Four skilled nursing facilities and a physical therapy center in the Chicago area have agreed to pay $9.7 million to resolve allegations of False Claims Act violations.
Quality Therapy & Consultation worked with the SNFs to increase Medicare reimbursements related to RUG scores, according to a civil whistleblower lawsuit filed in the U.S. District Court in Chicago. This resulted in patients receiving physical, occupational or speech therapy that they did not need or couldn’t benefit from.
Per the settlement’s terms, Carlton at the Lake in Chicago will pay $3.63 million; Lakeshore Healthcare in Chicago will pay $2.73 million; Balmoral Home in Chicago will pay $1.17 million, and Ridgeview Rehab in Chicago will pay $1 million. Quality Therapy, formerly in Orland Park, IL, will pay $1.09 million while its owner, Frances Parise, will pay $160,000. Parise also agreed to be excluded from participation in Medicare and Medicaid for five years.
Attempts to reach Parise and Quality Therapy were not successful, and three of the involved nursing homes did not return calls seeking comment. The Carlton Skilled Nursing Facility said in a statement that the previous operator reached the settlement.
“As always, the care of our residents of Carlton Skilled is our top priority, and the investigation and settlement by the prior operator of our facility has no impact on our operations or the well-being of our residents,” the statement read.
Whistleblower Katherine Verhulst, a former occupational therapist for Quality Therapy and Consultation Inc. who filed the lawsuit in 2014, will receive $1.9 million.
Her attorney, Brian J. Markovitz of Joseph Greenwald & Laake, said the case was particularly important because the populations serviced “consisted of vulnerable individuals who were elderly or were suffering with mental health issues or both.”