Life Care probed for Medicare fraud

Federal prosecutors allege that Cleveland, Tenn.-based Life Care Centers of America has bilked the federal government of hundreds of millions of dollars through a systematic Medicare fraud scheme since at least 2006. Full Story
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taxpayer

Morristown, TN

#1 Dec 1, 2012
Such waste and greed! Is there any wonder why Medicare is going broke?
What

Morristown, TN

#3 Dec 3, 2012
taxpayer wrote:
Such waste and greed! Is there any wonder why Medicare is going broke?
How does this affect Life Care of Morristown.
called in sick

Morristown, TN

#4 Dec 3, 2012
What wrote:
<quoted text>
How does this affect Life Care of Morristown.
Not Life Care Center but "LIFE CARE CENTERS OF AMERICA" All
life Care Centers are involved. The are all playing the same games and cashing in on the elderly!!
wondering

Morristown, TN

#5 Dec 4, 2012
December 3, 2012, 7:26 p.m. ET
Medicare Fraud Is Charged By THOMAS M. BURTONA Tennessee-based nursing-care company systematically defrauded Medicare of millions of dollars by pressuring therapists to perform expensive, unnecessary treatments, according to a recently unsealed federal complaint.
The filing against Life Care Centers of America Inc. is part of an investigation by the Office of Inspector General of the U.S. Department of Health and Human Services into high-priced nursing care.
The government's complaint, filed by the Justice Department in district court in Chattanooga and unsealed Friday, alleged the company—from its executives to lower-level supervisors—encouraged therapists to bill higher amounts and do more costly therapy. The document mentioned several cases of patients who allegedly didn't need therapy or could be harmed by it, but got it anyway.
For example, the government said, one 92-year-old cancer patient in Orlando was spitting up blood and medically fragile in 2007, but therapists recorded 48 minutes of physical therapy, 47 minutes of occupational therapy and 30 minutes of speech therapy two days before his death. The day he died, the patient allegedly got 35 minutes of physical therapy and was scheduled for more therapy later in the day.
Justice Department attorneys said they can't comment on the case.
Life Care Centers of America of Cleveland, Tenn., didn't respond to calls for comment. The company issued a statement on its website saying it "strongly disagrees with the allegations and will vigorously defend its therapy programs and the care provided." In addition, the website states that intensive and relatively expensive therapy actually saves the government money because it enables patients to improve and be discharged more quickly, "which ultimately reduces Medicare spending."
In addition to Medicare, the Tricare insurance plan, which covers military personnel, retirees and their dependents, also allegedly was billed for unnecessary treatment by Life Care Centers of America, according to the complaint.
The government said the company "engaged in a systematic scheme" since at least 2006 to maximize the number of days it billed to Medicare and Tricare. The government said the company did this by using false statements and false records to charge the government for the most expensive therapy.
The Justice Department said it has concluded that Life Care set aggressive targets for "ultra high" therapy—which is therapy billed at a high rate such as physical, speech and occupational—"that were completely unrelated to its beneficiaries' actual conditions, diagnoses or needs." The alleged pressure on therapists to hit those targets took the form of corporate presentations, emails and visits from high-ranking company officials and action plans on underperforming facilities.
As a result, the company billed nearly 68% of its Medicare rehabilitation days at that ultrahigh level by 2008, far above the 35% level of all skilled nursing facilities, the government said. The government declined to make internal company documents including emails illustrating the push toward high billing available immediately.
Another case set out in the federal complaint was that of a 62-year-old man at the Life Care Center of Columbia, S.C., in April 2007. In this instance, the government said documents show that the man "did not walk and was totally dependent…for bed mobility, transfers, toilet use and bathing." He even required assistance to move from lying down on his back to sitting upright, the complaint said.
But Life Care billed Medicare for group therapy focused on standing exercises in which the patient could not reasonably be expected to participate or receive any benefit, the complaint said. Life Care billed Medicare for "ultra-high" therapy for him from April 25, 2007, to June 23, 2007, the government said.
Coward Spotter

