May 01, 2013
A whistleblower lawsuit involving a nursing home chain and therapy providers in Missouri can move forward, a federal judge has ruled. The False Claims Act case originated with allegations that a therapy company received more than $10 million in kickbacks as part of a scheme to overbill Medicare and Medicaid.
Even if county nursing home workers provide poor care, the county is not liable unless the inadequate care results directly from an official policy or custom, a federal judge has ruled.
April 01, 2013
Federal authorities cracked down on another regional long-term care provider recently, reaching a roughly $2.7 million settlement in a lawsuit centering on alleged false therapy billing.
Nursing home company SSC Odin Operating Co. has asked the U.S. Supreme Court to again weigh in on arbitration agreements.
Two former nurses' complaints about alleged substandard care and inappropriate billing resulted in $28.1 million in penalties being levied against the former owner of an Illinois nursing home. A federal jury assessed the penalties.
March 01, 2013
If the U.S. Supreme Court thought it had the final word on the validity of certain nursing home admissions arbitration agreements in 2012, well, it was wrong.
A stolen laptop has resulted in an Idaho hospice organization paying the Department of Health and Human Services $50,000.
February 01, 2013
Lying about a wandering resident and foregoing help when lifting a resident were all it took to land a nursing home administrator and a nurse aide in legal trouble.
January 01, 2013
We've been accused of upcoding our therapy reimbursement claims. What can we do?
A well-known former nursing executive must repay the federal government $13.8 million for fraudulent business practices. Chief U.S. District Court Judge Mary M. Lisi handed down the ruling for the misuse of loans in Anthony Giordano's Rhode Island facilities on Dec. 3.
A U.S. District Judge has called federal prosecutors' years-long delay in announcing a Medicare fraud case involving one of the nation's largest nursing home companies "absurd."
A federal appeals court has upheld the government's leveling of Immediate Jeopardy level penalties at a Kentucky nursing home over allegations of resident sexual abuse.
December 01, 2012
A nursing home resident who suffered a broken leg while being helped out of bed has presented sufficient evidence of negligence to earn another chance to present her case to a jury, the Alabama Supreme Court recently ruled.
November 01, 2012
After struggling over a case involving a rehabilitation claim, a U.S. Court of Appeals has decided in favor of the Centers for Medicare & Medicaid Services' recovery audit contractor program.
The child of a deceased long-term care resident is not bound to an arbitration agreement because she signed it on behalf of her mother — not herself — an Illinois court ruled in September.
A former nursing home activities aide allegedly fired over refusing to pray the rosary with a Catholic resident can proceed with a religious discrimination claim, a federal court ruled in September.
October 01, 2012
A former long-term care provider has achieved a $25 million victory over state authorities. Brook Chambery, the owner of the long-closed Beechwood Restorative Care Center in Rochester, NY, became the benefactor of a $25 million settlement from the state.
What hospice services will pay for, and whether beneficiaries receive correct information from the Centers for Medicare & Medicaid Services, converged as issues in court this summer.
Five residents of a for-profit California skilled nursing facility sued a Mariner Health Care Inc. facility in June, alleging inadequate staffing and an unsafe environment.
A verdict against a nursing home of slightly over $90 million is being reconsidered in West Virginia due to a verdict-form error.
A nursing home closed 13 years ago opened a new chapter in May, when a trial between the state of New York and the home's former owner began.
July 05, 2012
HealthSouth Corporation is opposing a deal to build two skilled nursing facilities in Alabama.
The Internal Revenue Service is attempting to recoup $8 million from a convicted former Rhode Island nursing home executive, signaling a warning to providers that they can be held liable for misdeeds.
June 05, 2012
In another strike against the traditional nursing home census base, a federal judge in Maine has approved a class-action lawsuit settlement that lets those with long-term disabilities live in their home or the community.
May 01, 2012
A Jewish nursing home in Pennsylvania has been turned back in its attempt to have a penalty reviewed that it said resulted from a biased survey process.
