Guardian Elder Care Holdings, Inc., and its related companies will pay $15,466,278 to settle claims that the skilled nursing home chain provided medically unnecessary rehabilitation therapy to residents in order to meet revenue goals, instead of clinical needs. Guardian Elder Care operates more than fifty facilities throughout Pennsylvania—including locations in the Lehigh Valley, the Poconos, and Bucks County—as well as in Ohio and West Virginia. The settlement resolves allegations in a whistleblower complaint filed in federal court in the Eastern District of Pennsylvania under the qui tam provisions of the False Claims Act. The whistleblowers, Philippa Krauss and Julie White, will share approximately $2.8 million of the recovery between them.
The whistleblowers generally alleged that Guardian Elder Care pressured its rehabilitation therapists to provide services to meet financial targets and maximize revenue, without regard to clinical need. For example, they alleged that certain patients suffered from dementia and did not need or want rehabilitation therapy, but Guardian Elder Care allegedly pressured therapists to provide those services anyway to meet revenue goals. Other patients were allegedly dying and receiving hospice care—and therefore had no medical need for intensive therapy—but Guardian Elder Care allegedly pressured therapists to treat those patients, as well, in order to meet the same financial goals. Today’s announced settlement agreement resolves the allegations arising from Guardian Elder Care’s facilities management practices from January 2011 through December 2017. Additionally, while the government was investigating these allegations, Guardian Elder Care voluntarily disclosed that it had employed two people who were excluded from federal healthcare programs. The settlement therefore encompasses claims that Guardian Elder Care inappropriately received payment for services provided through these excluded persons during their term of exclusion.
