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FRAUD


1. Two Whistle-Blower suits, under the False Claims Act, were brought by private citizens on behalf of the United States against Extendicare Health Services Inc, a corporation that operates 146 skilled nursing facilities. The actions alleged that Extendicare billed Medicare and Medicaid for materially substandard nursing services including insufficient staffing, inadequate catheter care and failure to follow appropriate protocols to prevent pressure ulcers and resident falls. The action further alleged that Extendicare billed Medicare for medically unreasonable and unnecessary rehabilitation therapy services. Extendicare agreed to pay $38 million in settlement and to enter into a 5 year Corporate Integrity Agreement with HHS-OIG. According to HHS-OIG, this is the department’s largest failure of care settlement with a chain-wide skilled nursing facility to date. See Justice News, U.S. Department of Justice, Office of Public Affairs, October 10, 2014; U.S. ex rel. Lovvom v. EHSI, et. al. C.A. 10-1580 (E.D. Pa) and U.S. ex rel. Gallick et al., v. EHSI et al., C.A. 2:13cv-092 (S.D. Ohio).