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Tamarac Nursing Home Abuse Watch: Neglect & Medicaid Fraud

Our Tamarac nursing home abuse attorneys were appalled to hear of the squalid conditions of a Georgia nursing home: little food, skimpy air conditioning, plastic buckets catching the drips of leaky roofs, trash heaps and flies and rodents running rampant. rats.jpg

Sadly, Florida nursing home abuse attorneys know that this is not an isolated incident. This time, it was discovered by the Federal Bureau of Investigation in Georgia, where agents said elderly residents in three nursing homes there lived for years in horrid conditions. Meanwhile, the owner of the centers lined his pockets with fat Medicaid and Medicare checks, rather than investing that money to create a minimally acceptable environment for these residents.

According to a press release issued by the FBI, the owner of the three homes had pocketed some $33 million in government money – checks that were supposed to go to keeping up these properties.

You figure, this is an extreme case. How many long-term care residences and nursing homes skirt the minimum standards, simply so they aren’t caught?

The owner of these Georgia facilities was found guilty in Atlanta of defrauding Medicare and Medicaid. Additionally, his wife and accomplice pleaded guilty late last year.

As part of the agreement the pair had with the government, they promised to give residents in their care with a clean and safe environment to live. They also promised to feed them nutritious meals. They promised adequate medical care. They also promised access to certain social services.

But when family members, residents and even staffers started to complain that very little of that was being done, the owner simply didn’t respond to their concerns.

Some of those complaints were then forwarded to the FBI. Agents there kick-started an investigation, with the help of numerous federal and state agencies, including the Department of Health and Human Services, the IRS and the Office of Inspector General.

Investigators, who presented evidence at trial, were able to illustrate that the services provided by this nursing home owner were “worthless.”

In fact, the federal government determined that the nursing home owner didn’t hire enough staff. The staff he did hire started getting used to paychecks that bounced and health insurance premiums that lapsed, sticking many with large, unpaid medical bills and causing many of them to quit.

He also didn’t pay vendors. Those included the companies that were to supply food, medicine, laboratory services, trash disposal, medical waste disposal and basic nursing supplies.

Sometimes, employees would use their own money to buy basic food staples like bread and milk, so that the residents wouldn’t starve. They also frequently took the residents’ clothes home so they could launder their linens.

Meanwhile, the owner and his wife were buying hotel real estate, purchasing luxury cars, brand new furniture and paying for high-end child care.

FBI agents say the case is precedent-setting because it was the first time a person had been convicted in a federal trial for submitting claims for payment for services that were worthless.

When a nursing home collects taxpayer money for services that they don’t actually give or that fall short of what they should, not only is that fraud, it’s exploitative. The FBI notes some ways to identify fraudulent billing by a nursing home:

1. Residents appear to be living in unsafe or unsanitary environments.
2. Residents appear to be either dehydrated or malnourished.
3. Nursing homes send in “ghost-billing,” which are bills for patients who either don’t exist or who have already died..
4. The nursing home may offer free services or items to its residents, in exchange for a Medicaid or Medicare number.
5. The nursing home will “upcode” or put residents in a very high category of billing, which is typically reserved only for those who need care that is highly-specialized.
6. Giving patients medicine or using medical equipment that is inferior.
7. Billing the insurance company or the government for services that are never provided.

If you or a loved one have suffered from nursing home abuse in Tamarac, West Palm Beach or the surrounding areas, contact the Law Offices of Freeman, Mallard, Sharp & Gonzalez for legal assistance. 1-800-561-7777 for a free appointment to discuss your rights.

Additional Resources:
Nursing Home Abuse, Owner Cheats Government and Neglects Residents, FBI Press Release

More Blog Entries:
West Palm Beach Nursing Home Abuse: Advocate Files State Lawsuit, April 27, 2012, Tamarac Nursing Home Abuse Attorneys Blog

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