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Genesis HealthCare – Nursing Home Abuse and Fraud Information

Genesis HealthCare – Nursing Home Abuse and Fraud Information

Genesis HealthCare is considered the largest provider of nursing home care in the United States. With 450 facilities in 30 states, the company provides short stay, long term care, memory support, orthopedic rehabilitation, dialysis care and assisted living services.

Genesis’ website claims, “How and where we can make a difference in the overall well-being and healthy outlook of everyone we serve is our daily mission.”  From the stories we hear, the company has miserably failed in its mission.

Beyond the happy faces of seniors and staff on its website is a troubling tale of patient neglect, abuse and poor care.

Genesis Healthcare Pays $53.6 Million to Settle Poor Care Claims

In June of this year, Genesis HealthCare settled federal charges of substandard care and unnecessary medical services.

On June 16th, the Justice Department announced that the company would pay $53,639,288.04 to settle six separate federal investigations. In announcing the settlement, prosecutors said that Genesis engaged in “grossly substandard nursing care.”

The government’s claims centered around four different allegations of misconduct.

First, the government claimed Skilled Healthcare Group Inc., Skilled Healthcare LLC and Creekside Hospice II knowingly submitted false claims to Medicare for services performed at the company’s Creekside Hospice facility in Las Vegas, Nevada.

Prosecutors say that the companies were housing and treating hospice care patients that didn’t need to be in a hospice and who were not terminally ill. Genesis Healthcare acquired the three companies after the conduct at issue.

The second set of claims involved the above three companies providing therapy services that patients didn’t need and providing less minutes of therapy than what was billed. That meant patients were either receiving therapy that they did not need or were being shortchanged on the therapy they were supposed to receive. The acts underlying those allegations went on for 8 years.

In a third set of claims, Genesis Healthcare and one of its affiliates billed for patient services in Georgia that were either not medically necessary or were provided by unskilled people.

The final set of claims involved Genesis affiliate Skilled LLC. The government says that some of the company’s nursing home programs in California were “grossly substandard and/or worthless.” More on those claims below.

In announcing the settlement, a Department of Health and Human Services spokesperson said, “It’s disturbing when health care companies bill Medicare and Medicaid to care for vulnerable patients, but provide grossly substandard care and medically unnecessary services just to boost company profits. We will continue to crack down on medical providers who betray the public’s trust and the needs of vulnerable patients through fraudulent billing and irresponsible practices.”

The cases were originally brought by seven former employees of the companies acquired by Genesis. The government awarded the whistleblowers a combined $9.67 million in awards for stepping forward and reporting the fraud and mistreatment of patients.

California Claims of Grossly Substandard Care

The California claims were originally filed by a former employee, Terri West. While working, Ms. West served as Director of Rehabilitation at a Genesis acquired facility. Prior to her promotion, she worked as a speech pathologist at Genesis HealthCare’s Woodland Care Center.

In a pattern we have seen repeated many times, West says nursing home management put profits before patients.

According to her complaint, while serving as Director of Rehabilitation, her pay was based in part on the profitability of the facility. The more employees billed for services, the more workers would get paid.

Medicare rules require medical services to be based on patient need and not profits.

West said to maximize profits, the company would “systematically evaluate and treat patients” without regard for whether the patients were good candidates for treatment. They would also keep patients in treatment even if they were not responding or no longer needed care. Often they would keep treating until the patient’s benefits were exhausted.

When Terri West complained to management she found herself on unpaid administrative leave and not allowed to return to work.

Massachusetts Investigates Poor Patient Care at Genesis

When state regulators visited the Genesis Healthcare nursing home in Danvers, Massachusetts, they probably had little clue what awaited them. The linen room reeked of urine suggesting that patient bedding was not being cleaned. The floors were so sticky that an inspector’s shoe came off when it stuck to the flooring!

At another facility in Amesbury, inspectors found there were not enough CNA’s on staff to feed all the patients.

At a facility in North Reading, officials learned that a delirious resident with a high fever died from a urinary tract infection that was left untreated.

An exposé by the Boston Globe said Genesis Healthcare’s rapid expansion in Massachusetts came with a heavy cost. According to the Globe, “problems at Genesis facilities worsened over time, and by early this year, the score for Genesis homes was twice as bad as the statewide number.”

Patient Complaints of Assault and Neglect at Genesis HealthCare

It isn’t just the federal government and state regulators that have pursued claims against Genesis Healthcare for poor patient care.

The company has been plagued with patient neglect and abuse complaints. Finding out about those complaints is difficult for members of the public, however.

Genesis Healthcare follows the industry practice of requiring all settlements to be sealed and remain confidential. Those gag orders keep both patients and their lawyers from discussing nursing home neglect cases and how much Genesis was forced to pay.

