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Nursing Home Operator to Pay $11 Mil Resolving Rehab Fraud Claims by Waters & Kraus Client and Others

06-02-2021 08:32 AM CET | Health & Medicine

Press release from: Waters & Kraus, LLP

Waters & Kraus Partners Charles Siegel and Caitlyn Silhan Represent Whistleblower Terrence Scott

Waters & Kraus Partners Charles Siegel and Caitlyn Silhan Represent Whistleblower Terrence Scott

SavaSeniorCare agrees to settle whistleblower claims alleging the company bilked Medicare for medically unnecessary rehab therapy and substandard skilled nursing services.

TENNESSEE – One of the largest nursing home chains in the U.S., SavaSeniorCare LLC (Sava) and related entities, has agreed to pay $11.2 million to resolve a long-running case alleging the company knowingly billed Medicare and Medicaid for excessive and unnecessary amounts of rehabilitation therapy and “grossly substandard” skilled nursing services. The U.S. Department of Justice announced the settlement on Friday, May 21, 2021.

“The government pays skilled nursing facilities to provide services to vulnerable patients with the goal of rehabilitating them, not maximizing corporate profits at the patients’ and the government’s expense,” said Waters & Kraus partner Caitlyn Silhan. “Our client refused to engage in the fraudulent conduct alleged in his and the government’s complaint, and his courage and determination in filing suit under the False Claims Act helped hold Sava accountable. We hope his example motivates other whistleblowers to come forward and report fraud committed against the government.”

Whistleblowers, also known as relators, filed the initial case against Sava in 2011, alleging Sava violated the False Claims Act. The federal government intervened in the case in 2015, joining the lawsuit against the nursing home chain.

This settlement agreement resolves allegations that from 2008 to 2012, Sava knowingly submitted false claims for rehabilitation therapy services as part of a broader scheme to increase its Medicare billings. The complaint alleged corporate-wide policies pressured Sava skilled nursing facilities (SNFs) to meet unrealistic financial goals. This pressure resulted in SNF staff providing unnecessary or unskilled services to Medicare patients without regard for those in their care. As part of the scheme, Sava also allegedly delayed discharging patients who were medically ready to be released in order to run up the bill.

The settlement amount was based on Sava’s ability to pay, and its terms include additional amounts if certain financial contingencies occur. Additionally, Sava entered into a Corporate Integrity Agreement with HHS-OIG, which mandates an annual independent review of patient stays and associated paid claims by Medicare for five years. Sava is also required to have independent monitoring of its residents’ quality of care.

The civil settlement resolves claims brought under the qui tam, or whistleblower, provisions of the False Claims Act against Sava by Relators Rita Hayward, Trammel Kukoyi, Terrence Scott, James Thornton, and Barbara Roberts. Under the qui tam provisions of the False Claims Act, a private party can file a lawsuit on behalf of the U.S. government and receive a portion of any recovery, as the whistleblowers did here.

Whistleblower Terrence Scott is represented by Charles Siegel and Caitlyn Silhan of Waters & Kraus in Dallas, Texas, along with co-counsel Christopher McKinney and Dan Hargrove of San Antonio, Texas, and local counsel Dave Garrison of Barrett, Johnston, Martin, & Garrison in Nashville, Tennessee.

Waters & Kraus, LLP
Attn: Brandy Dietz, Marketing Director
3141 Hood Street
Suite 700
Dallas, Texas 75219
waterskraus.com
214-357-6244

Waters & Kraus is a national plaintiffs’ firm with lawyers litigating complex civil matters as well as practicing qui tam whistleblower litigation and False Claims Act litigation nationwide. Based in Dallas, Texas, the firm has offices in Los Angeles, California, and by appointment in Illinois and Louisiana. Our attorneys represent whistleblowers who expose fraud and false claims against the government in a variety of matters, including government contractor fraud and procurement fraud, healthcare fraud, assisted living fraud, SEC fraud, and Foreign Corrupt Practices Act (FCPA) violations. Contact us at 800.226.9880 to learn more about our practice and our qui tam attorneys.

Waters Kraus & Paul is the West Coast practice Waters & Kraus, LLP, a national plaintiffs’ law firm.

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