Just a few weeks worth of news on Medicaid fraud and elder abuses associated with Nursing Homes
Attorney
General to focus on Nursing Home crimes
It is difficult
enough for most people to send aged or infirm relatives to nursing homes when
they believe good care will be provided. But the thought that frail elderly
parents or incapacitated younger patients may be victims of neglect or active
abuse is intolerable.
In Ohio,
concern about that may be increasing — with good reason.
Attorney
General Mike DeWine reports complaints about nursing home abuse and neglect
have nearly doubled this year. His office’s Medicaid Fraud Control Unit is
investigating 131 cases, compared to 74 for the same period in 2012.
About half this
year’s complaints have been received last month, after DeWine announced his
office will be aggressive in pursuing complaints of substandard nursing home
care or abuse of patients.
DeWine — and
those who place relatives or friends in nursing homes — have a new weapon to
ensure quality care is provided. It was used earlier this year in Zanesville.
There,
investigators placed surveillance cameras in the rooms of some patients, with
their knowledge and that of families. Nursing home personnel were unaware they
were being watched, however.
Videotape from
some of the rooms revealed “absolutely shocking and disturbing” treatment of
patients, DeWine said.
Most nursing
homes and the dedicated personnel who staff them provide good care for
patients. In many cases, it is not too much to say residents of nursing homes
are treated lovingly.
That makes it
especially upsetting that a few people in a handful of facilities are
neglecting and/or abusing patients. DeWine should make it a top priority to
find and punish those criminals.
The (Tiffin)
Advertiser-Tribune
Senate should act quickly
Nurse guilty of diverting medications at Nursing
Home
A prescription drug fraud
charge has been filed against an Abbotsford nurse accused of diverting
medications from the nursing home where she worked.
Patricia Pokallus, 51, of
Spencer, was charged with one felony count of obtaining controlled substances
by fraud and her nursing license was suspended after she told staff members at
Golden LivingCenter - Continental Manor, 600 E. Elm St., Abbotsford, she took
lorazepam, an anti-anxiety drug, from the facility for personal use Feb. 3.
A nurse manager at
Continental Manor noted Pokallus administered lorazepam on Feb. 3 to two
residents who did not normally receive the medication, according to an incident
report filed with the Wisconsin Department of Health Services.
The nurse manager
questioned the residents, who said they had not been feeling anxious and did
not receive lorazepam that day, according to the report.
Pokallus told Continental
Manor staff members that she used the medication herself and said she took
lorazepam from the facility on four or five other occasions.
A drug test administered
Feb. 3 came back positive for lorazepam, clonazepam, oxazepam, morphine and
marijuana.
Pokallus was fired after
the incident.
“It was a regretful
experience,” Pokallus said.
The Wisconsin Board of
Nursing found Pokallus demonstrated negligence and engaged in unprofessional
conduct, and her nursing license was suspended indefinitely in an order issued
May 9.
Pokallus was ordered to
enter a treatment program, abstain from controlled substances other than those
prescribed for a medical condition and submit to periodic drug screenings.
She may apply for a stay
of suspension Aug. 9. If a stay is granted, Pokallus may practice nursing under
the direct supervision of a fully licensed nurse in a setting pre-approved by
the Board of Nursing, and she may not have access to controlled substances.
Pokallus may petition for
reinstatement of her nursing license after five years of compliance with the
order.
The Wisconsin Board of
Nursing has issued disciplinary orders against 23 nurses for drug-related
violations so far in 2013, according to the agency’s website.
Continental Manor has
implemented a new system for storing and counting controlled substances,
according to the incident report.
Representatives from Continental Manor
declined to comment regarding the case.
Nursing Home
finances not as much problem as neglect
A few weeks back, you published a letter about financial
challenges facing nursing homes. The real problem at nursing homes is the poor
quality of care that families have to deal with in this state.
I gave the only 24/7 care both of my parents received for
five-plus years. My dad died in 2010 and I then continued to care for my mother
until April of 2012, when she finally went into a local nursing home. It was
something that I would never do again considering the poor care and outright
neglect she received there.
I lost count of the times they allowed her to fall. Once they
actually abandoned her in the bathroom. Call buttons were thrown on the floor
where she couldn’t get to them. She got no help for the whole first month
regarding what on the menu she wanted to eat. They lost her hearing aid twice
and dentures once, and would do nothing about a roommate who stole her
belongings, and countless other matters I could list.
