The complaint specifically identified 5 residents who were not adequately cared for by Chester Care Center, Bishop Nursing Home, and Manchester House Nursing and Convalescent Center. One resident died of injuries received when she was placed in a scalding tub of water by a nurse's aide and 3 other residents died of receiving inadequate diabetes care. Another resident died due to a failure to respond in a timely manner to the resident's progressive weight loss and failure to treat his pressure sores properly.
The reach of these enforcement efforts was further increased by a FCA action filed against Extendicare-owned Greenbelt, Nursing & Rehabilitation Center in Baltimore in August, 1998, which ended up settled in a month.
In this case, state officials had surveyed Greenbelt in January, 1998, and warned the facility in February that it was providing substandard care. Another survey in April, 1998 found that Greenbelt had lied in a report that claimed it was now in compliance.
Within a month, the government got Greenbelt to agree to a detailed court order under the FCA that included strict standards for quality assurance, staffing, staff training, medical care, nursing care, wound care, nutritional needs, psychiatric services, and resident safety.
In addition, the company had to hire a monitor and an interim manager, who had to be approved by the government but paid for by Extendicare and allow the government to interview Greenbelt staff without supervisors or company lawyers present.
Thus, the FCA action achieved outstanding results in a month, when more than 7 months of surveys, warnings, and fines had accomplished nothing.
In 2001, Vencor Inc agreed to pay $104.5 million to settle a case with allegations that it had submitted false claims to Medicare, Medicaid, and other government programs and according to the Department of Justice, $20 million of the false claims were related to failure to provide care, including inadequate staffing, improper care of decubitus ulcers, and failure to meet residents' dietary needs.
Attorney Kennard Bennett believes that civil litigation has raised the awareness of the public about poor care in nursing homes.
"Litigation can hold corporations accountable for poor care," Mr. Bennett explains. "Over time, the goal of this type of litigation is to make it cost more to provide bad care than to provide good care."
Virginia Attorney John Harris III agrees and says, "the way to clean up nursing homes is to make it more expensive to neglect the residents than it is to take proper care of them."
Since there is no provision for fining offending nursing homes in Virginia, he says, the health department is helpless because they can only do one of two things, send the nursing home a dunning letter or close the nursing home.
"If the nursing home is closed," he points out, "where do you put 100 old folks?"
"If a dunning letter is sent," he advised, "the nursing home promises not to do it again and after a month or so goes right back to business as usual."
According to Irvine, California Attorney, James Daily, the situation is not getting better.
"Quite the opposite," he says, "people either need to not get old, or have lots of money - don't grow old poor."
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