The United States Department of Justice has filed a Complaint against HCR ManorCare, Inc., one of the country’s largest nursing home chains, following a lengthy civil investigation for deceptive Medicare billing practices. The DOJ’s investigation began after three separate lawsuits were filed by former employees of ManorCare in Ohio and Virginia, each alleging that the company was providing, and billing for, unnecessary and unreasonable therapy services.
The DOJ has alleged that ManorCare sets financial targets for its facility administrators, putting pressure on them to bill for unnecessary care. One of the whistleblower lawsuits explained the systematic process of putting frail and dying patients through strenuous rehabilitation and therapy just to be able to bill Medicare for the additional services. Another lawsuit describes an 85 year old hospice patient who, rather than receiving the hospice care ordered by his doctors and therapists, was put through 100 days of therapy, the maximum allowed by Medicare, at the instruction of the facility. Once Medicare cut off his therapy payments, he was transferred to hospice. The goal: to increase revenue for ManorCare.
ManorCare has 283 facilities across 30 states, including Arizona, operating under the names of ManorCare, Heartland, and Arden Court. ManorCare received more than $6 billion from Medicare between January, 2006 and May, 2012.
We are encouraged by the DOJ’s apparent increased willingness to take on these facilities regarding deceptive billing. These lawsuits are a relatively recent trend, and a good one, in our view. If you suspect that your loved one is being subjected to unnecessary treatment simply so the facility can bill for them, report it to the Arizona Attorney General, or contact our office with any questions or concerns.