California is elevating and expanding its efforts to uncover and pursue fraud, abuse and neglect cases.
The Division of Medi-Cal Fraud and Elder Abuse will continue investigating and prosecuting both fraud against the Medi-Cal program as well as physical or financial abuse or neglect of residents of residential care facilities for the elderly and skilled nursing facilities statewide.
California Attorney General Xavier Becerra, President Joe Biden’s nominee for secretary for the Department of Health and Human Services, on Wednesday announced additional resources for the California Department of Justice Medicaid Fraud Control Unit, making it a full-fledged division.
“All too often, California’s elder citizens and those with disabilities are the principal targets of bad actors,” Becerra said. “DMFEA will build upon previous success aggressively protecting our state’s most vulnerable citizens against fraud, abuse and neglect.”
Approximately 150,000 older adults live in the state’s roughly 7,500 licensed RCFEs, and about 110,000 Californians live in the approximately 1,300 licensed skilled nursing homes. Those numbers are expected to increase as the state’s aging population is anticipated to grow to 6.4 million older adults by 2025.
The new division will pursue crimes related to false claims filed for medical services, drugs or supplies. It also will go after entities for fraud under the California False Claims Act. The state loses billions of dollars annually through Medi-Cal fraud, Becerra’s office said.
An example of a recent criminal abuse case shared by the office, the owner of The Manse on Marsh, an independent living and assisted living community in San Luis Obispo, was convicted of elder abuse and involuntary manslaughter in the death of a resident with dementia who was struck and killed by a car. Prosecutors said the resident was improperly admitted to the facility, which was not licensed to care for residents with dementia. Owner Christopher Skiff was sentenced in 2019 to 180 days and five years felony programs, and he was barred from operating elder care facilities.
In another case cited by Beccera, the owners and operators of Varenna and Villa Capri senior living communities entered into a civil settlement and injunction related to their conducts on the night of the 2017 Tubbs wildfire. Varenna, Oakmont Senior Living and Oakmont Management Group agreed to pay $500,000 to settle an unlawful business practices lawsuit filed by state and federal prosecutors. The complaint alleged that the communities did not adequately plan for and train staff members about emergency evacuation and preparedness, did not timely and adequately notify residents of the need to evacuate, and did not provide adequate care and support to residents.
In a separate move, the state also launched Operation SAFE (Stop Abuse and Fraud of Elders), a new initiative aimed at investigating complaints of abuse and fraud in California SNFs.