“While our case is focused on staffing data, there is a real human cost to the defendants’ choices and their failure of care,” Nessel said in a July 30 press release.
Michigan Attorney General Dana Nessel has filed a lawsuit against a nursing home operator and several related companies, claiming they fraudulently collected more than $111 million in Medicaid reimbursements while failing to provide a reasonable standard of care.
According to WILX, the lawsuit names Fahim Uddin, Pioneer Health Care Management, and nine nursing home facilities in Southeast Michigan as defendants. Nessel’s office claims that these defendants violated provisions of the state Medicaid False Claim Act by accepting payments while failing to maintain the staffing levels necessary to bill for certain services.
“Michigan law requires per-shift minimum ratios to ensure care and services are not concentrated in a single period. It is alleged that the defendants failed to meet these shift ratios on at least 496 instances. Michigan law also requires a nursing home to provide staff sufficient to provide not less than 2.25 hours of nursing care per resident, per day,” Nessel’s office said. “It is further alleged that the defendants operated below the per resident, per day threshold on 1,454 occasions – higher than any other nursing home chain with four or more facilities in Michigan during this period. On at least 4,658 occasions, the defendants also allegedly failed to staff a registered nurse for at least eight consecutive hours a day, seven days a week, as required by federal law.”
The lawsuit claims that Uddin and his companies did not merely make an oversight but instead intentionally unstaffed their facilities for the sake of amassing greater profits, potentially endangering the residents under their care.
“While our case is focused on staffing data, there is a real human cost to the defendants’ choices and their failure of care,” Nessel said in a July 30 press release. “The consequences of chronic understaffing placed vulnerable residents at unnecessary risk of harm, violated their rights, and resulted in numerous injuries. I would like to thank the U.S. Department of Health and Human Services, Office of Inspector General for their valuable assistance in this matter. My office remains committed to doing all we can to hold long-term care facilities accountable to ensure residents receive the high-quality care they deserve.”
Sources
Michigan Attorney General sues nursing home operator, alleges $111M Medicaid fraud
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