in depth reporting by Jessica Silver-Greenberg and Amy Julia Harris at the New York Times reveals a new threat to residents’ care and...

June 9, 2020

Partner Jessica T. Moore was quoted in the Bloomberg Law article, Nursing Homes, States Vary in Meeting New Inspection Demands.  Click here to read the article.

Increased Federal Funds, Incentives, and Requirements for Nursing Homes Brings Worrisome Opportunities for Fraud

Posted  06/5/20
By Jessica T. Moore
wheelchair in the hospital lobby
The pandemic has exposed the razor thin margin for error by which our most vulnerable are cared for in nursing homes. New aggregate federal data reveal the appalling toll on facility residents and staff: over 31,700 deaths as of June 4, 2020 (an undercounted 1/3 of all US COVID-19 deaths), according to the federal government’s Nursing Home Compare.  Responsive federal funding for nursing homes, requirements for...

Private Equity Ownership of Nursing Homes Might Have Made Everything Worse

Posted  05/15/20
By Jessica T. Moore
person pocketing money in a business suit
Most nursing homes already had no room for error before COVID-19.  Years of private equity ownership and competition with other elder-care services dealt a one-two punch to the cash-strapped facilities’ ability to react to the pandemic crisis, says The New York Times in a troubling analysis.  In particular, private equity firms’ relentless quest for profits, miniscule margins, and regular cash-draining...

Let’s Talk about Nursing Homes – Who Will Raise the Red Flag Now That Routine Inspections Are Halted?

Posted  05/14/20
By Jessica T. Moore
nurse checking on elder woman
In March 2020, the federal government abruptly paused non-emergency inspections of some 15,300 nursing homes and other long-term healthcare facilities nationwide in order to focus on preparations to respond to the threat of COVID-19 pandemic.  This triage means that an on-site survey will be authorized only in cases of “immediate jeopardy” of serious harm (e.g., abuse) or reported infection-control...
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