Genesis Healthcare to pay $52.7M to resolve four federal lawsuits

A national nursing home operator has agreed to pay more than $52 million to resolve four separate federal investigations that included allegations of unnecessary hospice services, therapy overbilling, and insufficient staffing, according to the Philadelphia Inquirer.

Genesis Healthcare Inc., which operates more than 500 nursing homes, rehab facilities and assisted living facilities in 34 different states, told the newspaper it entered an “agreement in principle” that would resolve four different lawsuits against Skilled Healthcare Group, which was acquired by Genesis in 2015. In a first quarter SEC filing released in May, the company indicated it had set aside more than $39 million to resolve the four cases. Company officials told the newspaper that Genesis added $13.6 million to that figure in the second quarter.

The lawsuits accuse Skilled Healthcare and several subsidiaries of billing Medicare for hospice services that did not meet federal requirements, overbilling Medicare for therapy reimbursement as far back as 2005, and providing inadequate staffing at certain facilities. Genesis officials told Philadelphia Business Journal the company agreed to settle the allegations “to avoid the uncertainty and expense of litigation.”

The settlement comes on the heels of criminal charges against the owner of 30 skilled nursing facilities in Florida, who is accused of fraudulently billing the government more than $1 billion, and nearly seven months after Kindred Healthcare paid $125 million to settle claims that its subsidiary billed Medicare for higher than necessary levels of therapy. Utilization data released earlier this year by the Centers for Medicare & Medicaid Services highlighted unusual spending linked to high level therapy.

- read the Philadelphia Inquirer article
- here's the Philadelphia Business Journal article