Genesis Healthcare Inc., one of the largest skilled nursing facility operators in the United States, paid $53.6 million to resolve six federal lawsuits alleging it submitted false Medicare claims for medically unnecessary rehabilitation therapy, unnecessary hospice services, and grossly substandard nursing home care.

Genesis Healthcare (National) — $53.6M Settlement for Unnecessary Therapy, Hospice, and Substandard Care (2017)

Outcome: Genesis Healthcare, Inc., headquartered in Kennett Square, Pennsylvania and one of the largest nursing home chains in the United States, paid $53,639,288.04 to resolve six federal lawsuits and investigations alleging it submitted false Medicare claims for medically unnecessary rehabilitation therapy, enrolled ineligible patients in hospice for medically unnecessary hospice services, and provided grossly substandard nursing home care.

Genesis Healthcare operates hundreds of skilled nursing facilities across the eastern United States. The company acquired numerous facilities that were already subjects of federal investigations into fraudulent billing practices. The settlement resolved allegations that: (1) Genesis submitted false Medicare claims for rehabilitation therapy services that were not medically necessary; (2) the company enrolled patients in hospice when they did not qualify for the hospice benefit; and (3) some facilities provided nursing care that fell below acceptable standards.

The $53.6 million settlement was announced June 16, 2017 and resolved claims through six separate federal lawsuits and investigations. The breadth of the settlement — covering therapy fraud, hospice fraud, and care quality simultaneously — reflects the systemic nature of compliance failures at facilities acquired by Genesis.

Primary Source: OIG Enforcement Record