Nursing Home Chain Settles For Millions in Whistleblower Claim

On February 19, 2020, the U.S. Attorney’s Office released news that Guardian Elder Care Holdings Inc. agreed to paying more than $15 million in damages. This settlement resolves allegations under the False Claims Act that Guardian knowingly up-charged Medicare and the Federal Employees Health Benefits Program for over six years for rehabilitation services that were deemed medically unnecessary.

Guardian is a privately-owned chain of 59 Healthcare Communities servicing Pennsylvania, Ohio and West Virginia. The company is advertised as a top provider of healthcare services for providing skilled nursing and rehabilitation services to the elderly.

Allegations of Overbilling for Unneeded Rehabilitation Services

Federal officials reported that the allegations describe how Guardian pressured therapists to provide rehabilitation services even when there was no medical need for them, such as for dementia patients or patients in hospice.

Guardian volunteered additional information that it had received reimbursements for ineligible services. These payments were inappropriate because the two employees providing the services were excluded from federal healthcare programs.

According to court records, no civil liability has been assessed to date.

The two former employees of Guardian Elder Care who filed these whistleblower allegations back in 2015 on behalf of the government will share a portion of the recovery in the amount of $2.8 million.

Putting Economic Profits Before Patient Needs

Engaging in false billing for economic gain does more than deplete Medicare funds or take money from taxpayers who pay into these funds. The act of forcing unwanted or unnecessary medical treatment on elderly residents also exploits some of the most vulnerable individuals in our country.

U.S. Attorney, Scott W. Brady of the Western District of Pennsylvania promises, “Our office will continue to aggressively pursue providers who take advantage of our seniors by putting financial gain ahead of patient care.”

Deputy Assistant Inspector General for Investigations, Thomas W. South also called the allegations, “unconscionable.”

Nursing home residents in Wisconsin are protected by federal and state patient rights to help ensure they are treated with dignity and respect. These rights include the ability to refuse any unwanted treatment. Additionally, no patient should be forced to receive any type of medical care or treatment that is not only medically unnecessary, but which may also cause more harm to those already in a frail state of health.

Is Your Loved One Receiving Medically Unnecessary Treatment?

If you suspect your loved one is being forced to receive medical care that he or she does not want or need, you may have legal options.

Contact our Wisconsin nursing home abuse lawyers for more information and to schedule a free, no-obligation nursing home abuse consultation. We can answer your legal questions and help determine whether you may have grounds to pursue compensation on behalf of your loved one.

We charge no money upfront for our services, and we do not collect any fees unless we are successful in recovering compensation on your behalf.

Our law firm can receive your call 24/7, day or night: 877-877-2228