A nursing home company is accused of bilking the federal government out of hundreds of millions of your tax dollars.
The U.S. Attorney's Office in Nashville has announced that Signature Healthcare has agreed to pay more than $30 million to settle the case.
Signature Healthcare allegedly charged the government for services at its nursing homes that patients didn't need and sometimes didn't get. And this was all discovered because two women working at Signature's facility in Columbia saw what was going on and knew it was wrong.
"There were a couple of times when things happened with patients where we would just look at each other and say, 'We can't do this. We just cannot do this any more,'" LeeAnn Holt recalled.
Holt and Kristi Emerson are the whistle-blowers who exposed a company-wide system of over-billing the federal government by Signature Healthcare. The Louisville, Kentucky-based company runs more than a hundred skilled nursing homes, including seven in middle Tennessee. Among them, Metro's long-term care facility in Bordeaux.
The women were occupational therapists at the company's facility in Columbia when they sued Signature as whistle-blowers, reporting the fraud and alleging the company was overcharging the federal government by providing more therapy than necessary and claiming patients were getting more therapy than they were actually receiving.
"It wasn't an easy decision," Emerson admitted.
The women say before filing their suit, they repeatedly went to administrators all the way up to the corporate office.
"And no one was doing anything. And the more we reported, the more they came in and just started pushing back on us," Emerson explained.
Emerson and Holt said they were pretty sure it wasn't just happening at their facility. And they were right. According to court documents, state and federal investigators discovered Signature was "knowingly submitting false claims to Medicare for rehabilitation therapy services that were not reasonable or necessary" at 115 of its facilities. Investigators said that led to a total of $232 million in false claims. The company also allegedly forged documents submitted to Tennessee's Medicaid or Tenncare program, leading to another $12 million in fraudulent reimbursements.
The Department of Justice just announced a settlement in the case in which Signature admitted no wrongdoing, but agreed to pay $30 million.
The women are disappointed that it wasn't more, but, Holt added, "What we feel really good about is that the government saw the problem and they agreed that there's a problem and there's concern and changes need to be made."
Holt and Emerson said it wasn't just that taxpayers' money was lost, but elderly patients suffered too, being forced to undergo excessive and exhausting treatments.
Their attorney Jerry Martin called the settlement significant.
"And that agreement will hopefully go a long way in making sure that this never happens again," Martin said.
Both women will get a share of the settlement. They are also seeking damages for retaliation. They say Signature fired them after they filed their whistle-blower suit.
When asked about the settlement, Joe Steier, CEO and President of Signature Healthcare, said in a statement:
"This settlement allows us to move forward in serving our residents and families with quality health care and a commitment to compassion. We worked with the government over the past year to get us here. Resident care remains our first priority, and therapy services are and remain an important part of that care. We are more focused than ever on our mission to serve each resident and family with excellence, and will continue to work hard each and every day to deliver great outcomes for our residents.”