A chain of skilled-nursing facilities with two locations in West Palm Beach and one in Palm Beach Gardens has reached a $145 million settlement that federal officials called the largest ever of its kind.
Life Care Centers of America Inc. and its owner Forrest L. Preston agreed to resolve allegations that the nursing chain billed the government for rehabilitation services that were not needed, U.S. Department of Justice officials said Monday.
“This resolution is the largest settlement with a skilled nursing facility chain in the department’s history,” said Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Justice Department’s Civil Division. “It is critically important that we protect the integrity of government health care programs by ensuring that services are provided based on clinical rather than financial considerations.”
“We deny in the strongest possible terms that Life Care engaged in any illegal or improper conduct,” Preston said in a statement. “We are, however, pleased to finally put this matter behind us, without any admission of wrongdoing, and we look forward to continuing our efforts to deliver quality care and services to our patients, residents, and their families.”
This settlement resolves allegations that between 2006 and 2013, Life Care submitted false claims for rehabilitation therapy by “engaging in a systematic effort” to increase its Medicare and TRICARE billings. It stemmed from whistleblower cases filed by former employees Tammie Taylor and Glenda Martin, who will receive $29 million as part of the settlement. Taylor was an occupational therapist in Lauderhill, Fla. and Martin worked as a nurse in Morristown, Tenn., court records show.
Life Care “instituted corporate-wide policies and practices” designed to place beneficiaries in the “Ultra High reimbursement level irrespective of the clinical needs of the patients,” U.S. officials alleged. That resulted in “unreasonable and unnecessary therapy” to many beneficiaries, officials said.
The chain’s locations in Palm Beach County include Darcy Hall of Life Care and Lakeside Health Center in West Palm Beach and The Gardens Court in Palm Beach Gardens.
“The resolution announced today demonstrates the commitment of the U.S. Attorney’s Office to aggressively pursue providers who utilize fraudulent practices to knowingly put their own financial self-interest over a duty to patients,” said U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida. “It is imperative that providers make healthcare decisions based upon a patient’s need for services rather than a self-serving desire to maximize financial profit. Our office will continue to investigate fraud allegations, in order to ensure that providers do not compromise the integrity of our public health care programs.”