Then they not only have the nerve to charge almost $9,000 a
month for this, they also over-bill patients and refuse to supply the family
with an itemized billing so that you can see what you are paying for. (This
week I filed over-billing fraud charges with the state Attorney General's
office and the Postal Inspector's office for mail fraud.)
The earlier letter said the nursing homes are in financial
trouble. Well they’d be in a lot more trouble if they only got paid for the
actual quality of the care they gave. So, readers with a family in a nursing
home – check your bill and demand it be itemized every month.
PAUL W. FAUST, Susquehanna Twp.
New York State Gets $2.5 Million in Medicaid Fraud Case
In
life, Helen Sieger was the embattled owner of a Bronx nursing home.
Her employees at the Kingsbridge Heights
Rehabilitation and Care Center went on strike in 2008 after she stopped paying
their health insurance premiums, drawing attention from state lawmakers, labor
leaders and even Barack Obama, then a senator from Illinois.
Ms. Sieger was arrested a year later on
charges of bribing a hospital social worker to steer patients to her nursing
home, and of improperly collecting payments from the state’s Medicaid program.
She jumped bail, only to be caught in a Miami hotel and returned to New York,
where she died in custody in 2011.
But now Ms. Sieger is making amends in death.
The state attorney general, Eric T.
Schneiderman, said on Tuesday that his office had reached a settlement with the
estate of Ms. Sieger to pay a total of $2.5 million to the state’s Medicaid
program, which includes $1.2 million in reimbursements, and $1.3 million for
damages.
“There are few programs as sacred and
important to our most vulnerable citizens as Medicaid,” Mr. Schneiderman said
in a statement. “So, when we have a case involving a criminal scheme that robs
Medicaid, our prosecutors will do whatever it takes to restore those stolen
funds — whether that criminal is alive or we’re forced to settle with their
estate.”
Nicholas Gravante, Jr., a lawyer at Boies,
Schiller & Flexner who represented Ms. Sieger’s estate, said that her
family was “pleased to have this matter behind it.”
Ms. Sieger, who took over the nursing home in
the mid-1990s, was removed in 2009 by the State Health Department because of an
issue over the nursing home’s lease. The operation of the 400-bed nursing home,
one of the largest in the Bronx, was eventually transferred to a state
receiver, which still runs it today.
Also in 2009, Ms. Sieger was indicted,
accused of paying Frank Rivera, a former social worker at NewYork-Presbyterian
Hospital/Columbia University Medical Center, $300 for every patient that he
referred who was subsequently admitted to her nursing home, plus a bonus of
$1,000 for every 10 patients, according to the attorney general’s office.
Beginning in 2005, he received more than $19,750 from Ms. Sieger.
Mr. Rivera pleaded guilty to felony and
misdemeanor violations under a state law, and is awaiting sentencing, according
to the attorney general’s office.
The attorney general’s office also said that
the investigation had found that Ms. Sieger, who lived in Borough Park,
Brooklyn, held several bank accounts, including one in Montana with $2 million.
Michael Benjamin, a former Bronx assemblyman,
praised the settlement, calling it an appropriate way for “the state to recoup
her ill-gotten gains.”
“It sends a signal that the state will not be
cheated,” he said. “And that people who steal from the poor and from the
elderly will be pursued whether they’re dead or alive.”
http://www.nytimes.com/2013/06/12/nyregion/new-york-state-gets-2-5-million-in-medicaid-fraud-case.html
For-Profit Nursing Home Accused of Medicare Fraud
Yet
another national, for-profit nursing home chain, Life Care, is being sued by
the Justice Department over allegations of overbilling Medicare. Life Care is
accused of billing nearly 68 percent of its Medicare rehabilitation days at the
highest level, nearly twice the national average of 35 percent. CBS This
Morning has spent months examining Life Care’s rehabilitation services and
claims. It recently presented a scathing report, based in part on statements by
at least a half dozen former Life Care employees.
A former assistant manager speech therapist at multiple Life Care locations
told
CBS
This Morning that she eventually quit the facility because she felt
that its insistence on unnecessary rehabilitation services was detrimental to
the
health
of the nursing home residents. By the time she left, she said,
nearly 40 percent of her work was neither reasonable nor necessary. In
addition, she said, in many cases the nursing home would simply refuse to let
patients leave, because they wanted to continue to bill Medicare for services!
