Nursing Home Fraud Neglect & Abuse Much Too Common

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By Evelyn Pringle (about the author) Page 6 of 7 page(s)

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"Prosecution" he points out, "would require prosecutors to leave their comfort zone and shift resources away from other areas of law breaking."

It seems as if prosecutors in some states have at least begun to chip away at abuse and neglect that amount to crimes against the elderly because on May 19, 2006, the Indy Star reported that, "A grand jury has indicted two former nursing home officials on neglect charges, alleging they allowed a resident to lie in his own waste for days with back sores and maggot-covered clothing."

As for private lawsuits, legal experts say they accomplish little when it comes to stopping abuse and neglect of the elderly. For instance, in October 2005, Beverly agreed to pay $18.9 million to 800 residents in nursing homes in Arkansas to settle two class action lawsuits, and yet the giant chain is facing more lawsuits this year for the exact same type of misconduct.

In another case, on May 4, 2006, after a 6-week trial, a jury awarded $20 million to the estate of a man who died at a Beverly facility in Frankfort, Kentucky after nurses failed to respond to his cries for help.

Twenty million is chump change to Beverly. On August 18, 2006, the US Department of Justice issued a press release to announce that Beverly Enterprises "has agreed to pay the United States and the State of California $20 million to settle allegations that its former wholly owned subsidiary, MK Medical, violated the civil False Claims Act."

The government charged that MK Medical submitted false claims to the Medicare and Medi-Cal programs from 1998 until 2002, while Beverly owned the company.

Beverly was permitted to settle the case by paying $14,487,278 to the United States and $5,512,722 to the state of California, and as usual, no company executive was charged or jailed for criminal wrongdoing.

Unfortunately, the prospect of prosecuting the for-profit nursing home chains and the culprits at the top, as well as obtaining justice in private civil actions, seems to be growing dimmer each year. To insulate themselves from liability, the largest nursing home conglomerates are going to great lengths to restructure their businesses. The latest stunt, according to Consumer's Reports, is where; "A nursing-home chain splits itself into little pieces, called "single-purpose entities."

"Some of these entities own the individual nursing homes," Consumer explains, "while others lease and operate the facilities, effectively putting the company's major assets--its real estate--beyond reach of a lawsuit."

Legal experts say the only truly effective tool for rooting out fraud, abuse and neglect in the nursing home industry falls under the False Claims Act. The Qui Tam provision in the Act allows persons with knowledge of fraudulent claims being submitted to federal programs like Medicare or Medicaid to bring a lawsuit against the facility on behalf of the government.

According to Lou O'Reilly, Founder of Texas Advocates for Nursing Home Residents, "We need more lawsuits filed against providers using the False Claims Act and have them pay back the government for abuse and neglect of residents."

"Maybe it would clean up the bad nursing homes," he says.

FCA charges can result in substantial penalties. According to cases compiled by the watchdog group, Taxpayers Against Fraud, in 2001, Vencor Inc paid $104.5 million to settle charges that it had submitted false claims to Medicare, Medicaid, and other government programs. $20 million of that amount, the Department of Justice said, was for false claims submitted related to failure to provide care, including inadequate staffing, improper care of decubitus ulcers, and failure to meet residents' dietary needs.

Critics say it should be mandatory for nursing homes to post a notice informing employees that under the provisions of the False Claims Act, whistleblowers can earn between 15 and 30% of money recovered from a nursing home that submits fraudulent claims to a federal program for inadequate care or services never rendered.

More information for injured parties can be found at Lawyers and Settlements.com

http://www.lawyersandsettlements.com/

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