A Le Mars, Iowa nursing facility, Abbey of Le Mars, Inc., and others with financial interests in facility operations, have agreed to pay $100,000 to resolve allegations of Iowa Medicaid Fraud after allegedly submitting false claims for payment to Iowa Medicaid for grossly substandard care of 16 residents over a period of six years.
Federal authorities have terminated Abbey of Le Mars’ participation in Iowa Medicaid and Medicare programs and the Iowa Department of Inspections and Appeals ordered Abbey of Le Mars’ to close down operations, effective February 1. The investigation into the nursing home was initiated by the Department of Justice’s recently assembled Northern District of Iowa Elder Justice Task Force.
Abbey Bills Iowa Medicare While Ignoring Broken Bones, Infections, Food and Hygiene Needs
Abbey of Le Mars’ trouble arose from the lack of care it provided for 16 Iowa Medicaid beneficiaries between January 2009 and February 2015.
The government claims that Abbey providers failed to properly treat bone fractures and skin conditions, resulting in further complications and additional medical costs. Rather than address simple issues with the proper responses, caretakers resorted immediately to physical restraints and anti-psychotic medications to sedate residents and silence patient requests. Extreme negligence led to malnourishment, infections resulting from lack of bathing and toileting assistance, and impactions requiring numerous emergency room visits.
In one tragic incident, Abbey staff reportedly changed the sheets and dressings of 89-year old resident, Robert Nipp, before noticing he was deceased and alerting coworkers. Personnel allegedly attempted to cover up the incident by falsifying medical records to reflect care associated with breathing problems for the man days prior.
Billing Iowa Medicaid and Medicare for substandard products and services or services never performed is a violation of the both the federal False Claims Act and Iowa False Claims Act. Abbey’s settlement agreement resolves government claims alleging the nursing facility submitted claims for payment to Medicaid when the services provided were “worthless and effectively without value.”
Federal and Iowa False Claims Acts offer generous cash awards to individuals who come forward with inside information on elder abuse, patient negligence and Iowa Medicaid fraud. Whistleblowers who choose to file a qui tam lawsuit are eligible to receive up to 30% of the total amount of any government recovery.
U.S. Elder Justice Task Force Targets Iowa Medicaid Fraudsters
Elder abuse is one particularly distressing form of Iowa Medicaid fraud. When health care professionals choose to side step quality care for Medicare beneficiaries in order to cut costs and profit from others’ hard-earned taxpayer dollars, everyone suffers.
Medicaid fraud associated with elder abuse is a serious crime in Iowa. So serious that, in March 2016, the Department of Justice selected the Northern District of Iowa as one ten new U.S. Elder Justice Task Forces initiatives to combat elder abuse in nursing facilities. The Iowa Task Force focuses on over half of the counties in the state, including Cedar Rapids, Sioux City, Waterloo, and Dubuque.
The Iowa Elder Justice Task Force coordinates efforts from the U.S. Attorney’s Office, Iowa Medicaid Fraud Control Unit, state and local prosecutors’ offices, the U.S. Department of Health and Human Services, Iowa Adult Protective Services, Long-Term Care programs and law enforcement.
“The Elder Justice Task Forces reflect the department’s larger strategy and commitment to protecting our nation’s seniors, spearheaded by the department’s Elder Justice Initiative,” said the Department of Justice release. “The United States Attorney’s Office for the Northern District of Iowa has rededicated its efforts and resources to investigate and hold accountable those who have been involved in activities incompatible with ensuring that the state’s more vulnerable citizens are treated with dignity and respect.”
Abbey Pays $100,000 Settlement for Mistreating Patients, Wasting Iowa Medicaid Dollars
Abbey of Le Mars building owner Leo Lenaghan, paid consultant John Florina, Jr., Abbey president Janet Howe, administrator Don Butcher and former nursing director Donna Stuhrenberg signed the $100,000 settlement agreement. The claims settled by this agreement are allegations only and there has been no determination of liability.
“Nursing facility residents deserve to be treated with dignity, respect, and attentive care sufficient to meet their medical needs and support their mental health,” said United States Attorney Kevin W. Techau. “This settlement demonstrates the commitment of the Northern District of Iowa United States Attorney’s Office to defending the integrity of the system and ensuring that taxpayer money is spent as Congress intended. We will continue to work with our federal and state partners to hold nursing facility owners, administrators, and employees across the district accountable if they are responsible for nursing facility residents being mistreated or if Medicaid or Medicare payments are wasted or misspent.”
Do You Have Information On Iowa Medicaid Fraud?
You may be eligible for a substantial cash award for reporting non-public information on Iowa Medicaid fraud. If you have information on health care providers who may be submitting claims to Medicaid or Medicare for substandard care or services never rendered, call 888.742.7248.