United States

#6 Dec 7, 2012
Mike
wondering

Morristown, TN

#7 Dec 7, 2012
Coward Spotter wrote:
Mike
What does that mean?
have you read the article?
Rip off

Morristown, TN

#8 Dec 7, 2012
We wander why the Government is going broke, it"s because all these big health care systems are trying to get rich. they take these elderly folks in and are supposed to provide them with the best care possible and all they do is rip the tax payers off millions of dollars. They are billing for therapy and all kinds of things that they are not doing, and you wander why your granny- mom-dad-grandad can't walk are they are not getting better, well that why. They get paid millions for doing nothing!!
wondering

Morristown, TN

#9 Dec 7, 2012
Rip off wrote:
We wander why the Government is going broke, it"s because all these big health care systems are trying to get rich. they take these elderly folks in and are supposed to provide them with the best care possible and all they do is rip the tax payers off millions of dollars. They are billing for therapy and all kinds of things that they are not doing, and you wander why your granny- mom-dad-grandad can't walk are they are not getting better, well that why. They get paid millions for doing nothing!!
Oh but they are doing something. According to several articles I have read, they are causing harm to the patients they are resonsible to care for. One article states dying patient spitting up blood recieved max number minutes with two or three therapies the day they died and had more sceduled that day. They use these frail elderly people who have no voice in the matter and get rich off them. They are also causing Tn Care and Medicare to increase rates in the billions for poor people to pay while they sit back and collect billions. I feel angry about that but mostly I feel for the frail and elderly who are at risk by this and subjected to unneeded pain and suffering.
I do feel therapy is and can be a good thing and has helped many but don't push for the ultra high at patients expense.
Rip off

Morristown, TN

#10 Dec 7, 2012
I have seen they leading them in there like cattle going to slaughter. This is our family members that are being used so they can make money. These old people hurt but they don't care they just want to make money. This is just another goverment rip off.
finger pointing

Morristown, TN

#11 Dec 10, 2012
Wendy

Shame Shame Shame
Shame on all of you for this money making RipOff and Fraud!
ronone

Pittsburgh, PA

#12 Dec 10, 2012
youtube.com/watch... ………Our Goverment
at Work lol
PT Aide

Morristown, TN

#13 Dec 22, 2012


Chattanooga, Tenn.— Details of an ongoing federal investigation into Life Care Centers of America reveal claims that elderly patients undergoing end-of-life care at several company facilities were pushed to high levels of unnecessary therapies so the company could bill maximum Medicare amounts for profit.

The examples in the federal complaint show a more personal side to the allegations of corporate-encouraged fraud that prosecutors have leveled against the Cleveland, Tenn.-based company.

One segment details the case of "Patient D," a 92-year-old resident at a Life Care facility in Orlando, Fla., who was dying of melanoma in 2007. Though the cancer had spread to Patient D's brain and lungs and radiation treatments had made him "medically fragile," he still was administered two hours of therapy every day.

Two days before Patient D died, he was spitting out blood. Yet therapists recorded 48 minutes of physical therapy, 47 minutes of occupational therapy and 30 minutes of speech therapy in one day.

"The day Patient D died, Life Care therapists recorded 35 minutes of physical therapy and had him scheduled for occupational therapy later in the day," court records state.

Other cases described in court records include:

n Patient C: An "extremely frail" 80-year-old female resident of the company's center in Columbia, S.C., in March 2006 was "very lethargic, hard to arouse" and "required assistance to control her head and to open her eyes." But therapists placed her in a standing frame -- equipment that holds the patient in a standing position -- supporting areas too weak to remain standing. Both the physical and occupational therapists recorded 42 minutes each for the time Patient C spent standing in the frame. The woman died five days later.

n Patient I: A 62-year-old male resident at the Columbia, S.C., center could not walk and was "totally dependent" for "bed mobility, transfers, toilet use and bathing." Life Care billed Medicare for "standing exercises" at the highest level allowed from April until June 2007.

