DOJ says ManorCare pressured skilled nursing facility administrators and rehabilitation therapists to meet unrealistic financial goals.
HCR ManorCare, one of the nation’s largest skilled nursing facility providers, allegedly submitted false claims to Medicare and Tricare for rehabilitation therapy services that were not medically reasonable or necessary, according to the U.S. Department of Justice.
ManorCare pressured skilled nursing facility administrators and rehabilitation therapists to meet unrealistic financial goals that resulted in medically unreasonable and unnecessary services to Medicare and Tricare patients, the DOJ said.
Feds have not disclosed a dollar amount tied to the alleged fraud.
ManorCare allegedly set prospective billing goals designed to significantly increase revenues without regard to patients’ actual clinical needs and threatened to terminate skilled nursing facility managers and therapists if they did not administer the additional treatments necessary to qualify for the highest Medicare payments, according to the complaint.
It also allegedly increased its Medicare payments by keeping patients in its facilities even though they were medically ready to be discharged.
ManorCare, which is owned by The Carlyle Group and has corporate offices in Toledo, Ohio, runs about 281 skilled nursing facilities in 30 states.
The government consolidated three separate lawsuits filed against ManorCare. The federal complaint announced April 21 was brought under the whistleblower provision of the False Claims Act.
A defendant who violates the False Claims Act is liable for three times the government’s losses plus civil penalties.