Nursing assistant faces 3 years in prison for HIPAA crime

Nursing home operator Ralex Services Inc. has agreed to a $2.2 million settlement in a whistleblower case involving forged documents at a facility in New Rochelle, New York.

The charges were brought in 2010 by full-time resident nurse Carolyn Hinestroza, according to a summary of the case posted to a law firm blog. Hinestroza said that her name had been forged on patient review instruments at the Glen Island Center for Nursing and Rehab, so that the documentation falsely stated that certain services had been provided. These services included suction and oxygen treatments and cancer care. Glen Island subsequently billed Medicaid for the treatments, even though they would not have been supported by doctors’ orders, Hinestroza contended.

“The settlement requires Ralex to return government funds related to the conduct of a former employee who pleaded guilty to a crime,” the nursing home’s attorney, Gabriel M. Nugent of Hiscock & Barclay LLP, stated in an email to McKnight’s. “The conduct occurred years ago and had no impact on the excellent service and care Ralex provides to its residents.”

The employee in question, administrator Eufemia Fe Salomon-Flores, pleaded guilty in 2011 to falsifying the documentation to increase reimbursements. She executed a confession of judgment for $2.2 million and also admitted to an unrelated tax fraud.

Both the state of New York and the federal government intervened in the case in part, and each will get a share of the settlement.

Glen Island is a 184-bed, for-profit facility, according to Nursing Home Compare.