Two former nursing home employees may be headed to trial over what they say is their previous employer's failure to pay into a group health plan.
April 02, 2012
A former Aegis occupational therapy assistant can move forward with a lawsuit over what she says were fraudulent therapy claims.
Alabama's high court has ordered a nursing home's breach of contract suit against the state's largest health insurer to be dismissed.
March 01, 2012
Arizona has the right to recover a community spouse's annuity to pay for an institutionalized spouse's medical costs, a U.S. Court of Appeals has affirmed.
Same-sex partners who want to participate in a state long-term care program can move forward with a federal lawsuit, a federal judge has said.
February 01, 2012
Sun Healthcare will pay more than $60,000 in a settlement over a failure to pay vacation wages to former employees, the Massachusetts Attorney General said in December.
The federal government has joined a whistleblower complaint that alleges a major hospice company defrauded Medicare.
January 03, 2012
Nursing home arbitration agreements received another blow when the Florida Supreme Court ruled them invalid in two separate cases in November.
A federal appeals court agreed that an agreement between union nurses and a hospital should have been honored by new owners.
December 01, 2011
A continuing care retirement community must make sure it is using standard, uniform questions in screening applicants, experts emphasized at the LeadingAge convention.
A U.S. Court of Appeals has agreed that an arbitration agreement signed by a nursing home resident with dementia is void.
November 01, 2011
A group of Pittsburgh nursing home operators' lack of oversight for their now-defunct nonprofit facility may leave them liable in the eyes of the law, according to the ruling of a federal appeals court.
A federal judge has imposed a 50-year prison sentence on a Florida executive found guilty of creating a $205 million Medicare fraud scheme that targeted patients with dementia.
October 01, 2011
A high-profile ousted Florida ombudsman has filed a lawsuit against the Florida Department of Elder Affairs, the Florida Health Care Association and the Florida Assisted Living Association for alleged whistle-blower retaliation and tortuous interference in a business relationship.
A skilled nursing facility should not use a medical supply company as an exclusive supplier in order to get lower prices, according to an advisory opinion from the Office of the Inspector General.
September 01, 2011
A federal court ruled in favor of a fiscal intermediary's decision to exclude the allocation of nursing administration costs to therapy costs in Medicare reimbursements for 30 skilled nursing facilities.
The U.S. Equal Employment Opportunity Commission is suing a Florida nursing and rehabilitation facility for firing a certified nursing assistant who did not want to work on her religion's Sabbath day.
August 02, 2011
The year 2009 was a time of transition for Peninsula United Methodist Homes. CEO Allen Johnson was retiring; a partner was needed for a project in Bethany Beach; and the financial future of the company, while not dire, was uncertain.
August 02, 2011
The death of a nursing home resident from a spider bite is a healthcare liability claim and requires an expert report to be filed as such, the Supreme Court of Texas ruled in July.
Nursing homes cannot use arbitration agreements to combat lawsuits related to residents' care, the Supreme Court of Appeals of West Virginia has ruled.
A nursing home operator has agreed to pay close to $1 million to settle allegations that it defrauded Medicare, the U.S. Attorney's Office for the Western District of North Carolina has announced.
June 01, 2011
A pharmacy employee's joint ownership of a long-term care pharmacy with facility owners would potentially violate anti-kickback statues, according to a federal opinion.
May 02, 2011
John Durso, Esq., Ungaretti & Harris LLP
April 01, 2011
House Republicans recently moved one step closer to passing a key tort reform bill. Following an 18-15 vote in the House Judiciary Committee, the "Help Efficient, Accessible, Low-cost, Timely Healthcare (HEALTH) Act," went to the full House for consideration.
More than nine out of 10 nursing homes in the United States have at least one convicted criminal on staff, according to a new report from the Department of Health and Human Services Office of Inspector General. The OIG recommends developing procedures to help implement a nationwide criminal background check program.
