The Grand Health Care System and 12 affiliated SNFs settled for $21.3 million for billing Medicare and Medicaid for rehabilitation therapy services that were unreasonable, unnecessary, unskilled, or not provided as billed; supervisory officials admitted to falsifying medical records.

The Grand Health Care System (New York) — $21.3M Rehabilitation Therapy Fraud

Outcome: Settled for $21.3 million for billing federal healthcare programs for rehabilitation therapy services that were unreasonable, unnecessary, unskilled, or not provided as billed; supervisory officials admitted to falsifying medical records.

Strauss Ventures LLC, doing business as The Grand Health Care System, and its 12 affiliated skilled nursing facilities in New York, billed Medicare and Medicaid for rehabilitation therapy services that systematically failed to meet program requirements. The violations included: billing for therapy services that were medically unreasonable or unnecessary, billing for unskilled services at skilled therapy rates, and billing for services that did not actually occur as documented.

The supervisory-level falsification of medical records is particularly significant — it means the fraud was not incidental or employee-level, but directed and covered up by management through deliberate record manipulation. This level of institutional involvement warranted both the $21.3 million financial settlement and a Corporate Integrity Agreement requiring ongoing compliance oversight.

The settlement was reached on July 10, 2024, through the U.S. Attorney's Office for the Northern District of New York.

Primary Source: The Grand Health Care System And 12 Affiliated Skilled Nursing Facilities To Pay $21.3M For Allegedly Providing And Billing For Fraudulent Rehabilitation Therapy Services