SavaSeniorCare LLC and related entities (Sava), based in Georgia, have agreed to pay $11.2 million, plus additional amounts if certain financial contingencies occur, to resolve allegations that Sava violated the False Claims Act by causing its skilled nursing facilities (SNFs) to bill the Medicare program for rehabilitation therapy services that were not reasonable, necessary or skilled, and to resolve allegations that Sava billed the Medicare and Medicaid programs for grossly substandard skilled nursing services. Sava currently owns and operates SNFs across the country. In 2015, the government filed a consolidated False Claims Act complaint against Sava, alleging that between October 2008 and September 2012, Sava knowingly submitted false claims for rehabilitation therapy services as a result of a systematic effort to increase its Medicare billings. The United States’ complaint alleged that, through corporate-wide policies and practices, Sava exerted significant pressure on its SNFs to meet unrealistic financial goals, resulting in the provision of medically unreasonable, unnecessary, or unskilled services to Medicare patients. Sava allegedly set these aggressive, prospective corporate targets for the highest Medicare reimbursement rates without regard for its patients’ actual clinical needs and then pressured its staff to meet those targets. Sava also allegedly sought to increase its Medicare payments by delaying the discharge of patients from its facilities, even though the patients were medically ready to be discharged.
This settlement also resolves allegations that between October 2008 and September 2012, Sava knowingly submitted false claims to Medicaid for coinsurance amounts for rehabilitation therapy services for beneficiaries eligible for both Medicare and Medicaid and for whom Sava also allegedly submitted or caused the submission of false claims to Medicare for those services. In addition, this settlement resolves allegations that between January 2008 and December 2018, Sava knowingly submitted false claims for payment to Medicare and Medicaid for grossly and materially substandard and/or worthless skilled nursing services. The government alleged that some of the nursing services provided by Sava failed to meet federal standards of care and federal statutory and regulatory requirements, including failing to have sufficient staffing in certain facilities to meet certain residents’ needs. The government also alleged that in certain skilled nursing facilities, Sava failed to follow appropriate pressure ulcer protocols and appropriate falls protocols, and failed to appropriately administer medications to some of the residents.
