BRADFORD, Pa. — The parent company of Lakeview Senior Care & Living Center in Smethport will pay a more than $15 million settlement for allegedly providing unnecessary therapy to patients to meet revenue goals.
U.S. Attorney Scott W. Brady said Wednesday that Guardian Elder Care Holdings Inc., based in Brockway, will pay $15,466,278 to settle whistleblower claims alleging that Guardian pressured its rehabilitation therapists to provide services to meet financial targets and maximize revenue without regard to clinical need.
For example, Brady said claims alleged that certain patients suffered from dementia and did not need or want rehabilitation therapy, but Guardian Elder Care pressured therapists to provide the billable services anyway.
Other patients were allegedly dying and receiving hospice care — and therefore had no medical need for intensive therapy — but Guardian pressured therapists to treat those patients, as well, in order to meet financial goals.
The allegations arose from Guardian Elder Care’s facilities management practices from January 2011 through December 2017. The alleged actions took place at 28 facilities in Pennsylvania, Ohio and West Virginia, including at Lakeview, Carleton Senior Care & Rehabilitation Center in Wellsboro and Highland View Health Care in Brockway.
Lakeview administrator Terry Lopus referred questions to Guardian. A message left with Guardian’s communications team was not immediately returned Wednesday.
The case was filed in 2015, and remains under seal in the U.S. District Court for the Eastern District of Pennsylvania. No specific details were released.
The federal officials involved in the case had some harsh criticism for Guardian.
“Billing federal health care programs for medically unnecessary rehabilitation services not only depletes these programs’ funds but also exploits our most vulnerable citizens,” Brady said. “Our office will continue to aggressively pursue providers who take advantage of our seniors by putting financial gain ahead of patient care.”
U.S. Attorney William M. McSwain of the Eastern District of Pennsylvania agreed.
“Too much rehabilitation therapy can actually harm patients, just like giving them too many pills or too much medicine,” he said. “And of course it harms taxpayers who foot the bill for unnecessary treatment.”
The whistleblowers, Philippa Krauss and Julie White, both of Carlisle and former Guardian Elder Care employees, will share approximately $2.8 million of the recovery between them.
Brady noted that while the government was investigating these allegations, Guardian Elder Care voluntarily disclosed that it had employed two people who were excluded from federal health care programs. The settlement therefore encompasses claims that Guardian inappropriately received payment for services provided through these excluded persons during their term of exclusion.
In addition to the nearly $15.5 million payment, Guardian agreed to enter into a chain-wide Corporate Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General.