The California Attorney General’s Office accuses the country’s largest senior living center of falsifying patient care data to achieve a higher Medicare ranking.
BAKERSFIELD, Calif. (CN) — Brookdale, the largest chain of senior living centers in the United States, is proud of its high Medicare ranking. The state of California doesn’t think it’s legitimate — and has taken the business to court to prove it.
The federal government assigns a star rating to nursing homes based on a number of factors, key among them is the amount of one-on-one time nurses spend with patients per day. As in other industries, ratings are a powerful tool for customer acquisition, and senior care centers routinely tout their prized five-star rankings in marketing materials.
Naturally, residents and their families are drawn to the highest rated senior care facilities, giving those with a five-star ranking choice of the industry’s highest paying customers.
In the past that data was self-reported by nursing homes, allowing bad actors to take advantage of an honor system and skew their rankings skyward. Starting in 2018, however, the U.S. Centers for Medicare & Medicaid Services began calculating the rankings using payroll records.
The company has over 70,000 staff members and 100,000 residents spread across 800 facilities in 45 states. But state Attorney General’s Office believes Brookdale is falsifying its payroll figures to game the system.
According to the complaint filed on behalf of the state by Kern County District Attorney Cynthia Zimmer, Brookdale wrongfully transfers and discharges residents “without giving them reasonable notice or adequate preparation” so it can “fill its beds with residents who will bring in more money.”
Senior care centers are paid substantially more by Medicare than by other sources such as Medi-Cal, leading facilities to covet those residents. California accuses Brookdale of pushing out others to make way for the highest bidder — regardless of care and treatment needs — while ignoring patients’ legal protections.
Prosecutors cite the case of an 80-year-old resident Brookdale transferred despite the man’s Alzheimer’s disease, congestive heart failure, chronic atrial fibrillation and a host of other ailments, and did so without providing him a discharge plan. Within a week, the man had to be admitted to a nearby acute care hospital.
The state also accuses Brookdale of discharging a 78-year-old resident who had difficulty walking, heart disease and kidney disease — while the patient was recovering from pneumonia — without notifying him or his family. The man was discharged in such a hurry that Brookdale staff neglected to remove his PICC line catheter before releasing him, the state says in its complaint.
Prosecutors say as a result of Brookdale gaming the system, the company achieved a higher star rating than it deserves — a rating the state says the company uses to entice higher-paying residents into their facilities.
If found liable, Brookdale faces fines of up to $2,500 for each violation, and an additional $2,500 per violation involving senior citizens.
A Brookdale spokesperson denied the allegations and noted the Golden State has either filed or threatened to file similar actions against other senior facilities.
“We categorically deny that Brookdale engaged in intentional or fraudulent conduct. We are disappointed in the allegations against the skilled nursing industry,” the spokesperson said. “Publicizing unproven allegations is reckless and undermines the public’s confidence in a service necessary to the care of elderly individuals, especially during the Covid-19 pandemic.
“Brookdale is dedicated to providing quality care to our residents and patients, and we take our mission of enriching the lives of those we serve seriously.”
California Attorney General Xavier Becerra has been nominated by President Joe Biden to lead the Department of Health and Human Services, which oversees the U.S. Centers for Medicare & Medicaid Services.