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(COLUMBUS, Ohio) -- Ohio Attorney General Mike DeWine announced today
that Ohio has joined with seven states and the federal government in a $28 million settlement agreement with a Delaware-based skilled nursing corporation after an
investigation led in part by the Ohio Attorney General's Office revealed that the company billed Medicaid and Medicare for materially substandard nursing services that were so deficient that they were effectively worthless.
This resolution is
the largest ever failure of care settlement with a national chain of skilled nursing facilities. Ohio's share of the settlement is $2,593,883.77.
The agreement with Extendicare Health Services, Inc.
and its subsidiary Progressive Step (ProStep) Corporation settles allegations
that, between 2007 and 2013, Extendicare failed to provide care that met federal and state standards of care and regulatory
requirements in 33 of its skilled nursing facilities in eight states.
Six of the 33 skilled nursing facilities are in Ohio:
- The Arbors at
London, London, Ohio
- Rockmill
Rehabilitation Centre, Carroll, Ohio
- The Arbors at
Milford, Milford, Ohio
- Columbus
Rehabilitation and Subacute Institute, Columbus, Ohio
- The Arbors East
Subacute and Rehabilitation Center, Columbus, Ohio
- The Arbors at
Sylvania, Toledo, Ohio
Among the allegations are that Extendicare did not have enough skilled nurses to adequately care for its skilled nursing residents, that it failed to provide adequate catheter care to some residents, and that it failed to follow appropriate protocols to prevent pressure ulcers or falls.
"Through this settlement, not only
will the states and federal government be reimbursed for the millions that we believe was paid for inadequate care, but we will also make sure that residents
living in every Extendicare skilled nursing facility across the country receive the quality
care that they depend on and deserve," said Attorney General DeWine.
In addition to paying the
states and the federal government $28 million in civil damages to
compensate Medicaid, Medicare, and various federal healthcare programs for harm
suffered as a result of its conduct, the settlement also requires that Extendicare and
ProStep enter into a five-year chain-wide Corporate Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General under which Extendicare must have a comprehensive compliance program with
systems to address the quality of resident care.
Extendicare’s compliance program must include, among
other things, corporate-level committees to address compliance and quality
including a committee to assess staffing, and an internal audit program to
assess the quality of care provided to its residents. Extendicare must
also retain an independent monitor who will regularly visit Extendicare’s skilled care facilities.
"This agreement is one of the first nursing home chain settlements that includes a national Corporate Integrity Agreement," said Attorney General DeWine. "This investigation and settlement highlights the importance of leveraging the joint resources and expertise of the states and federal government. Working together allowed us to focus our efforts nationally on protecting the most vulnerable in our population who rely on quality care in our nursing homes."
The seven other states involved in the settlement
are Indiana, Kentucky, Michigan, Minnestoa, Pennsylvania, Washington, and
Wisconsin. Extendicare operates a total of 146 skilled care facilities in 11 states.
On top of the $28 million settlement, an additional $10 million settlement was reached with Extendicare and the federal government to resolve allegations that the corporation provided medically unreasonable and unnecessary rehabilitation therapy services to its Medicare Part A beneficiaries.
A National Association of Medicaid Fraud Control Units team, which was led by Ohio Attorney General DeWine's Health Care Fraud Section, participated in the investigation and conducted the settlement negotiations with Extendicare on behalf of the settling states.
Additional agencies involved in the state and federal investigation include the U.S. Department of Justice, U.S. Department of Health and Human Services Office of Inspector General, U.S. Attorney's Office for the Southern District of Ohio, U.S. Attorney's Office for the Eastern District of Pennsylvania, and the Attorneys General for Indiana, Kentucky, Michigan, Minnesota, Pennsylvania, Washington, and Wisconsin.
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