Signature HealthCARE, the owner of 115 skilled nursing facilities, has agreed to pay $30 million to resolve allegations that it routinely placed residents at higher therapy levels to increase claims.
The settlement with the U.S. Department of Justice, announced Friday, also resolves allegations that Kentucky-based Signature submitted forged pre-admission certifications of patient need to Tennessee’s Medicaid program.
The allegations stemmed from a federal whistleblower lawsuit brought by former Signature therapy employees Kristi Emerson and LeeAnn Tuesca. The government intervened in the case, accusing Signature of engaging in several practices that resulted in claims for “unreasonable, unnecessary, and unskilled services to Medicare patients.”
Joe Steier, CEO and president of Signature Healthcare, told McKnight’s working with the government over the last two years to reach the settlement “allows us to move forward in serving our residents and families with quality health care and a commitment to compassion.”
“Resident care remains our first priority, and therapy services are and remain an important part of that care,” he said in an email. “We are more focused than ever on our mission to serve each resident and family with excellence and will continue to work hard each and every day to deliver great outcomes for our residents.”
According to the a Justice Department press release, Siganture’s improper practices included automatically placing patients in the highest therapy reimbursement level rather than conducting individualized evaluations to determine each patient’s clinical needs; providing the minimum number of minutes required to bill at a given reimbursement level while discouraging additional care above the threshold; and pressuring therapists and patients to complete planned minutes even when patients were sick or disinterested.
“Nursing home facilities provide important services to our elderly, and those facilities must uphold the trust placed in them by billing the government only for reasonable and necessary services,” Acting Assistant Attorney General Chad A. Readler said in the announcement.
The settlement does not include an omission of wrongdoing.
Seven of the company’s facilities are in the middle district of Tennessee, where the allegations were first made in court. As part of the resolution, the state will receive a portion of the overall settlement, as will Emerson and Tuesca.
