A chain of 19 nursing homes has agreed to continue allowing independent monitoring and could be forced to pay nearly $18 million to settle state charges that it understaffed facilities, neglected patient care and inflated its ratings.
The settlement, announced Tuesday by California Attorney General Rob Bonta (D), requires the once behemoth Mariner Health Care “to reform and improve its practices” and services, and pay $2.25 million up front for the costs of a multi-year investigation.
Penalties could total $15.5 million for violations of the expanded injunction.
Neither Mariner’s in-house or external legal team responded to emails from McKnight’s Long-Term News seeking comment Wednesday after news of the settlement had started to hit local media and beyond.
The case is among a growing number in which state attorneys general have used the courts to force nursing homes into regulatory compliance, bringing legal action under a variety of causes.
In this case, California alleged Mariner inflated self-reported measures to the Centers for Medicare & Medicaid Services to artificially boost their ratings in the consumer-facing 5-Star system, essentially defrauding consumers. One law enforcement official involved in the lawsuit called this week’s resolution a “signal to owners of skilled nursing facilities — treat your patients with compassion, dignity, and respect or you will be held accountable.”
“Mariner jeopardized residents’ health and well-being, and misled prospective residents and their families about the quality of its California facilities,” added Bonta, in a statement announcing the settlement.
Bonta’s office first opened the investigation into Mariner in 2021, joined by district attorneys from Alameda, Marin, Santa Cruz and Los Angeles Counties. Since that time, the company has entered into Chapter 11 bankruptcy proceedings and is attempting to reorganize.
To support that effort and the company’s debtors, including plaintiffs in personal injury cases, the state agreed to pause collection of any penalties.
Any sell-off would be closely monitored
Mariner was once a major player nationally, with more than 250 skilled nursing facilities when it merged with NCARE, a subsidiary of National Senior Care, in a $1.05 billion deal in 2004. The move took the once-public entity private, and the Mariner brand has dwindled to just 19 buildings.
The settlement allows Mariner to explore the sale of affected facilities, though the attorney general has established strict new oversight rules that require his sign-off on most large healthcare mergers and acquisitions.
The state would have to determine that a buyer is” qualified to assume whatever duties of skilled nursing operations that are transferred, and that the buyer is not affiliated in any way with the persons or entities identified as Enjoined Parties” before lifting the injunction in whole or in part.
An independent monitor that took on an oversight role during that investigation will continue to gauge compliance with Mariner’s general skilled nursing regulations, as well as a series of additional discharge standards, abuse reporting and data compliance requirements stipulated in an injunction.
The monitoring will run for three years or until Mariner finalizes a related bankruptcy proceeding, with the state able to exercise an extension. The monitor will have complete, confidential access to patients’ electronic medical records, staffing information and financial records.
