The nursing home operator SavaSeniorCare LLC and its related entities have agreed to pay $11.2 million to resolve allegations it violated the False Claims Act (FCA), the Department of Justice (DOJ) announced Friday.
That amount encompasses both federal and state settlements, with additional payments possible “if certain financial contingencies occur,” according to the DOJ.
The government filed a consolidated FCA complaint against the chain in 2015, alleging that between October 2008 and September 2012, Sava knowingly submitted false claims for rehabilitation services as part of a system-wide effort to boost Medicare billings. The government’s complaint alleges that Sava “exerted significant pressure on its SNFs to meet unrealistic financial goals, resulting in the provision of medically unreasonable, unnecessary or unskilled services to Medicare patients” through its policies and procedures.
Other allegations from the DOJ include knowingly submitting false claims to Medicaid for coinsurance amounts for rehab services for dually eligible Medicare and Medicaid , as well as knowingly submitting “false claims for payment to Medicare and Medicaid for grossly and materially substandard and/or worthless skilled nursing services.”
The quality of care investigation was supported by the DOJ’s Elder Justice Initiative, which it announced in March 2020.
Sava resolved the allegations without admitting any wrongdoing, the DOJ noted in its press release.
The settlement comes after Sava has spent 10 years “and several million dollars” defending its position in these cases, Annaliese Impink, spokesperson for SavaSeniorCare Administrative and Consulting, LLC, said in a statement provided to Skilled Nursing News via email.
“As stated in the settlement agreement, we believe that the allegations were unfounded,” she said in the statement. “Nevertheless, the cost of continuing to litigate would have exceeded the settlement payment. We believe it is the right time to put these matters behind us as we begin to recover from the pandemic.”
In relation to the settlement, Atlanta-based Sava entered a five-year corporate integrity agreement (CIA) with the Department of Health and Human Services (HHS) Office of Inspector General (OIG). It requires patient stays and paid claims by Medicare for those stays to be reviewed annually by an independent review organization. Sava also must engage an independent monitor to review the quality of resident care.
The CIA is a positive for Sava, Impink noted in the statement, and the compliance committee at Sava is looking forward to working with the quality monitor under it, she added.
“We believe that this process will assist us with further enhancing our clinical and quality systems and will provide additional educational support for our center teams,” Impink said. “We also hope to take advantage of best practices the monitor can share from other providers they have worked with. As is always the case, we will continue to focus our efforts on supporting our staff who work tirelessly to improve the quality of care and quality of life for those individuals we are privileged to serve.”