n Patient A: A 78-year-old male patient at the company's Park View Care Center in Indiana was "frail and debilitated" when admitted in early May 2008. Therapists "subjected him" to more than 13 hours of physical, occupational and speech therapies in his first week at the location. Later that month Patient A was admitted to the hospital, then returned to the Life Care facility on May 28 for palliative care. Instead, therapists provided nearly five hours of therapy on May 31 and June 1. Patient A died on June 2, 2008
Truthisoutthere

Cleveland, TN

#14 Dec 24, 2012
Look at who sits in First baptist and gives money to keep his position in the community....then it becomes clear!
Cala

Morristown, TN

#15 Dec 24, 2012
Truthisoutthere wrote:
Look at who sits in First baptist and gives money to keep his position in the community....then it becomes clear!
Who?
PT Aide

Morristown, TN

#16 Dec 27, 2012
CLEVELAND, TN.(Times Free Press)-- Federal prosecutors allege that a widespread Medicare fraud scheme at Life Care Centers of America began at the highest levels of the corporate hierarchy and that employees who complained about possibly illegal practices were "ignored," "chastised," "punished" or fired.

Recently unsealed court records in an ongoing whistle-blower lawsuit against the Cleveland, Tenn.-based company reveal claims that the company founder and sole shareholder, Forrest Preston, forbade his own compliance department from conducting unannounced inspections at facilities.

Prosecutors claim that former Chief Operating Officer Cathy Murray circumvented the department's responses to employee complaints while she "aggressively drove the company's push for increased Medicare revenue."

Read more on the story from our news partners at the Chattanooga Times Free Press

If you have family at any Lifecare Center you really should see if they are among the thousands or tens of thousands of residents who have been used and abused for a dollor, well actually for millions of dollors. The elderly placed in nursing home care are frail, no one listens any longer and they are at risk for all sorts of abuse but you'd never expect it to come from the people we put in charge of caring for them. The people we trust to make them comfortable and their last days as pain free and tolerable as possible. Wr're not talking about all the ambulatory patients who need ultra high therapy, yes theray is good for the right people. People who have potential to improve, people who can and want aggressive therapy to get well and go home . People who have had a fracture, a stroke, an acute illness and needs therapy to improve, it is wonderful and they sould have it, but we're talking about sick, frail, weak, confused, incontinent, bed and chair ridden little bodies that can't tolerate or benefit but done solely for the green back dollor. A massive company Enriching their life while at another, a weaker one's expense. I don't know how some of these people over the facilities like the administrators, DON'S, Therapy Managers let this happen and drag them into it too. Anyone could see it, everyone knew, it was reported all over at all the facilities but they continued on, maybe to look good for corporate, I know alot of peple who did it for that reason, maybe for bonuses, I know some there too. Of course we know now it was a corporate thing starting all the way up at the top, about as high as it gets and everyone at Corporate knew of it to if they were't stupid.
outraged

Fayetteville, NC

#17 Jan 16, 2013
I can't believe this happen. I know people have said things like this before but i never believed them. I agree these people need criminal charges brought against them. No one should be above the law.
How Dare YOU

Cleveland, TN

#18 Jan 18, 2013
Life Care Centers of America is a great company. They have taken care of both my parents-in-law and given them rehabiliation and now they are both back in the community doing well. I myself have watched their therapy sessions and witnessed the compassion and care given by the therapists and nursing staff during a time of vulnerability and dependence. I ask all those that are talking negative about Life Care:
1. If your loved one is in a nursing facility, you should be part of that. You can attend their therapy sessions, and talk with their therapist. The responsibility of caring for ones parents/elderly is not souly the responsibility of the nursing home. It is ours too, the family.
2. If people like you continue to hurt companies like Life Care and they cannot continue to do business in our States then where who would take care of our frail and elderly. As it is nursing homes find it difficult to recruit staff to care for America's frail.
3. Do not attack people that choose to get up everyday and spend countless hours working, changing bed pans, giving medications, loving and caring. Do not attack people like Forest Preston that has spent his life creating a legacy of care which you utilize and yet judge. You have the choice, if Life Care is sooo bad why place your mom or dad there?

