$38 Million Settlement for Nursing Home’s Medicare Fraud

Washington will receive about $1 million in reimbursement for Medicaid and Medicare charges billed by Extendicare.

The nursing facility company is paying out $38 million to eight states and the federal government. A Department of Justice investigation found that Extendicare billed for care that didn’t meet Medicare standards—or in some cases, didn’t happen at all—including:

–       Procedures to prevent pressure ulcers, and prevent falls

–       Improper staffing, providing too few skilled nurses

–       Failure to provide proper catheter care

When a nursing home bills Medicare for patient services, the facility has to meet basic standards of care.

Extendicare currently operates 146 nursing facilities in 11 states (15 are in Washington). Of those, 33 nursing homes billed for patient care that did not meet federal and state standards.

The Extendicare investigation, prompted by two whistleblowers in separate nursing facilities, found that Extendicare billed Medicare and Medicaid for services that “were so deficient that they were effectively worthless…”

Extendicare also billed for unnecessary rehabilitation services, timed with the goal of charging Medicare as much as possible.

“Health care providers must make decisions regarding the level of services to be provided based solely on their patients’ clinical needs, and not corporate financial targets.”

– Acting Assistant U.S. Attorney General Joyce R. Branda

According to the Seattle PI’s Boomer Consumer investigator, $595,000 of Washington’s reimbursement will go to the federal government for its share of Washington’s Medicaid program.

Medicare fraud is a serious crime: reporting is crucial for holding nursing homes and other medical facilities accountable.

About Kevin

Kevin Coluccio was recently named one of the Top 10 Super Lawyers in Washington State. He has long history of successful elder abuse/neglect cases and has a stellar reputation for getting results for his injury clients in serious car crashes, pedestrian accidents, trucking accidents, maritime claims, and asbestos injury cases.