DOJ Files False Claims Suit Against Nursing Homes Over “Substandard Services and Nonexistent” Care

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law

On June 15, 2022, the U.S. Department of Justice (DOJ) announced it has sued three nursing homes in Ohio and Pennsylvania, citing their “grossly substandard skilled nursing services.” The False Claims Act (FCA) complaint against the American Health Foundation (AHF), its affiliate AHF Management Corporation, and three nursing homes alleges the facilities fraudulently billed the Centers for Medicare & Medicaid Services (CMS) for often “nonexistent care.”

According to the complaint, all three AHF nursing homes not only provided substandard nursing home care services that failed to meet required standards of care but also did not maintain adequate staffing levels between 2016 and 2018.

Click here to view the complaint filed by the DOJ in the U.S. District Court for the Eastern District of Pennsylvania.

FCA Violations For “Substandard or Nonexistent Care.”

The government alleged AHF Management and its entities violated the FCA stemming from reimbursements for “grossly substandard” care provided at the Cheltenham, Wilmington Place, and Samaritan nursing homes.

“The defendants knowingly submitted, or caused the submission of, false claims to Medicare and Medicaid for nursing home care and services that were blatantly substandard or nonexistent,” the complaint read. “The Medicare and Medicaid programs provided reimbursement for the claims, but these payments were by mistake as CMS didn’t know the true and full extent of the defendants’ failure to provide patients with proper treatment and care.”

Alleged Patient Conditions and Mistreatment.

Examples of the appalling conditions described in the complaint included housing elderly and medically vulnerable patients in “pest-infested” buildings whose belongings were often stolen; giving residents unnecessary medications, including antibiotic, anti-psychotic, anti-anxiety, and hypnotic drugs; subjecting residents to verbal abuse; neglecting to provide residents with activities or stimulation, and failing to provide needed psychiatric care.

Additionally, the complaint outlines the suicide of a resident who was admitted with a history of self-harm and was later hospitalized after slashing his wrists but still was not provided psychiatric services. Tragically, just weeks after readmission, the resident committed suicide by hanging himself from a bedsheet in a shower room, justice officials said.

“Nursing homes are expected to provide their residents, which include some of our most vulnerable individuals, with quality care and to treat them with dignity and respect,” said Assistant Attorney General Brian M. Boynton, head of the DOJ’s Civil Division in a statement. He continued, “the department will not tolerate nursing homes, or their owners or managing entities, who abdicate these responsibilities and seek taxpayer funds to which they are not entitled.”

To read the DOJ’s press release in full on the case, click here.

The United States’ complaint stems from an investigation that the DOJ initiated as part of its “National Nursing Home Initiative.” The department launched the initiative in March 2020 to identify and investigate nursing homes that provide grossly substandard care.

Click here to learn more about the Justice Department’s nursing home initiative.

The case is United States v. American Health Foundation Inc., case number 2:22-cv-02344, in the U.S. District Court for the Eastern District of Pennsylvania.

Contact Health Law Attorneys Experienced in Handling False Claims Act (FCA) Violations, Investigations, and other Legal Proceedings.

The attorneys of The Health Law Firm represent healthcare providers in defending audits and investigations by the Department of Health and Human Services, the Department of Justice, The Drug Enforcement Administration (DEA), the Florida Department of Health (DOH), Medicaid Fraud Control Unit (MFCU), state boards of medicine, state boards of pharmacy, and state boards of nursing. They also represent health professionals and providers in administrative litigation (state and federal) and civil litigation (state and federal). They represent physicians, nurses, medical groups, nursing homes, home health agencies, pharmacies, dentists, pharmacies, assisted living facilities, and other healthcare providers and institutions in recovery actions and termination from Medicare and Medicaid Programs.

To contact The Health Law Firm please call (407) 331-6620 or toll-free at (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

D’Annunzio, P.J. “Feds Hit Nursing Home With FCA Suit Over ‘Nonexistent’ Care.” Law360. (June 15, 2022). Web.

Marceas, Kimberly. ‘Grossly substandard’ care leads to False Claims charges for Ohio-based nursing home operator. McKnights Long Term Care News. (June 16, 2022). Web.

“Nursing Homes Face DOJ False Claims Suit Over Standards of Care.” Bloomberg Law. (June 15, 2022). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law is an attorney with The Health Law Firm, which has a national practice. Its main office is in Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Avenue, Suite 1000, Altamonte Springs, Florida 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620.

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2022 The Health Law Firm. All rights reserved.

 

Two Admins at a Veterans Home Criminally Charged For Mishandling Deadly COVID-19 Outbreak

George Indest Headshot

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified in Health Law

On September 25, 2020, two administrators at a Massachusetts veterans home were criminally charged with negligence for their role in a COVID-19 outbreak that killed 76 veterans. Attorney General (AG) Maura Healey reportedly stated that the criminal case involving Soldiers’ Home in Holyoke (SHH) is the first in the country against nursing home operators related to the pandemic.

