FRANKFORT, KY (FOX19) - The U.S. Attorney's Office has filed a civil complaint on Friday which alleges that a nursing home in Erlanger provided worthless services that resulted in the death of several residents.
The U.S. Attorney's Office alleges that Villaspring Health Care and Rehabilitation, Villaspring's parent company, Carespring Health Care Management, and its owner billed Medicare and Medicaid for services purportedly provided to its residents, despite knowing that the services were so inadequate that they were essentially worthless.
This is the first suit filed in Kentucky in which the government alleges that a nursing home defrauded Medicare and Medicaid by submitting bills for reimbursement for providing systemically poor resident care.
The complaint accuses the defendants of violating the federal False Claims Act, committing common law fraud, and unjust enrichment.
If found liable, the defendants would face financial penalties between $5,500 to $11,000 per false claim. The defendants would also have to repay Medicare and Medicaid three times the amount of the government's loss for the fraud.
"Today's filing represents an important milestone in the effort to insure effective care for Medicare and Medicaid recipients in long term care facilities," said U.S. Attorney Kerry Harvey. "In appropriate cases, the False Claims Act will be an important tool to protect both the taxpayers and federal healthcare program beneficiaries."
The complaint alleges that from 2004 to 2008, numerous patients suffered serious injuries resulting from the worthless care; five of those patients died.
The alleged inadequate care included failure to follow physicians orders, failure to treat wounds and pressure sores, failure to update resident care plans, and failure to monitor the blood sugar levels of diabetic residents.
"Investigators from my office worked diligently on this case to help protect the residents of this nursing home," said Attorney General Jack Conway. "We are pleased that United States Attorney Harvey has filed this action to help achieve that goal and we look forward to working with his office throughout this process. We will continue to investigate abuse and neglect in Medicaid-funded facilities and take action to protect Kentucky's vulnerable citizens."
Villaspring released the following statement in response to the U.S. Attorney General's allegations:
A civil complaint filed today by the U. S. Attorney's office in Frankfort, Kentucky against Villaspring stems from an allegation that is more than five years old. The Kentucky Attorney General's office thoroughly investigated this case without bringing any charges. "We do not feel the government's case has any merit. The federal government is alleging that we did not provide services that we did in fact provide," said Villaspring spokesperson Kim Majick. "Villaspring has consistently provided high quality care to the residents of Northern Kentucky and looks forward to continuing that care in the future.
"These allegations are over five years old, we cooperated fully with the state investigators, and made changes that put us into compliance," said Majick. "Since then, we have operated exceptionally; in total compliance with the state regulations.
"The families of the patients we have been caring for during the past five years, and before, should have absolute assurance that their loved ones come first and that the quality of care that they have come to know and expect from Villaspring will continue," added Majick.
"Our doors are always open to anyone who wishes to visit and see the work we do here on a daily basis, which is the same invitation we extended to the U. S. Attorney's office," said Majick. "We look forward to the opportunity to present out story and believe that the outcome will prove that Villaspring is strong and committed to its patients."
Six families have been dealing with these allegations in a very personal and painful way for years.
"We left our father there thinking they were a medical facility that was professional and that they knew how to take care of this," said Janet McIntosh in an interview with FOX19 in 2007, seven months after her 73-year old father Cliff Broadus died due to complications from diabetes.
When Villaspring invited FOX19 inside to shoot four years ago, we found only a clean, bright facility.
But the family claims there was a dark side, saying nurses rarely checked their father's room, gave him the wrong medication, and let his blood pressure spiral out of control.
"I got the call the next morning that he had gone into the diabetic coma," McIntosh said. "And he never came out."
"The complaint is full of factual inaccuracies," said Kim Majick, spokesperson for Villaspring.
"We cooperated with that investigation," Majick said. "We were put back into compliance with the State."
Villaspring said the case has "no merit".
"Of course it bothers us to hear that kind of stuff," Majick said. "It's shocking for us to read that."
Villaspring said they provided excellent care then.
"Staffing changes occur all the time here," Majick said. "We have 170 employees, so, in-response to the concerns years ago, we made changes."
And will continue to do so for families there now.
"We provide great care to these residents and that our employees that are here every single day are doing great work," Majick said.