Understaffing and fraudulent billing spur consumer protection lawsuit against Pa. nursing home company: 7 things to know

Pennsylvania has filed a consumer protection lawsuit against a nursing home company, alleging the company has staffing problems, which led to fraudulent billing, according to Insurance Journal.

Advertisement

Here are seven things to know about the lawsuit.

1. The lawsuit was filed Friday against Grane Healthcare, based in O’Hara Township near Pittsburgh, which has 11 skilled nursing homes in Pennsylvania.

2. In the lawsuit, Pennsylvania Attorney General Bruce R. Beemer said Grane doesn’t have enough staff to provide basic patient care — and “deceived the Commonwealth regarding the true conditions and level of care they provided by increasing staffing levels on the floor” when inspectors with the Pennsylvania Department of Health were around, according to the report.

3. Specifically, the lawsuit contends Grane advertised “high staff-to-patient” ratios but had too few certified nursing assistants to ensure patients were fed, clothed, bathed and otherwise cared for properly and as advertised, reports Insurance Journal.

4. Additionally, the report states, the lawsuit contends the staffing problems resulted in fraudulent billing because patients did not receive the level of care that Grane advertised which was paid for by their Medicare, Medicaid and other insurance programs.

5. Overall, “these alleged misrepresentations not only deceived the residents of these facilities, but Grane’s business practices also degraded residents and increased the risk of negative health consequences,” Mr. Beemer said, according to the report.

6. Grane did not immediately respond to a phone call and email by Insurance Journal seeking comment.

7. The lawsuit seeks $1,000 per violation of Pennsylvania’s consumer protection law, or $3,000 for each violation where the victim is 60 or older, according to the report.

 

More articles on legal and regulatory: 

California voters OK permanent hospital fee program that supports Medi-Cal
MACRA drives physicians toward value-based care
Walgreens files breach-of-contract lawsuit against Theranos

 

 

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Download Whitepaper

The cost-saving opportunity most health systems overlook

Many hospitals and health systems scrutinize staffing, service lines, and payer contracts for savings. Fewer look at one of their largest assets: real estate.…

Advertisement

Next Up in Legal & Regulatory Issues

Advertisement

Comments are closed.