A Maryland man’s family filed a complaint after a family member was moved to a Genesis Health Care facility in Montgomery County, Maryland. Records show the man had a significant medical history when admitted. A physical exam at the facility noted he was at high risk for a fall. Exams revealed suffered from episodes of confusion, poor insight, confusion, anxiety, and episodes of forgetfulness. Despite his high risk of falling, no fall prevention measures were ordered.

That same day, the man fell and fractured his neck.

The most recent case against Genesis HealthCare was filed several weeks ago by a New Jersey woman. Carol Reardon says she had complications from back surgery that required months of hospitalization. Prior to being able to come home, doctors wanted her to get some rehabilitation. She was admitted to Genesis’ Brighton Manor facility located in Glen Mills, Pennsylvania.

Reardon’s recovery was slow. Although able to walk short distances with a walker, she was still required to be accompanied by an aide. On April 22nd, 2016, she summoned an aide to help her to the bathroom. She did get help getting to the bathroom but upon finishing in the bathroom, the aide was gone.

Reardon says she called for help 10 to 20 times. She also repeatedly activated the call button.

When no one came, Reardon tried to get back to bed on her own. She fell and lay on the floor, screaming in pain. Reardon says she knew that something was wrong and wanted to get an x-ray. Staff ignored her request, however, and instead gave her narcotics.

When she finally was x-rayed, doctors found she fractured her hip, re-injured her spine and received a head wound.

Genesis HealthCare Staff Complaints

Genesis Healthcare is paying tens of millions to resolve federal charges related to nursing home neglect and Medicare fraud. The states are investigating. Patients are suing. Can it get worse?

Actually, yes.

A nurse from New Jersey, Nikki Thompson, went to the media after being fired from a Genesis nursing home in Voorhees Township. She says she was fired for blowing the whistle on poor patient care at the facility.

Thompson was upset that co-workers had tied up an 85-year-old hospice patient. Because of the patient’s age and condition, one-on-one care had been ordered. Instead of following those orders, overworked staff simply tied her up because they didn’t have enough caregivers on duty.

When Thompson complained, she received an ominous message, “Snitches get stitches.” When the woman’s family members tried to get answers, Thompson says the facility covered up the incident. When she told the family the truth, she was fired.

A Fox News TV crew investigated and was told by Genesis Healthcare management that patients were never restrained. A picture of the woman tied up with a bedsheet suggests otherwise.

A state investigation revealed that conditions at the Voorhees facility were so horrendous that they constituted “immediate jeopardy to resident health and safety.

Both the family of the 85-year-old patient and Nikki Thompson have sued Genesis.

Genesis HealthCare Shameful Attempts to Deny Access to Courts

Many nursing home and hospice residents are elderly, frail or have cognitive difficulties. Often, they fit all three categories. Buried in Genesis Healthcare nursing home and hospice contracts was a clause that says patients cannot sue if they are injured or killed by poor care. Instead, any claims must be submitted to arbitration with no jury and with strict secrecy provisions.

We believe that Genesis is afraid of courts and juries. The company knows it will not get much sympathy from a jury. They also don’t want the public to know when they are guilty of patient neglect or nursing home abuse.

In 2011, the Supreme Court of West Virginia took up three claims brought by family members of residents who died in nursing homes. Two of those three patients died in a Genesis Healthcare facility.

The basic facts of each case were similar. In each case, a person was ill or incapacitated and needed extensive, ongoing nursing care. The person was admitted to a nursing home, and a family member signed an admission agreement with the facility that contained an arbitration clause.

The clause required all disputes the ill or incapacitated person might have in the future with the nursing home to be submitted to arbitration. Later, after the person died, a family member filed a lawsuit against the nursing home, alleging some variation of neglect, nursing home abuse or malpractice which eventually resulted in the patient’s death.

In each case, the nursing home sought an order from the circuit court dismissing the lawsuit and compelling the dismissal of the lawsuit and requiring the family to participate in binding arbitration.

Federal law recognizes arbitration agreements and says that these agreements are to be enforced absent some compelling reason. The Supreme Court was asked to decide whether the lawsuit waivers signed by the family member were enforceable.

In a landmark decision, the Supreme Court found that the lawsuit waiver clauses were unconscionable in two of the cases and probably unconscionable in the third. The court also ruled that Congress never intended for the Federal Arbitration Act to apply to arbitration clauses in pre-injury contracts where a serious injury or death occurs later.

One of the three cases considered by the Court was that of Clarence Brown.

Mr. Brown was just 56 when admitted to a Genesis HealthCare facility. He suffered from cerebral palsy and was unable to care for himself. He lived at the facility for 8 years. In 2004, the nursing home asked his brother to sign a new admission agreement.

Buried in the document was an arbitration clause. It said that Clarence could not sue the home for anything including “neglect, abuse or negligence.” All patient disputes had to be resolved by arbitration. The company, however, still retained the right to sue Mr. Brown.

