Medicare/Medicaid

Medicaid Delays Leave Another Illinois Nursing Home Bankrupt

Published on: August 28, 2019 | Levin & Perconti

nursing home closures

Delays by Illinois’s Medicaid Program Creates Ongoing Demise of Non-Profit Nursing Home Operator and Its Former Residents

It has been nearly 12 months since Pleasant Hill Village in Girard was forced to close citing a lack of Medicaid funds and backlog of the payment reimbursement process as the cause. Last year, the state of Illinois admitted to the multi-million Medicaid eligibility delay that makes it difficult for long term care coverage applications to be processed and payments made to Illinois skilled nursing facility operators. Pleasant Hill Village is now declaring bankruptcy on the disruptions and inability to pay debts and vendors, according to a report by The State Journal-Register.

Here is a recap of the August 16, 2019 news article:

Medicaid Residents Struggle To Receive Quality Care

Published on: August 5, 2019 | Levin & Perconti

Hole torn in a dollar bill with medicaid text

Nursing Home Residents on Medicaid Suffer Most

Most whose financial situation would be characterized as low income and need to remain in a nursing home for longer than expected, Medicaid will quickly become the primary payer for their long-term care. Designed as a public assistance program for individuals with limited financial support, Medicaid funds a person’s physician visits, hospital, and long-term care, drugs, medical equipment and transportation, and other medical services.

Chicago Nursing Homes That Stole Medicare Benefits

Published on: June 20, 2019 | Levin & Perconti

medicare theft

Four Chicago Nursing Facilities Caught Up in Medicare Fraud Whistleblower Case

Some Chicago nursing homes and rehabilitation centers are paying nearly $10 million back to the U.S. government after being caught lying about the level of care their patients required and for violating the False Claims Act by overbilling federal health insurers. Greed came through by abusing power over resident benefits paid for through Medicare and maximizing those amounts under fraudulent therapies and support.

At the center of the fraud sat Quality Therapy and Consultation Inc. of Orland Park, and its owner, Frances Parise. Parise allegedly worked with these four Chicago facilities.

Nursing Homes And No Harm Deficiencies

Published on: May 31, 2019 | Levin & Perconti

retirement home

Nursing Homes With “No Harm” Deficiencies Are Not Being Held Accountable

Nationwide, a majority of nursing homes voluntarily participate in the Medicare and Medicaid programs. Because of this partnership, facilities must adhere to minimum standards of care established by the federal Nursing Home Reform Law. Those who do not comply, should receive health violations leading to various penalties including fines or in some of the most severe cases, a group’s Medicare or Medicaid certification will be suspended or revoked by the Centers for Medicare & Medicaid Services (CMS), a part of the Department of Health and Human Services (HHS).

CMS data indicates that about 95 percent of these health violations are cited as causing “no harm” to residents. In a May 2019 newsletter published by the Center for Medicare Advocacy and the Long Term Care Community Coalition (LTCCC) several examples of these “no harm” deficiencies, taken from Statements of Deficiencies (SoDs) on Nursing Home Compare, were discussed. Surveyors classified all of the shortcomings listed below as “no harm,” meaning that they determined that residents were neither hurt nor put into immediate jeopardy for their health or well-being.

AARP Concerned By Enforcement of Nursing Home Regulations

Published on: April 12, 2019 | Levin & Perconti

AARP Speaks Out on Alarming Proposed Changes to Nursing Home Regulation

At Levin & Perconti we continuously monitor changes to current federal and state nursing home regulations in order to inform our clients of how those changes might impact quality of care. Recently we were pleased to see one of the most powerful lobbying groups in the country, AARP, voice concerns about regulatory actions of the Centers for Medicare & Medicaid Services (CMS) in a letter to the United States Senate Committee on Finance.

Not Enforcing the Rules

Largest Healthcare Fraud Exposed Through Nursing Home Mogul

Published on: April 9, 2019 | Levin & Perconti

healthcare fraud

Miami-Dade Nursing Home Owner Convicted in Largest U.S. Healthcare Fraud Scheme

Just last week, a 12-person jury deliberated for four days before finding Philip Esformes, a 50-year-old entrepreneur and owner of a network of 16 nursing homes and assisted living facilities in Florida, guilty on 20 out of 26 charges related to healthcare fraud. This is believed to be the largest fraud scheme ever charged by the U.S. Justice Department and a reflection of the business owner’s greed through receiving kickbacks, money laundering and conspiracy to commit federal program bribery totaling $37 million. In an April 5^th, 2019 public statement, prosecutors called him a “despicable,” “vampire” who was fueled by “unbounded greed.”

“Esformes exploited and victimized patients by providing inadequate medical care and poor conditions in his nursing homes. We will continue the fight against such parasites.”