DOJ sues Vanguard, Director of Operations for False Claims Act violations

by Ben Vernia | September 8th, 2016

On September 7, the Department of Justice announced that it had filed a civil action under the False Claims Act against six Vanguard nursing facilities and the company’s Director of Operations. According to DOJ’s press release:

The United States has filed a False Claims Act case against Vanguard Healthcare LLC, Vanguard Healthcare Services LLC, Boulevard Terrace LLC, Vanguard of Crestview LLC, Glen Oaks LLC, Imperial Gardens Healthcare and Rehabilitation LLC, Vanguard of Memphis LLC, Vanguard of Manchester LLC and Vanguard’s Director of Operations, Mark Miller, the Department of Justice announced today.  The lawsuit alleges that the defendants were responsible for the submission of false claims to Medicare and Medicaid for skilled nursing home services that were either non-existent or grossly substandard.  The lawsuit also alleges that the defendants submitted required nursing facility Pre-Admission forms with forged physician and nurse signatures.  Vanguard Healthcare LLC is headquartered in Brentwood, Tennessee, and has 14 long-term care nursing home providers operating around the United States.

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The United States’ complaint alleges that between Jan. 1, 2010, and Dec. 31, 2015, the six Vanguard facilities failed to provide the most basic and essential skilled nursing services to their residents.  The lack of adequate care at the Vanguard facilities included chronic staffing and critical medical supplies shortages, failure to provide standard infection control, failure to administer medication to residents as prescribed by their physicians, failure to provide wound care as ordered by physicians, failure to adequately manage residents’ pain and providing unnecessary and excessive psychotropic medications to residents and using unnecessary physical restraints on residents.  As a result, Vanguard residents suffered pressure ulcers, falls, dehydration and malnutrition, among other harms.  The United States’ complaint further alleges that Miller, who served as the Director of Operations for Vanguard from September 2011 through August 2014, knew that resident care at the Vanguard facilities was non-existent or grossly substandard but failed to correct these problems.

The United States’ Complaint also alleges that from September 2012 through April 2014, Boulevard Terrace LLC, Glen Oaks LLC, Vanguard of Memphis LLC and Vanguard of Manchester LLC fraudulently submitted falsified Pre-Admission forms to Tennessee Medicaid.

On May 6, the Vanguard corporate entities named in the government’s complaint filed voluntary petitions for relief under Chapter 11 of the Bankruptcy Code, which were administratively consolidated in the Middle District of Tennessee.

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