Federal and state government agencies can pursue prosecutorial investigations against nursing homes and similar institutions here in Oregon or anywhere else. This may happen if there are illegal billing practices and/or widespread institutional mistreatment of patients. Investigators can impose fines and penalties, along with bringing criminal charges against the wrongdoing entities and individuals. One of the biggest nursing home chains has agreed to settle with the Department of Justice and eight state governments for $28 million, which represents systemic substandard treatment of patients and widespread nursing home neglect.
The Extendicare Health Service and its subsidiary, ProStep, will also pay an additional $10 million for improper billing of federal health programs for the poor and aging. This was reportedly the biggest settlement with a nursing home facility in history. The company allegedly hired fewer skilled nurses than was needed and failed to train other personnel properly.
Additionally, there was reportedly a systemic finding of falls, fractures, head injuries, malnutrition, dehydration, ulcers and infections, according to the DOJ. The facilities admitted very sick patients that they were unable to care for properly and adequately. This led to the neglect of other patients.
Unfortunately, the settlement allowed Extendicare to make a public denial of any wrongdoing and claim that it settled only to put the matter to rest. This is a kind of standard corporate denial, which has the potential drawback of allowing a company to rationalize away its pressing need to make changes. It's difficult to justify a statement of innocence in a case where the entity has essentially not denied that it engaged in fraudulent billing to at least the tune of $10 million or more.
The better news is that the company must enter into a Corporate Integrity Agreement with the federal government. It requires the company to maintain a satisfactory level of patient care over the next five years. The settlement does not prevent victims of nursing home neglect in Oregon or other states from bringing private negligence claims against nursing homes for compensation of injuries.
Source: The Sacramento Bee, "Nursing home abuse claims lead to $38 million settlement with feds", Daniel Salazar, Oct. 10, 2014