by Ben Vernia | June 19th, 2022
On June 15, the Department of Justice announced that it had filed a lawsuit against American Health Foundation, an affiliated company and three of its nursing homes, alleging that the defendants violated the False Claims Act by billing for substandard nursing home services. According to DOJ’s complaint:
The Justice Department has filed a complaint under the False Claims Act against American Health Foundation (AHF), its affiliate AHF Management Corporation, and three affiliated nursing homes — Cheltenham Nursing & Rehabilitation Center (Cheltenham), The Sanctuary at Wilmington Place (Wilmington Place) and Samaritan Care Center and Villa (Samaritan) — for providing grossly substandard skilled nursing services between 2016 and 2018. AHF is a nonprofit corporation that is headquartered in Dublin, Ohio, and owns and controls nursing homes in Ohio, Pennsylvania and Iowa. Cheltenham is a 255-bed nursing home located in Philadelphia; Wilmington Place is a 63-bed nursing home located in Dayton, Ohio; and Samaritan is a 56-bed nursing home located in Medina, Ohio.
In its complaint, the United States alleged the three AHF nursing homes provided grossly substandard services that failed to meet required standards of care in various ways. For example, the United States alleged the defendant facilities failed to follow appropriate infection control protocols and did not maintain adequate staffing levels. The United States also alleged that Cheltenham housed its residents in a dirty, pest-infested building; gave its residents unnecessary medications, including antibiotic, antipsychotic, anti-anxiety and hypnotic drugs; failed to safeguard residents’ personal possessions; subjected residents to verbal abuse; neglected to provide residents with activities or stimulation; and failed to provide needed psychiatric care. The United States similarly alleged that Wilmington Place and Samaritan failed to create and maintain important medical records, and that Wilmington Place repeatedly gave its residents unnecessary medications, including antibiotic, antipsychotic, anti-anxiety and hypnotic drugs, while also failing to ensure that its residents had the prescriptions they actually needed.
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The United States’ complaint provides specific allegations of how grossly substandard care harmed nursing home residents. For instance, the complaint alleged that one Cheltenham resident was admitted with a history of self-harm and was hospitalized after slashing his wrists while in the facility’s care. Yet when this resident returned to Cheltenham, the facility again ignored additional warning signs and failed to provide him with needed psychiatric services. Mere weeks after being readmitted to Cheltenham, the resident committed suicide by hanging himself from a bedsheet in one of Cheltenham’s shower rooms.
The case arose from a government investigation, rather than a whistleblower’s complaint under the Act. DOJ’s press release continued:
The United States’ complaint stems from an investigation that the Department of Justice initiated as part of its National Nursing Home Initiative. The department launched the initiative in March 2020 to identify and investigate nursing homes that provide grossly substandard care. The National Nursing Home Initiative reflects the Department of Justice’s commitment to protecting our nation’s seniors, coordinated by the department’s Elder Justice Initiative in conjunction with the U.S. Attorneys’ Offices. The Elder Justice Initiative supports the efforts of state and local prosecutors, law enforcement, and other elder justice professionals to combat elder abuse, neglect and financial exploitation, with the development of training, resources and information. Learn more about the Justice Department’s Elder Justice Initiative at http://www.justice.gov/elderjustice.
