Nursing Homes

Last month, Pinnacle MultiCare Nursing and Rehabilitation Center (Pinnacle) filed a federal action to stop the U.S. Department of Health and Human Services (HHS) from recouping tens of millions of dollars in Medicare Part A payments made to Pinnacle during the COVID-19 pandemic. According to its Complaint, Pinnacle received a letter from…

Sligo Creek Center, a Maryland nursing home, recently appealed the constitutionality of the Centers for Medicare & Medicaid (CMS) enforcing a $1.5 million fine without a jury trial. The fine related to the facility’s failure to establish and maintain an infection control program. The appeal, currently pending in the Fourth Circuit of the…

A company that runs five nursing homes in Delaware recently agreed to pay a $182,000 fine to settle an investigation for alleged HIPAA violations. The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) investigated the company, referred to collectively as the Cadia Healthcare Facilities, after it received a complaint that the…

Two Pennsylvania nursing home operators were recently sentenced in federal court to pay more than $15 million in restitution in a healthcare fraud case. Comprehensive Healthcare Management Services, the operator of Brighton Rehabilitation and Wellness Center, and the affiliated operator of Mount Lebanon Rehabilitation and Wellness Center were convicted of making false statements in connection…

On January 29, the New York State Office of the Medicaid Inspector General (OMIG) published its 2025 Work Plan, which provides a preview of the OMIG’s program integrity initiatives for the upcoming year. While this post highlights several areas that the OMIG will focus on, Medicaid providers should refer to the Work Plan for…

On November 20, 2024, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released the “Nursing Facility ICPG,” an industry-specific compliance program guidance for nursing facilities. 

Background

The Nursing Facility ICPG serves as a voluntary, nonbinding tool to assist facilities in reducing risks related to fraud, waste, and abuse, while…

The U.S. Attorney’s Office for the District of Connecticut recently announced that Supportive Care Holdings, LLC and its related companies agreed to pay the federal government nearly $4,600,000 to resolve allegations of submitting false claims. The Supportive Care companies provide behavioral health services via telehealth to patients residing in skilled nursing facilities.

Supportive Care’s companies…

On March 4, the New York Attorney General announced an $8.6 million settlement with Fulton Commons Care Center, a nursing home located in East Meadow, NY. The settlement resolves an action brought against Fulton in 2022 claiming financial fraud, physical abuse, mistreatment of residents, and covering up resident complaints.

The AG had previously sued the…