Dive Brief:
- The Department of Justice is suing ProMedica Health System and its affiliated nursing homes over allegations they provided “non-existent, grossly substandard skilled nursing facility care” and jeopardized residents’ safety.
- In a press release on Tuesday, the DOJ said ProMedica failed to provide adequate care at four of its nursing homes in Pennsylvania, Ohio, South Carolina and Virginia. The government says ProMedica understaffed the facilities, which compromised patient safety and well-being.
- The government alleges it suffered millions in damages as a result of ProMedica fraudulently billing Medicare and Medicaid for inadequate services.
Dive Insight:
Although ProMedica owns 218 skilled nursing facilities across the country, the lawsuit centers on operations at four nursing homes from 2017-2023 that were run by ProMedica and its subsidiary ProMedica Senior Care, formerly known as HCR Manor Care, which ProMedica acquired in 2018.
The DOJ alleges ProMedica prioritized profits over patient well-being by understaffing the facilities and increasing admissions past capacity to grow revenue.
Despite executives receiving multiple notices from state regulators that its facilities were operating suboptimally, the government said ProMedica executives pressured its nursing homes to take on more residents in order to boost revenue.
In some cases, nursing home administrators’ annual bonuses were tied to policies that incentivized understaffing. In other instances, administrators were reprimanded if they did not increase revenue through “excessive” admissions, the DOJ said in its lawsuit.
The staffing shortages resulted in residents failing to receive adequate wound care to prevent ulcers, proper assistance with hygiene and showers, or help with feeding, in some cases leading to severe weight loss among patients, according to the complaint. One former nurse supervisor at ProMedica told the government the conditions at the nursing home were “absolutely terrible.”
Staff also falsely documented medical care, including listing fake services provided by caregivers who were not working at the time, the DOJ said.
“Grossly substandard care places nursing home residents at serious risk of harm and this suit sends a clear message that we will pursue health care providers who fail to meet their legal obligations to provide required care and who betray the trust of the residents they are meant to serve,” Assistant Attorney General Brett Shumate said in a press release.
ProMedica said in a statement it plans to defend the lawsuit “vigorously.”
The investigation comes as lawmakers are increasingly seeking to enhance care standards at long-term nursing facilities, after COVID-19 killed nursing home residents at an outsized rate and highlighted problems with infection control.
The Biden administration finalized a rule in 2023 that required some nursing homes to disclose more information about corporate ownership structures, in an effort to help residents be more discerning customers, following concerns that private equity-backed homes might provide substandard care.
The administration also sought to raise staffing minimums in skilled nursing facilities, citing evidence that residents tend to benefit from higher staffing levels. However, the proposal was unpopular with the industry, and has been tossed aside this year, both by the courts and by Congress.
