Nursing Home Chain Accused of Defrauding Medicare, Medicaid

Last month, we wrote that in an effort to stem the growing epidemic of nursing home abuse, the state of Kentucky was seeking more stringent criminal checks for workers responsible for the care of nursing home residents.

Now, says Courthouse News, a Kentucky “care center,” part of a nursing home chain, is accused in a lawsuit filed by the U.S. Justice Department of billing Medicare and Medicaid for $16 million of “worthless” services, wrote Courthouse News. The care at Villaspring Health Care Center of Erlanger, Kentucky, is described as “grossly deficient” and abusive, according to the federal complaint.

Courthouse News wrote that Villaspring Health Care Center, lead defendant in the federal lawsuit, iis wholly owned by Carespring Health Care Management, a co-defendant. Barry N. Bortz is the final defendant and both majority owner and CEO of the two companies, according to the federal complaint.

The complaint alleges fraud, unjust enrichment, and false claims and states, in part: “The defendants have failed to provide adequate care for the medically fragile and vulnerable elderly residents of the Villaspring nursing facility, resulting in egregious harm and even death to some of those residents.’

‘In the process, defendants have defrauded the United States and the Commonwealth of Kentucky by seeking, and receiving, substantial reimbursement from the Medicare and Kentucky Medicaid programs for care purportedly provided to these residents, despite knowing that such ‘care’ was either nonexistent or so inadequate as to be worthless,” it continues.

Abuse allegations span from 2004 to 2008 when Villaspring received $15,983,983.83 in Medicare and Medicaid payments.

The complaint went on to state that, “On numerous occasions, Villaspring residents did not receive their medication as prescribed or ordered…. Medication errors were prevalent, and Villaspring residents suffered and were harmed by not receiving the medication they needed and had been prescribed,” wrote Courthouse News.

Other allegations include understaffing in legal violation and fraudulent staffing—records indicating, for instance, that a Registered Nurse was on duty when that nurse had resigned weeks prior, noted Courthouse News. Allegations of nutritional abuse, failing to take residents to the bathroom, inaccurate care plans, and putting continent adults in diapers for no apparent reason, were also included in the complaint.

In one case a woman suffering from diarrhea was given laxatives; she underwent a colostomy and had one leg amputated before she died of sepsis. The government was billed nearly $13,000 for her care. In another case, said Courthouse News, another man who was deemed “likely to improve” at admission, did not receive appropriate wound care for a number of pressure sores. Among other issues, he underwent surgery to remove his coccyx before his death.

We have followed the horrendous abuses against seniors spanning physical, emotional, chemical, and sexual abuse; neglect; and even workers who have abused residents as part of pranks against each other. The elderly are among our most vulnerable citizens and, often, we have no choice but to place our older relatives in the care of others. Sadly, reports of nursing home abuse are on the rise as are nanny cams catching nursing home workers abusing residents. Recently, adding to the list of indignities, we wrote that 15 percent of U.S. nursing homes have received deficiency citations for the ways in which they manage infection.

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