Strange Tony,
The U.S. Department of Justice announced a case against Curo Health Services' Avalon Hospice for filing false claims with Medicare and Medicaid. The suit states:
Since at least 2010, the defendants violated the False Claims Act and the Tennessee Medicaid False Claims Act by knowingly submitting or causing to be submitted false claims, and knowingly and improperly concealing or avoiding Avalon’s obligation to repay overpayments, for hospice services provided to patients who were ineligible for the Medicare or Medicaid hospice benefit because they were not terminally ill.
The complaint alleges that the defendants pressured staff at their Tennessee hospice agencies to maximize admissions and census through aggressive financial targets and incentives, while simultaneously discouraging the discharge of patients who were no longer eligible for the Medicare or Medicaid hospice benefit.
The DOJ press release occurred on June 1. 2021.
This isn't Curo's first brush with the Department of Justice. Curo Health's Hospice Plus paid a $12.2 million fine in 2017 for paying for referrals.
Greed and bad management practices frequently come with private equity ownership. Curo CEO Larry Graham was put in charge of the hospice division Larry Graham was in charge for behavior that resulted in both DOJ cases.
I expect more false claim cases against our hospice division given Kindred Hospice adopted Curo's entrepreneurial platform for hospice. That's what financial rapscallions and Humana ownership did for us, besides ruining the quality of care provided.
Anonymous
Contacting Kindred Hospice's compliance department got me dismissed and a co-worker fired. One of the issues was admitting patients who did not qualify for hospice and keeping patients on hospice for long periods after they no longer met criteria.
ReplyDeleteAnother Curo Health hospice company, SouthernCare Hospice, settled with the DOJ for nearly $6 million for submitting false claims in December 2018.
ReplyDeleteIt was not their first time. SouthernCare was operating under a five-year corporate integrity agreement required by the settlement of a previous whistleblower case in 2009, which had claimed similar fraud.
Humana/TPG/WCAS would have known about this investigation from their due diligence process.
They put our ethically run hospice under these shysters. Curo is about greed and cheating. They destroyed our once great hospice.
https://homehealthcarenews.com/2018/12/curo-subsidiary-southerncare-settles-whistleblower-lawsuit-for-5-9-million/
Three of Curo Health's hospice brands got in trouble with the Department of Justice Avalon Hospice, Hospice Plus ($12.2 million fine) and SouthernCare Hospice ($5.9 million fine)
ReplyDeleteThat's the product of bad management. Larry Graham's track record continues:
https://citronresearch.com/amedisys-caught-between-a-rac-and-a-hard-place/
Georgia Patient Care Manager noticed pressure to admit patients from executives:
ReplyDeleteAlthough my co workers are amazing, we are all just numbers to upper level management. There is no work life balance, there is only the press to admit more and more and more, in spite of having no one to care for the current patients who have elected hospice care. Upper management is not supportive, and not truthful. Promises made are not kept. It feels like we are abandoned in the most stressful and trying situations, and survey results and census are priority. ALWAYS working short staffed, never feel as if our tasks are accomplished, never seem to be good enough, in spite of working 60 hour weeks. One of the worst employers I have ever worked for. I feel like a wheel in cog, and not valued, respected or supported.
Pros
salary, benefits
Cons
no breaks, middle and upper management is not supportive, no value of humanity, no work life balance
https://www.indeed.com/cmp/Kindred-At-Home/reviews/staff-at-our-office-is-amazing?id=407efc14a880ee88
Plaintiffs of the suit allege Regency and Curo pressured Avalon staff to initiate false claims and conceal overpayments to maximize census and profitability. The lawsuit also accuses the consortium of companies of failing to provide accurate clinical information to physicians when determining their eligibility for hospice, and that Curo audited patient medical records to omit words that signaled a patient’s health was improving, which would make them no longer eligible for hospice care.
ReplyDeletehttps://www.nashvillepost.com/business/health_care/feds-state-intervene-on-fraud-suit-against-local-hospice-companies/article_d740069c-c4a2-11eb-900c-3373941de38e.html
Hospice reps told our family our nurse had gotten the COVID-19 vaccine. Not true.
ReplyDeleteWe asked the question because it was important to us that anyone coming into the home would not be at risk of spreading COVID to our loved one with a compromised immune system.
Not a false Medicare claim but just as unethical.
Amedisys Home Health Companies Agree to Pay $150 Million to Resolve False Claims Act Allegations, Not Larry Grahams first public sht show rodeo
ReplyDelete