California prosecutors sued the nation’s largest network of elderly communities on Monday, accusing the company, Brookdale Senior Living, of manipulating the federal government’s nursing home classification system.
The lawsuit was filed by California Attorney General Xavier Becerra and other prosecutors against Brookdale, which operates several nursing homes in the state.
The lawsuit is one of the first of its kind to accuse nursing homes of sending false information to the Medicare rating program. The system assigns stars – one being the worst, five being the best – to the country’s more than 15,000 nursing homes.
The system is powered by largely unaudited data sent by nursing homes, including the amount of time nurses spend with residents and face-to-face examinations by state health inspectors.
Since its launch more than a decade ago, the rating system, overseen by the United States Medicare and Medicaid Service Centers, or CMS, has become an essential tool for nursing homes to attract potential customers. It can mean the difference between making or losing money in a nursing home.
The lawsuit, filed in the California Superior Court, comes in the wake of a New York Times investigation that found the rating system is broken. The Times found that much of the information that nursing homes, including Brookdale’s, send to the government is wrong, painting a very distorted picture of the quality of care in many homes. The sleight of hand in elderly people’s homes left the industry vulnerable when the coronavirus pandemic hit.
In the case filed on Monday, California prosecutors said that by April 2018, Brookdale had earned “undeserved higher ratings” by submitting false information about his team. In particular, the suit states, the company exaggerated the number of hours worked by registered nurses.
Prosecutors said Brookdale continued to circumvent the statistics even after the CMS improved the way it collected personnel data in an attempt to crack down on the increase in its numbers in nursing homes. Beginning in 2018, the CMS began using payroll records, which recorded nurses’ daily hours, to calculate home assessments, rather than relying on nursing homes to report the amount of time nurses spent with nurses. patients. Prosecutors accused Brookdale of “falsifying its payroll-based diaries”.
The result, prosecutors said, was that Brookdale “received higher star ratings than he deserved.” They added: “The manipulation of the network has allowed Brookdale to attract potential patients and their families to its facilities, deceiving them about the quality of care.”
Prosecutors also accused Brookdale of illegally evicting or transferring residents so that the network could “fill their beds with residents who will bring in more money”. In a case highlighted in the lawsuit, prosecutors said Brookdale discharged a 78-year-old resident who suffered from heart and kidney disease without removing his catheter.
Heather Hunter, a spokeswoman for Brookdale, vehemently denied on Monday that the company had “been involved in intentional or fraudulent conduct”.
“We are disappointed with the charges against the specialist nursing industry,” said Hunter. “Disclosing unproven claims is unwise and undermines public confidence in a service needed to care for the elderly, especially during the Covid-19 pandemic.”
The lawsuit seeks civil and preliminary penalties to prevent future illicit conduct. Under California law, civil penalties amount to $ 2,500 per violation. In that case, when violations are committed against the elderly or people with disabilities, the law provides for an additional fine of up to $ 2,500 per violation.
The Times previously reported that a Brookdale facility in Lexington, Ky., Told Medicare in 2017 that each resident received an average of 75 minutes of care per day. In fact, nurses at the Brookdale Richmond Place facility spent an average of less than 30 minutes a day with patients. Brookdale received five stars for his team. Without the inflated numbers, he probably would have received just one or two stars.
A former Brookdale nursing assistant said in a statement last year that her supervisors told her to falsify residents’ medical records to make it look like they received more care than they did.
At this point, Ms. Hunter told The Times: “We have detailed policies in place to ensure compliance with CMS reporting rules and we are not aware of any instance where inaccurate or false information has been submitted by anyone from our communities outside the limits of CMS rules. “
President Biden appointed Mr. Becerra, whose office opened the case against Brookdale, to secretary of health and human services, who oversees the CMS. The Senate has yet to vote on the nomination.
Robert Gebeloff contributed reporting.