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Several Tennessee Nursing Home Companies Pay Big After Defrauding Medicaid

Tennessee Health Management, Inc. Pays $9.7 Million for Fraudulent Claims

In early February, U.S. Attorney for the Middle District of Tennessee, Don Cochran, announced Tennessee Health Management, Inc. would pay $9.7 million after allegedly submitting false claims to Tennessee’s Medicaid program, TennCare.

The management company owns 27 skilled nursing facilities in Tennessee, including three in Memphis and one in Cordova.

According to TennCare, a physician must evaluate every patient entering a nursing home for placement purposes. Between 2010 and 2017, Tennessee Health Management allegedly submitted evaluations that contained pre-signed or photocopied physician signatures.

Under the settlement, the United States will receive roughly $5.4 million and Tennessee will receive approximately $4.3 million. According to the Department of Justice, Tennessee Health Management will also enter into a Corporate Integrity Agreement with the U.S. Department of Health and Human Services-Office of Inspector General.

Entering into the Agreement likely means THM will be given a compliance officer, and independent organizations may conduct annual reviews.

Vanguard Healthcare, LLC to Pay $18 Million for Fraudulently Billing Medicare, Medicaid

The United States and the state of Tennessee filed a lawsuit against Vanguard Healthcare, LLC after it allegedly billed Medicare and Medicaid “for grossly substandard nursing home services.” A February 27th media release from the Department of Justice stated the company will pay over $18 million in settlement funds, and Vanguard’s majority owner and CEO, William Orand, and its former director of operations, Mark Miller, will also pay roughly $250,000 in the settlement.

Vanguard owns multiple skilled nursing facilities in Tennessee, including ones in Murfreesboro, Shelbyville and Manchester. They previously operated additional homes in Nashville, Madison and Memphis.

The lawsuit claims Medicare and Medicaid were billed for “worthless nursing home services” between 2010 and 2015. Among the facilities’ worst failings, the lawsuit states that five Vanguard-owned nursing homes:

  • Failed to administer medications as prescribed
  • Failed to provide standard infection control, resulting in UTIs and other infections
  • Failed to provide wound care as ordered
  • Failed to take the proper steps to prevent pressure sores
  • Failed to meet basic nutrition and hygiene requirements
  • Used unnecessary physical restraints on residents

“Simply stated, our elderly and vulnerable citizens who can’t care for themselves deserve far better treatment than what they were subjected to by Vanguard,” U.S. Attorney Don Cochran said in the Department of Justice’s news release. “The substandard care that many of these facilities’ residents endured while the companies were raiding the public coffers is deplorable.”

Finding Help For the Vulnerable Who Are Suffering

Within a one-month span, two nursing home management companies were charged with defrauding Medicaid and Medicare and providing a completely unacceptable level of care. Sadly, the parent companies charged with such fraud own nursing homes in Memphis and across the entire state of Tennessee, meaning the consequences of their actions hit close to home.

If you or a loved one has been subjected to substandard care, do not wait to get help. The longer someone is exposed to worthless care, the more suffering that ensues. The Department of Justice realizes this is a problem that needs to be addressed, and so do we.

At Jehl Law Group, we have years of experience fighting against nursing home injustice and substandard care. We take pride in working hard and winning big verdicts for our clients. If you or someone you know has endured nursing home abuse or neglect, do not wait to get help. Call us today at (901) 322-4232 for a free, confidential consultation.