Recently, Extendicare Health Services Inc. agreed to pay $38 million to the U.S. government and eight states to settle allegations that it billed Medicare and Medicaid for substandard nursing care and unnecessary rehabilitation therapy. According to Reuters, this is a record: “The settlement is the largest paid by a nursing home chain to the government over failure to provide care.” The company, which operates more than 140 facilities in 11 states, of course, denied any wrongdoing…but you have to ask yourself: If the company is paying $38,000,000.00 to the federal government and some states…isn’t that a tacit admission of wrongdoing? After all, there’s no way it would cost that much to defend against legal action, right?

According to its website, Extendicare “operates 156 senior care facilities in the United States with approximately 15,000 beds. EHSI offers a continuum of health care services, including nursing care, assisted living and related medical specialty services, such as subacute care and rehabilitative therapy on an inpatient and outpatient basis.”  Although Extendicare operates two facilities in northern Idaho (Ivy Court and La Crosse Health & Rehabilitation, both in Coeur d’Alene), the investigation, thankfully, apparently did not find any fault with facilities in Idaho.

A total of $28 million of the settlement will cover claims that Extendicare billed Medicare and Medicaid for substandard services from 2007 to 2013. Another $10 million will cover claims that the company billed them for unnecessary rehabilitation therapy through its subsidiary Progressive Step Corp. According to Assistant Attorney General Joyce Branda, the investigation found that the facilities employed too few skilled nurses and that patients suffered injuries from falls, malnutrition, dehydration and infections, which in some cases required amputations.

What I found interesting is the settlement with the federal government also resolves two “whistle-blower” claims. What this means is staff or other employees stepped up and informed the proper authorities of the wrongful actions occurring at the facilities. To those two individuals, I say: “Thank you.” If only others would have done the same, perhaps a resident or two would not have suffered an injury.

Make no mistake, nursing homes are big business. In my experience, many large companies will stop at nothing to prevent the truth from getting out. That’s why it is so important for residents and family/friends to be watchful and, when something seems amiss, to report it. You might just save a life.