I for one am grateful that Life care was there for me when I needed someone to care and rehab my inlaws. I am grateful that I made the CHOICE to place them in the hands of caring people.
PT Aide

Morristown, TN

#19 Jan 18, 2013
How Dare YOU wrote:
Life Care Centers of America is a great company. They have taken care of both my parents-in-law and given them rehabiliation and now they are both back in the community doing well. I myself have watched their therapy sessions and witnessed the compassion and care given by the therapists and nursing staff during a time of vulnerability and dependence. I ask all those that are talking negative about Life Care:
1. If your loved one is in a nursing facility, you should be part of that. You can attend their therapy sessions, and talk with their therapist. The responsibility of caring for ones parents/elderly is not souly the responsibility of the nursing home. It is ours too, the family.
2. If people like you continue to hurt companies like Life Care and they cannot continue to do business in our States then where who would take care of our frail and elderly. As it is nursing homes find it difficult to recruit staff to care for America's frail.
3. Do not attack people that choose to get up everyday and spend countless hours working, changing bed pans, giving medications, loving and caring. Do not attack people like Forest Preston that has spent his life creating a legacy of care which you utilize and yet judge. You have the choice, if Life Care is sooo bad why place your mom or dad there?
I for one am grateful that Life care was there for me when I needed someone to care and rehab my inlaws. I am grateful that I made the CHOICE to place them in the hands of caring people.
Hello, Hello, Read the facts above you, read the news, read the cases as spelled out. There has been nothing negative said here about rehab or therapy. Therapy is a beautiful thing for those who need it. I think the issue here is those who DO NOT need it. Those who are at deaths door, those who do not have a say, those who have actually been harmed by this beautiful thing that we all need at one time or another in our lifes. I think this just may be about the issue of those who just can't benefit one bit from therapy but getting it in huge doses, good or bad, at the highest level of pay. Further more the people you say are being attacked has never changed a bedpan, never given meds or even never cared for our loved ones. You ask who would care for our loved ones if Life Care couldn't? Well maybe, just maybe it might be a caring reputable company who is not privately owned and for profit.
outraged

Morristown, TN

#20 Jan 19, 2013
I found this upon reading more about the scandal being reported.

Comments (5)

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ST Therapist · 5 weeks ago

I am one of those therapist and everything in the Compliant is true. I had to jepordize my integrity or quit. This is a terrible place to work and even worse place to put someone you love.

Jacky · 5 weeks ago

OT:Therapist
it is so true and the minute you question anything you get in so much trouble! There is so much more i wish the government will know.

Licensed Therapist · 5 weeks ago

The information about Life Care pressuring therapists to provide unnecessary and expensive therapy is accurate . If you work as a treating therapist (PT, OT, ST) for this company you will have to compromise your ethics and jeopardize your licensure in order for them to maximize their profits. It is good that this information is now being reported by the press. Perhaps other treating therapists can avoid working for this company and won't have to learn the "hard way."

jen · 5 weeks ago

Definitely true!
therapist · 3 weeks ago

This does not happen only at Life Care. It happens at a Massachusetts based company I work at as well. I am sick and tired of being pushed to bill and treat inappropriately and unethically, and then reprimanded if I don't do what I am told. And even when I request a lower category or discharge it is either ignored or "lost" in the paper pushing.
Therapist

Ozark, MO

#21 Jan 27, 2013
It's a sad state of affairs...because it's true. And what's even worse is that it's only become more stressful and MORE pressure has been placed on the therapists and managers since this story broke. All of the demands are still coming from the same people at the top of the food chain just via verbal communication so you have no evidence in writing. Yes, the very same people who have been indicted.

They made more demands of the managers and applied more expectations than anyone could possibly meet. Traditionally the Rehab Managers have managed now, they expect them to manage and provide patient treatment anywhere from 50 to 100% of their day. This is the most unrealistic expectation I've seen in LTC to date. And you dare not say anything, there are repercussions all the time. It's only going to get worse...

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