On April 7, 2025, Maryland Attorney General Anthony G. Brown announced a $1,289,679 settlement with a nursing home and its parent company to resolve allegations of violating the Maryland False Health Claims Act by providing substandard care to residents.
The facility came to the office’s attention in 2022 after a concerned citizen contacted the Medicaid Fraud and Vulnerable Victims Unit (MFVVU) with information. The settlement includes $400,679 paid by the company to fund a quality improvement plan in which the Office of Attorney General will oversee the facility for three years through regular performance evaluations by a third-party monitoring company. The settlement also includes $889,000 in restitution to the state.
The investigation was part of a broader effort by the MFVVU, which expanded its scope through a new “strike force” approach. This collaborative initiative involved the MFVVU partnering with Maryland’s Department of Human Services, the Office of Adult Services, the Adult Protective Services Program, and the State Long-Term Care Ombudsman. Together, they responded to systemic failures in long-term care by conducting unannounced visits to facilities, quickly assessing and addressing residents’ needs.
The investigation into the facility was thorough and included multiple steps. MFVVU conducted interviews with former staff and residents and reviewed survey reports from the Office of Health Care Quality, which documented numerous deficiencies. The team also analyzed facility staffing levels, personnel records, and resident census documents, as well as obtained and reviewed medical records for residents.
The MFVVU’s investigation revealed several deficiencies, including:
- Significant understaffing
- Serious wound care deficiencies
- Regulatory violations compromising patient care
- Numerous preventable falls
- Avoidable nutritional and hydration deficits
- Failures to respond to residents’ changes in condition
The MFVVU determined that these deficiencies were a signal that the Medicaid recipients at the facility were receiving substandard care, defrauding taxpayers who funded the Medicaid program. As part of the settlement, the MFVVU insisted on a quality improvement agreement. This agreement allows the state to monitor the facility’s day-to-day operations regularly through third-party evaluations and access to corporate documents, medical files, and staff. If further issues are identified, the facility must make improvements or face additional legal action.
Compliance Perspective
Issue
Quality of care is a fundamental principle that applies to all treatment and services provided to facility residents. Based on a comprehensive assessment, each resident must receive the necessary care to achieve or maintain the highest practicable physical, mental, and psychosocial well-being. The facility must ensure that care aligns with professional standards, the resident’s person-centered care plan, and their personal preferences. Staff must also protect residents’ rights by ensuring freedom from abuse, neglect, and exploitation. Failure to meet these standards may be considered substandard care, which could result in immediate jeopardy citations, fines, and other sanctions for the facility.
Discussion Points
- Regularly review and update your policies, procedures, and staffing guidelines to ensure they support the delivery of quality care. This includes reviewing the Facility Assessment, as required by F838, to ensure it addresses the needs of all residents.
- Train staff on their responsibilities for providing safe, high-quality care and support services. Ensure that training is ongoing and covers both the specific needs of residents and the facility’s standards for care.
- Audit to verify that staff are following policies and delivering safe, quality care. These audits should ensure that the Facility Assessment is up to date, accurately reflects resident needs, and identifies the resources required for quality care. Additionally, facilities should review their Quality Assurance and Performance Improvement (QAPI) initiatives to ensure that care quality is continuously monitored by the QAA/QAPI committee.
*This news alert has been prepared by Med-Net Concepts, Inc. for informational purposes only and is not intended to provide legal advice.*
