The U.S. Attorney’s Office Western District of Pennsylvania announced on February 19, 2020 that Guardian Elder Care Holdings, Inc., which operates more than 50 nursing homes throughout Pennsylvania, and its related companies, will pay $15,466,278 to settle claims that it provided medically unnecessary rehabilitation therapy to residents in order to meet revenue goals, instead of clinical needs.
The settlement resolves allegations in a whistleblower complaint filed in federal court in the Eastern District of Pennsylvania under the qui tam provisions of the False Claims Act that Guardian Elder Care pressured its rehabilitation therapists to provide services to meet financial targets and maximize revenue without regard to clinical need. The whistleblowers alleged that certain patients suffered from dementia and did not need or want rehabilitation therapy, but Guardian Elder Care allegedly pressured therapists to provide those services anyway to meet revenue goals. The whistleblowers further alleged that other patients were allegedly dying and receiving hospice care—and therefore had no medical need for intensive therapy—but Guardian Elder Care allegedly pressured therapists to treat those patients, as well, in order to meet the same financial goals.
While the government was investigating the whistleblowers’ allegations, Guardian Elder Care voluntarily disclosed that it had employed two people who were excluded from federal healthcare programs. The settlement therefore encompasses claims that Guardian Elder Care inappropriately received payment for services provided through these excluded persons during their term of exclusion.
In addition to the nearly $15.5 million payment, Guardian agreed to enter into a chain-wide Corporate Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General. Such agreements promote compliance and protect vulnerable nursing home residents.
The settlement agreement resolves the allegations arising from Guardian Elder Care’s facilities management practices from January 2011 through December 2017.
An Assistant Attorney General of the U.S. Department of Justice’s Civil Division stated, “Seniors rely on the Medicare program to provide them with appropriate care, and to ensure that they are treated with dignity and respect. The Department will not tolerate nursing home operators that put their own economic gain ahead of the needs of their residents, and will continue to hold accountable those operators who bill Medicare for unnecessary rehabilitation services.”
The case is docketed as United States ex rel. Krauss, et al. v. Guardian Elder Care Holdings, Inc., et al., Civil Action No. 3:15-cv-6850 (E.D. Pa.).
If you or a loved one suffered injuries (or worse) while a resident of a nursing home in Pennsylvania or in another U.S. state due to a nursing home fall, nursing home aspiration, nursing home neglect, nursing home negligence, nursing home abuse, nursing home under-staffing, or the nursing home failing to properly care for a vulnerable adult, you should promptly find a Pennsylvania nursing home claim lawyer, or a nursing home claim lawyer in your state, who may investigate your nursing home claim for you and file a nursing home claim on your behalf or behalf of your loved one, if appropriate.
Click here to visit our website to be connected with medical malpractice attorneys (nursing home claim attorneys) in your U.S. state who may assist you with your nursing home claim, or call us toll-free in the United States at 800-295-3959.
Turn to us when you don’t know where to turn.