Golden Living to settle Medicaid fraud claim

by The City Wire staff ( 26 views 

Golden Living agreed to a $613,300 settlement on Wednesday (Jan. 2) for failing to provide adequate wound care at some of its Georgia-based nursing home facilities.

Despite the agreement, however, the company is maintaining its hands are clean in the action.

“Golden Living agreed to the settlement not to dignify these baseless charges, but because we would rather spend the money on our patient care and staff than on the legal fees necessary each month simply to respond to the government’s actions in the investigation,” Dr. Neil Kurtz, president and CEO of Golden Living, said in a statement.

On Wednesday the Federal Bureau of Investigation (FBI) issued a statement accusing Golden Living of “fraudulently” billing Medicaid “for nursing services which were substandard and, tragically, resulted in harm to patients,” according to Georgia Attorney General Sam Olens.

“The nursing home patients depended on Golden Living to provide them with quality wound care services to help them heal, but, instead, were mistreated. We will not stand for such egregious misconduct by a Medicaid provider,” Olens said.

Sally Quillian Yates, U.S. Attorney for the Northern District of Georgia, agreed and said that by “failing to provide adequate wound care services to its nursing home residents, Golden Living placed at risk the life and health of individuals who were entrusted to its care.”

Derrick L. Jackson, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General for the Atlanta region, believed the case was a message to health care providers that “if they provide worthless services to those most in need, they will pay the price.”

According to the FBI release, the government alleged that “GGNSC (Golden Living) submitted false claims to Medicare, Medicaid, and the Veterans Administration because it provided residents at Golden LivingCenter–Glenwood…and Golden LivingCenter–Dunwoody…with inadequate and worthless monitoring, documentation, and prevention and treatment of wounds during the period from January 1, 2006 through May 31, 2011.”

However, to Golden Living’s claim the company is not guilty of wrongdoing, the FBI release does state, “The claims settled in the civil settlement are allegations only, and there has been no determination of liability.”

In a Wednesday release from Golden Living, the company trumpeted this fact and pointed to recent quality ratings from the Centers for Medicare and Medicaid Services (CMS) for the facilities involved.

“Specifically, Golden LivingCenter – Dunwoody received a Four-Star Overall rating (out of a possible Five Stars) and a Five-Star Quality rating (out of a possible Five Stars) in the most recent rankings. Golden LivingCenter – Glenwood received a Three-Star Overall rating and a Four-Star Quality rating,” the Golden Living release stated.

“Under the terms of the settlement, Golden Living has entered into a Corporate Integrity Agreement (CIA) that will apply to six Golden LivingCenters in the Atlanta area,” the release continued. “It will focus on conducting additional training for employees who provide clinical and administrative supportive services to those centers, and on the use of technology to enhance both care and the documentation supporting that care.”

The FBI statement added that “an independent monitor” would oversee compliance “for up to five years.”

The civil case originated in a lawsuit filed by Dr. Joseph L. Micca, who according to the FBI, will receive “a share of the settlement payment.” Golden Living noted that $423,544 of the settlement would go to the federal government while $189,756 would belong to the State of Georgia.

Golden Living will also pay interest and legal fees of an undisclosed amount.