$5 Million Whistleblower Qui Tam Nursing Home Settlement

Nursing Home Billing Fraud Whistleblower Case

Health Service Management Inc. has agreed to a $5,000,000 settlement with the US government in a nursing home whistleblower lawsuit. $1 million is being awarded to the brave nursing home employee who exposed the problems inside the facility. HSM settled the case involving allegations that the nursing home billed Medicare and Medicaid for worthless and unnecessary services.

The Underlying Lawsuit

Filed in 2014 by the Department of Justice, the qui tam case involved allegations of systemic neglect of residents. It was alleged that the facility provided inhumane living conditions, even going so far as to withholding water and food from vulnerable residents. The whistleblower was a former employee of HSM in their Huntsville Health Care Center facility.

The whistleblower alleged that the nursing home staff was abusive to residents and failed to provide for residents basic needs. As a result of these abuse allegations, the government investigated and agreed. When ‘worthless services’ are provided and Medicare foots the bill, the government will investigate whether actual, quality services were provided to residents in exchange for Medicare payments.

The DOJ investigated what Medicare and Medicaid paid for from 2013 to 2015 and found the following:

Huntsville Health Care Center billed for services that were not provided or which were so substandard and deficient that they were considered worthless and potentially harmful to specific Huntsville patients. The claims for payment to Medicare and Medicaid for those services were deemed to be fraudulent and submitted in violation of federal and state law. – Department of Justice

Nursing Home Whistleblower Settlement

The nursing home chain settled with the Federal Government for $5 million. As part of the settlement agreement, the facility owners entered into a corporate integrity agreement with the government. The whistleblower in this nursing home abuse case was awarded $1 million for coming forward.

More About Health Services Management, Inc.

HSM is based in Tennessee and owns, operates, manages and controls nursing homes throughout the US. The company is still in business but is currently under the watchful eye of various federal and state agencies.

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