In another piece of evidence, the entire rehab staff at the Life Care Center
of Estero in Florida signed a letter to the boss which read, in part, “we have
been encouraged to maximize reimbursement even when clinically inappropriate…”
There are six Life Care Centers in Kentucky: Laurel Creek Health Care
Center, in Manchester; Life Care Center of Bardstown, in Bardstown; Life Care
Center of La Center, in La Center; Life Care Center of Morehead, in Morehead;
Mountain View Health Care Center in Elkhorn City and Parkview Nursing and
Rehabilitation Center in Paducah. According to the CMS website, Life Care
Center of Bardstown and Parkview Nursing and Rehabilitation each had three
stars on their latest inspection report – that’s average. Life Care Center of
La Center and Life Care Center of Moreshead both had two stars – below average.
And Laurel Creek Health Care Center and Mountain View Health Care Center both
received only a single star and are rated as much below average.
In general, studies show that for-profit nursing homes provide
fewer
staffing hours and a lower quality of care than nonprofit or
government-run nursing homes.
Unfortunately, Life Care Centers is not the only nursing home chain being
suspected of overbilling Medicare. The most
recent
report from the U.S. Department of Health and Human Services
inspector general found that industry-wide, a quarter of all Medicare payments
to nursing homes are made in error. When nursing homes charge for services they
don’t provide, they increase the cost of Medicare and Medicaid to the taxpayer.
These programs are already overextended. Fraud puts them in even more jeopardy.
Equally seriously, if nursing home residents are given services they don’t
need, it can make them uncomfortable, confused or disoriented. It can even
endanger their health. The patients’ records are also likely to be inaccurate,
which may cause doctors to misdiagnose them later.
Nursing homes have an obligation to provide responsible care to patients who
need it – and not offer unnecessary services to patients simply so that they
can charge more money. Keeping seniors in a nursing home when they are ready to
be discharged simply to get more funds out of Medicare is unconscionable.
Winter Haven Nursing Home Aide Is Charged in Tax Return Fraud Case
Portia Charlton.
Published: Sunday, May 26, 2013 at 11:28 p.m.
Last Modified: Sunday, May 26, 2013 at 11:28 p.m.
WINTER HAVEN | Deputies jailed a 23-year-old woman Friday who is accused of
using the personal information of 13 nursing home residents to file fraudulent
income tax returns.
Portia Charlton, a nursing assistant, was arrested during a traffic stop in
Bartow. She remained jailed Sunday without bond.
Charlton formerly worked for Palm Garden of Winter Haven, where the victims
lived, her arrest report says. She stopped coming to work in March 2012, two
days after deputies searched her home at 3870 Horizon View Loop in Lakeland and
found a notebook listing the names, birth dates and Social Security numbers of
more than 100 people.
Dollar figures were written next to each name, indicating how much was
obtained using the person's information, an arrest report said.
The arrest report said Charlton led the Internal Revenue Service to lose
about $69,000.
Charlton became a suspect in the crime following a larger Sheriff's Office
investigation into tax fraud in 2012. Her charges include scheming to defraud,
aggravated white-collar crime and grand theft.
Deputies are still searching for her father, Norman Vince Charlton, 49.
He is wanted on federal charges of aggravated identity theft, theft of
government property and conspiracy. Deputies believe he's in the South Florida
area.
[ Matthew Pleasant can be reached at 863-802-7590. ]
Two Nursing Home Executives
Charged With Medicaid Fraud
(Your time is coming
Yuba, be prepared for the next audit)
GAINESVILLE - An
80-year-old woman and her daughter face charges of defrauding Medicaid of more
than $2 million. Prosecutors say the two nursing home executives used Medicaid
checks to pay off personal expenses.
Maxcine Darville and her
daughter, Joanne Carter, were arrested Monday, after the state attorney general
issued a warrant for their arrest. Darville is currently the CEO of a nursing
home company called "Council on Aging of Florida," which manages four
facilities across the state, including one in Gainesville. We're told Carter
served as the non-profit's "assistant-CEO".
According to the state
attorney general's office, both Darville and Carter used their positions to
defraud the Medicaid system out of $2.75 million over a period of six years.
They then used that money to pay off personal expenses, including a cable and
internet bill at a home Darville claims was used for employees.
Both Darville and Carter
were released from jail on a $50,000 bond. Darville's attorney says his client
and her daughter deny any wrongdoing, and both intend to fight the charges
until their names are cleared.
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