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Mar 25, 2023 by |

San Francisco Elder Abuse And Whistleblower Attorney: Nursing Home Operator To Pay $7.168 Million To Resolve False Claims Act Allegations Of Worthless Services


False Claims For Medicaid Payments Alleged

Accused Of Inadequate Staffing And No Hot Water

Licensing Irregularities

Healthcare fraud, including fraud against Medicare and Medicaid, is the biggest kind of fraud perpetrated against the government.  When the targeted patients are elders, such fraud cases may also constitute elder abuse under the California Elder Abuse and Dependent Adult Protection Act, Cal. Welf. & Inst. Code § 15600 et seq.  Medicare and Medi-Cal fraud often overlaps with elder abuse in nursing homes and assisted care facilities, as the recently reported case discussed below illustrates. Evans Law Firm, Inc. represents California seniors who have suffered elder abuse and individuals with credible information of fraud against government-sponsored healthcare programs like Medicare and Medi-Cal. The whistleblower suit (known as qui tam cases) for the Medicare/Medi-Cal fraud aspect of any fraud against elder patients would be brought under the federal False Claims Act (FCA), 31 U.S.C. §§ 3729 et seq., and the California act.   See Cal. Gov’t Code § 12650 et seq. (California False Claims Act). Both acts offer sizeable awards to whistleblowers.  31 U.S.C. § 3730(d)(federal rewards); Cal. Gov’t Code § 12652(g).  If you have credible information of elder, Medicare fraud in San Francisco, or elsewhere in California, call us today at (415)441-8669 and we can help. Our toll-free number is 1-888-50EVANS (888-503-8267).

Recent Settlement Of Allegations Against Skilled Nursing Facility

The U.S. Department of Justice (DOJ) recently announced a $7,168,000 settlement with a skilled nursing facility and several affiliated individuals and business entities of False Claims Act allegations of improper Medicaid payments for worthless services provided to facility residents.[1]  The complaint in the case alleged that the skilled nursing facility operated by defendants delivered worthless services to residents, and its physical conditions deteriorated to such a degree that it violated federal and state regulations. Specifically, the operators failed to adequately staff the home, and residents suffered medication errors, unnecessary falls, and the development of pressure ulcers. Additionally, the government alleged that the facility did not consistently maintain hot water throughout the facility, have an adequate linen inventory, and dispose of solid waste. In 2019, the facility was placed on the Centers for Medicare and Medicaid Services Special Focus Facility list – a list of the worst-performing nursing homes in the United States.

The United States contends that, between February 2017 and February 2021, defendants knowingly submitted or caused the submission of false claims for payment to Medicaid for worthless nursing services. This settlement resolves those allegations.

False Claims And Elder Abuse

Patients and employees may have information of abuse and government fraud.  Our attorneys will pursue all available remedies to any plaintiffs injured by abuse or impacted by fraud.  If you are an employee with information of Medi-Cal or Medicare fraud, State and federal laws protect you from retaliation by your employer from bringing a qui tam case.  Cal. Gov’t Code § 12653; 31 U.S.C. § 3730 (h).  Despite the legal prohibition employers continue to retaliate against whistleblowers.  State and federal laws allow you to fight back and you may be entitled to sue your employer in court and seek double back pay (with interest), reinstatement, reasonable attorneys’ fees, and reimbursement for certain costs in connection with the litigation. 31 U.S.C. § 3730(h)(2); Cal. Gov’t Code § 12653. Evans Law Firm, Inc. can represent you in any action for retaliation as well as represent you in your underlying whistleblower application.

Contact Us

If you have credible information of fraud against Medicare or Medi-Cal in San Francisco or elsewhere in California, call Ingrid M. Evans at (415) 441-8669, or toll-free at 1-888-50EVANS (888-503-8267) or by email at <a href=””></a>.  In addition to FCA whistleblower cases, Ingrid also handles bank fraud whistleblower cases under FIRREA/FIAFEA, commodity trading and securities fraud under the Commodities Futures Trading Commission Whistleblower Program and the Securities and Exchange Commission Whistleblower Program, and tax fraud under the Internal Revenue Service Whistleblower Program. 

[1] Evans Law Firm, Inc. was not involved in the case in any way. 

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