A Nashville-based skilled nursing company has agreed to pay $9.8 million to settle allegations that it forged physician’s signatures to certify patients’ entry into its facilities.
During an eight-year period that ended in 2017, Tennessee Health Management allegedly submitted pre-admission evaluations to both the state and federal authorities, with photocopied or pre-written signatures from physicians. TennCare, the state’s Medicaid program, requires that doctors conduct a patient-placement evaluation prior to an individual entering a SNF.
For violating the False Claims Act, THM has agreed to pay almost $5.5 million to the U.S. government and $4.3 million to the state of Tennessee, the Department of Justice said Tuesday. The company also is entering a federal corporate integrity agreement to improve practices and avoid further such conduct.
In a statement issued Tuesday, THM said that it completed a reorganization, including the appointment of new management, in 2016, which is when it became aware of the issue. An internal review stemming from that discovery determined that staff at some SNFs did not properly adhere to TennCare regulations on pre-admission evaluations. The company said it started addressing those issues in early 2017, following the investigation.
None of the administrative errors impacted patient care, noted THM, which operates 27 SNFs across Tennessee. A records review determined that all affected residents did meet admission criteria for medical necessity. The DOJ noted in its announcement that the claims are allegations only, and commended Tennessee Health for immediately cooperating and resolving the issue.
“Under the leadership of new management, THM has continued to implement a series of corrective actions, including the adoption of new processes, staff retraining, and the reorganization and expansion of its compliance program,” THM said in its statement.