The settlement was made with the U.S. Department of Justice after Signature HealthCare was found to have submitted forged pre-admission certifications regarding patient needs to the Medicaid program in Tennessee.
These allegations initially arose after two former employees of the nursing home company filed a federal whistleblower lawsuit. The U.S. government became involved and also accused Signature HealthCare of engaging in multiple fraudulent practices that were lead to false claims for “unreasonable, unnecessary, and unskilled services to Medicare patients.”
The two whistleblowers say they felt that it was necessary to file a lawsuit after one of their patients had been very sick for days and was not able to attend therapy. Even so, their boss demanded that the resident undergo 4 hours of therapy in a single day so that his reimbursement bill would not fall into a lower bracket.
The CEO and President of Signature HealthCare, Joe Steier, says since working with the U.S. government for the last two years to come to an amicable settlement, has “allows us to move forward in serving our residents and families with quality health care and a commitment to compassion.” He continues to explain that the care of the residents is the “first priority”, and that the therapy services “are and remain an important part of that care.” Steier also emphasised that the company is focused more than ever to provide residents and their loved one’s with “excellence and great outcomes. ”
Regardless of what Steiers’ kind words might have been, what is for certain is that the company he runs was found to have defrauded the Medicare system and lied to residents and their families. In many cases, residents were forced to participate in therapy they did not need or want. In a press release by the U.S. Justice Department, Signature HealthCare engaged in several wrongful practices of which included the automatic placement of patients in the highest therapy reimbursement levels instead of performing an individual exam to identify the resident’s unique medical and clinical needs. As a result this would begin with a reimbursement bill that includes the minimum number of minutes needed to file a claim, while also avoiding unnecessary care.
Chad A. Readler, the Acting Assistant Attorney General, explains that nursing homes are important facilities for elderly people. They must uphold the trust which is placed in them by the government, by ensuring that only reasonable services are given and billed for.
As part of agreement, the state of Tennessee will receive a portion in addition to the two whistleblowers. The $30 million settlement does not include any wrongdoing which suggests the resident’s who were put through unnecessary therapy, and possibly harmed – psychologically or physically – could file a personal injury lawsuit.
Do you believe you have been the victim of negligence in a Tennessee nursing home?
If you or a loved one has been harmed, neglected, or abused while under the care and supervision of a nursing home, you should consult a Tennessee nursing home abuse lawyer from The Higgins Firm as soon as possible. Call now for a consultation.