Mishandling of the Coronavirus Outbreak.

The superintendent and the facility’s former medical director were indicted by a grand jury and charged with recklessly permitting bodily injury or abuse to the residents. The charges stem from their decision to combine two dementia units in March of 2020. They are accused of packing residents who were positive for the coronavirus into the same space as those with no symptoms. According to the AG, the decision contributed to the death of at least 76 residents at the facility.

The Investigation.

The AG’s Office began investigating in early April 2020 after learning of serious issues with COVID-19 infection control procedures at SHH. The investigation found that staffing shortages led to the decision to consolidate the two dementia units, totaling 42 residents. It resulted in confirmed COVID-19-positive residents being placed within feet of other veterans at the facility. The AG’s Office alleges that this decision was reckless from an infection control perspective and put the asymptomatic veterans at an increased risk of contracting COVID-19 from the positive ones.

Since March 1, 2020, 76 veterans who contracted the coronavirus at SHH have died, officials said. Click here to read the Attorney General’s press release on the case.

To read about a similar case against a Florida nursing home, click here.

Contact a Health Law Attorney Experienced in the Representation of Veterans Administration (VA) Physician Representation and Military Physician Representation.

The attorneys of The Health Law Firm have represented nursing home administrators, health care executives, nurses, nurse practitioners, assisted living facilities, skilled nursing facilities, and health professionals working for the Veterans Administration (VA) throughout the United States. Representation has included personnel and employment issues, disciplinary action, investigations, peer review investigations, clinical privileges actions, fair hearings, National Practitioner Data Bank (NPDB) actions, and appeals.

To contact The Health Law Firm, please call (407) 331-6620 or (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Durkin, Alanna. “2 Charged Over Handling of Virus Outbreak at Veterans Home.” Associated Press. (September 25, 2020). Web.

Dowling, Bryan. “Mass. Vet Home Leaders Charged Over Deadly Virus Outbreak.” Law360. (September 25, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

 

Two Administrators Charged With Negligence For Deadly COVID-19 Outbreak at Veterans Home

George Indest Headshot

By George F. Indest III, J.D., M.P.A., LL.M., Board Certified in Health Law

On September 25, 2020, two administrators at a Massachusetts veterans home were criminally charged with negligence for their role in a COVID-19 outbreak that killed 76 veterans. Attorney General (AG) Maura Healey reportedly stated that the criminal case involving Soldiers’ Home in Holyoke (SHH) is the first in the country against nursing home operators related to the pandemic.

Mishandling of the Coronavirus Outbreak.

The superintendent and the facility’s former medical director were indicted by a grand jury and charged with recklessly permitting bodily injury or abuse to the residents. The charges stem from their decision to combine two dementia units in March of 2020. They are accused of packing residents who were positive for the coronavirus into the same space as those with no symptoms. According to the AG, the decision contributed to the death of at least 76 residents at the facility.

The Investigation.

The AG’s Office began investigating in early April 2020 after learning of serious issues with COVID-19 infection control procedures at SHH. The investigation found that staffing shortages led to the decision to consolidate the two dementia units, totaling 42 residents. It resulted in confirmed COVID-19-positive residents being placed within feet of other veterans at the facility. The AG’s Office alleges that this decision was reckless from an infection control perspective and put the asymptomatic veterans at an increased risk of contracting COVID-19 from the positive ones.

Since March 1, 2020, 76 veterans who contracted the coronavirus at SHH have died, officials said. Click here to read the Attorney General’s press release on the case.

To read about a similar case against a Florida nursing home, click here.

Contact a Health Law Attorney Experienced in the Representation of Veterans Administration (VA) Physician Representation and Military Physician Representation.

The attorneys of The Health Law Firm have represented nursing home administrators, health care executives, nurses, nurse practitioners, assisted living facilities, skilled nursing facilities, and health professionals working for the Veterans Administration (VA) throughout the United States. Representation has included personnel and employment issues, disciplinary action, investigations, peer review investigations, clinical privileges actions, fair hearings, National Practitioner Data Bank (NPDB) actions, and appeals.

To contact The Health Law Firm, please call (407) 331-6620 or (888) 331-6620 and visit our website at www.TheHealthLawFirm.com.

Sources:

Durkin, Alanna. “2 Charged Over Handling of Virus Outbreak at Veterans Home.” Associated Press. (September 25, 2020). Web.

Dowling, Bryan. “Mass. Vet Home Leaders Charged Over Deadly Virus Outbreak.” Law360. (September 25, 2020). Web.

About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave. Suite 1000, Altamonte Springs, FL 32714, Phone: (407) 331-6620 or Toll-Free: (888) 331-6620

“The Health Law Firm” is a registered fictitious business name of and a registered service mark of The Health Law Firm, P.A., a Florida professional service corporation, since 1999.
Copyright © 2020 The Health Law Firm. All rights reserved.

 

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