Nursing Home Providers Should Brace for Government Audits, Enforcement Actions Over Covid Relief Funding

Nursing home providers should expect more government scrutiny related to Covid-19 relief funding.

This is one message from Matthew Murer, the health care, public policy and government investigations department chair for the national health care practice of law firm Polsinelli.

“I think a lot of people are going to be surprised by audits of CARES Act funding they received, and PPP [Paycheck Protection Program] funding,” Murer told Skilled Nursing News at the recent American Seniors Housing Association (ASHA) conference in Scottsdale, Arizona. “ … Every single case we have with the Department of Justice … they are looking at whether you received those funds and how did you account for them.”

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The DOJ is inquiring about the funds even if the primary focus of the case is unrelated, Murer noted.

The federal Provider Relief Fund (PRF) and the PPP were lifelines for nursing home operators during the darkest days of the Covid-19 pandemic, but concerns over fraud and misuse have hovered over the programs.

Government agencies already have gone after egregious instances of fraud, Murer said, but now they are casting a wider net, targeting “negligent mistakes” and other situations.

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He anticipates that one area of investigatory focus will be whether organizations were qualified to receive government relief funds at all. Another focus area will be on whether funds were used in accordance with guidelines and correctly reported.

In terms of potential repercussions, the government in some cases could demand that a provider pay the relief funds back, in addition to a civil penalty. These would likely be consequences for situations in which organizations basically made mistakes, Murer believes.

Organizations or individuals will be in deeper trouble if they used the funds for personal gain or invested into other businesses.

“I think there’ll be a lot of settlements,” Murer said. “I don’t think most people would be willing to run the risk of trying to take that to the jury.”

Now is the time for providers to be reviewing their documentation and otherwise engaging in “good housekeeping,” he advised.

This is especially important because the government moves slowly, so audits could stretch over several years. Assembling documentation will be easier today than further down the road. 

If such housekeeping efforts reveal potential issues, company leaders will have to decide whether to self-disclose, Murer said.

In any case, he has a “strong suspicion” that a “reckoning” will be underway within the next year to 18 months, amid a more general increase in governmental investigations and enforcement actions.

“The government is back,” Murer said.

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