According to the court, “During Clarence's residency at the nursing home, the plaintiff alleges that Clarence suffered pressure sores, dehydration, malnutrition, contractures, aspiration pneumonia, and infections.” He died shortly thereafter. The family says he died of complications caused by neglect and poor nursing care.

In an unrelated case, 86-year-old Leo Taylor was admitted to the same facility. He was suffering dementia. His elderly wife signed the admission papers. That lengthy admission form had the same lawsuit waiver and arbitration provision.

Leo’s wife died. His remaining family members claim that during his short stay at the facility, Leo fell repeatedly. They say those falls resulted in pressure ulcers, dehydration, an infection and other injuries that contributed to his death.

In deciding what to do with the two Genesis Healthcare cases, the court noted, “The process of signing paperwork for medical care—specifically, a contract for admission to a nursing home—is often fraught with urgency, confusion, and stress. People seek medical care in a nursing home for long-term treatment to heal; they rarely view the admission process as an interstate commercial transaction with far-reaching legal consequences.”

The court also noted that patients admitted to nursing facilities are often quite vulnerable. In the words of the court, “[T]he decision to be admitted to a nursing home, and the choice of a nursing home, often is made in the midst of a crisis brought on by a precipitous deterioration in the person's health. The decision is also often impelled by the loss of, or deterioration in the health of, a spouse or care giver, or when their care-giving family is no longer able to adequately manage the demands of home care.”

Ultimately, after a thorough analysis, the court ruled that patient’s Constitutional right to a jury trial outweighed the provisions of Genesis’ contracts. “[O]ur Constitution recognizes that factual disputes should be decided by juries of lay citizens rather than paid, professional fact-finders (arbitrators) who may be more interested in their fees than the disputes at hand.”

Why Nursing Homes Seek to Force Patients into Arbitration

Nursing homes, banks, credit card companies and even Uber share something in common. They seek to prevent customers from suing.  Many of the arbitration clauses we read are blatantly unfair and one sided.

In this post, we need to look no farther than Clarence Brown. Only after he was in the facility and fully dependent on his caregivers did Genesis seek to change the rules of the game and require arbitration. Worse, the arbitration clause said Brown couldn’t even sue if he was injured by their negligence or neglect. Although Brown was precluded from suing, the nursing home retained its right to sue him.

Why Arbitration Agreements Hurt Victims of Nursing Home Abuse

Arbitration agreements hurt plaintiffs – victims – for three primary reasons.

First, the patient is deprived of a jury. Our founding fathers granted us a Constitutional right to seek redress in the courts. Genesis wants to block that right.

If the results of arbitration proceedings were balanced, we would have less beef with mandatory arbitration but they are not. There is a reason nursing home companies prefer arbitration over trial by jury. The financial awards are often lower in arbitration cases.

Professional arbitrators are paid to hear a case. That is how they make their living. Genesis is likely to have thousands of claims against it. The average patient will have maybe one. Who do you think the arbitrators cater to? If an arbitrator repeatedly rules for patients, that arbitrator probably won’t get any more work!

Finally, arbitrations are largely conducted in secret. There is no open court room, public dockets, published decisions or the like. Most arbitration forums do not even require arbitrators to explain their decision. And unless the arbitrator made a very egregious mistake, there is no right of appeal.

By forcing cases into arbitration, companies like Genesis Healthcare avoid adverse media attention and accountability.

How Do I Make a Claim Nursing Home Abuse?

Our team of elder abuse lawyers have decades of experience handling nursing home neglect and elder abuse lawsuits.

We have the resources to help nursing home residents and their loved ones. Unlike some lawyers who simply look for a quick settlement, our lawyers look at each case individually and prepare the case as if it is going to trial.

We can afford to that since our lawyers have extensive trial experience.

When we take a case, we have two goals.

First, we work hard to obtain the highest damage awards possible. Our job doesn’t end with the money, however. We also work to protect our clients and seek to deter future nursing home misconduct.

Nursing homes are responsible for the safety and well-being of their residents. If they or their employees act negligently, the nursing home can be held liable for any resulting damages.

These damages may include both medical expenses, pain and suffering. In some states, patients may also be eligible for punitive damages awards. These awards are intended to deter the facility from engaging in similar misconduct.

While many patients suffered from abuse and neglect, the top seven executives including George V. Hager, David C. Almquist, Paul D. Bach, Richard P. Blinn, Dan Hirschfield, Tom DiVittorio and others at Genesis Health Care reportedly earned over $6 million last year.

There is no excuse for overbilling, understaffing, greed and poor care.

What Should You Do?

The first step in making a claim for nursing home abuse is as easy as picking up the phone or emailing us.

If you or a loved one is being abused or neglected in a nursing home, contact us immediately.  Many states have very short time frames for filing nursing home abuse claims. Contact us by filling out our confidential contact form or calling us at 833.201.1555.

Whether your case involves Genesis HealthCare or some other facility, our experienced Nursing Home Abuse and Long Term Care whistleblower lawyers want to help.

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