FRANKFORT, Ky. (CN) – A nursing home chain defrauded Medicare and Medicaid by billing $16 million for “worthless” services at a Kentucky “care center” whose care was so “grossly deficient” and abusive it caused “egregious harm and even death to some of those residents,” the United States says.
Lead defendant Villaspring Health Care Center, of Erlanger, Ky., is wholly owned by co-defendant Carespring Health Care Management. The final defendant, Barry N. Bortz, of Ohio, is majority owner and CEO of both companies, according to the federal complaint alleging fraud, unjust enrichment and false claims.
“The defendants have failed to provide adequate care for the medically fragile and vulnerable elderly residents of the Villaspring nursing facility, resulting in egregious harm and even death to some of those residents,” the complaint states. “In the process, defendants have defrauded the United States and the Commonwealth of Kentucky by seeking, and receiving, substantial reimbursement from the Medicare and Kentucky Medicaid programs for care purportedly provided to these residents, despite knowing that such ‘care’ was either nonexistent or so inadequate as to be worthless.
The 36-page complaint reels off a litany of abuses that allegedly happened from 2004 through 2008.
“On numerous occasions, Villaspring residents did not receive their medication as prescribed or ordered,” the complaint states. “Medication errors were prevalent, and Villaspring residents suffered and were harmed by not receiving the medication they needed and had been prescribed. By way of example only, residents suffered from extremely high and low blood sugar levels – including to the point of lapsing into a hypoglycemic coma – when medication to regulate blood sugar levels was not administered as ordered.”
Understaffing “placed Villaspring residents in immediate jeopardy of harm. Such harm consisted of, inter alia, a failure to treat pressure sores and administer medications and treatments as prescribed.”
Villaspring did not have a registered nurse on duty for 8 consecutive hours each day, as required by law: in one case, there was no RN on duty for more than 63 consecutive hours.
In another case, Villaspring listed the RN on duty as a woman who had resigned 2 weeks before: “Thus, not only did Villaspring fail to comply with 42 C.F.R. § 483.30(b), it falsified its records to create the false appearance of compliance.”
The litany continues: “Medical records and state survey reports also evidence repeated failures to provide nutrition to residents in accordance with their plans of care; failures to promptly respond when residents turned their call light on, often resulting in a humiliating inability to reach the restroom on time; failures to revise or update resident plans of care to account for pressure sores, increased pain, or other changes in condition; and placement of adult diapers on patients who were deemed continent or had no history of bowel or bladder problems.”
One patient, who was described as “likely to improve” when he was admitted, received inadequate wound care for nine untreated pressure sores, forcing him to have surgery to remove his coccyx; he died. Throughout his stay at Villaspring he received less than half the fluids recommended by the dietician.
A suffering old woman was administered laxatives for 4 days in a row while suffering from diarrhea. She was not fed properly, suffered necrotic, poorly tended sores and underwent a colostomy and amputation of one leg above the knee before she died of sepsis. Villaspring billed Uncle Sam $12,896.93 for the care it “purportedly provided” to her.
And so on.
Villaspring received $15,983,983.83 in Medicare and Medicaid payments for the period at issue.
Uncle Sam seeks civil penalties of $5,500 to $11,000 for each false claim, and treble damages and penalties for fraud and unjust enrichment.