February 19, 2020
A Pennsylvania nursing home chain will pay nearly $15.5 million to settle allegations that it provided unnecessary medical care to residents in order to meet its revenue goals.
Guardian Elder Care Holdings Inc. allegedly pressured its rehabilitation therapists to provide unnecessary services so the company could maximize reimbursements from government programs, federal prosecutors announced Wednesday.
Guardian, based in Brockway, Jefferson County, operates more than 50 homes across Pennsylvania, Ohio and West Virginia. Most are located in the Pittsburgh area, but Guardian also has locations in Bucks County, the Lehigh Valley and the Poconos.
The company allegedly instructed therapists to provide intensive medical therapy to residents who were dying or receiving hospice care and therefore had no need or desire for the services. Therapists also were pressured to provide unnecessary therapy to patients with dementia, prosecutors allege.
Guardian billed the unnecessary services to Medicare and the Federal Employee Health Benefits Program, prosecutors say.
The allegations arose from a whistleblower complaint filed by two former employees of the nursing home, Philippa Krauss and Julie White. The two women will share $2.8 million from the settlement.
The case was settled in the U.S. District Court for the Eastern District of Pennsylvania.
"Too much rehabilitation therapy can actually harm patients, just like giving them too many pills or too much medicine," said U.S. Attorney William McSwain in a statement. "And of course it harms taxpayers who foot the bill for unnecessary treatment."
The nursing home chain also agreed to enter into a "Corporate Integrity Agreement" with the U.S. Department of Health and Human Services to help protect vulnerable nursing home residents and promote compliance.
"Resident care remains our first priority and we are committed to meeting our obligations under this agreement," Guardian Elder Care said in a statement. "We are confident that Guardian’s Corporate Compliance Program advocates for our patients, their families and caregivers."
This article was updated with information from Guardian Elder Care on Feb. 20, after it was originally published.