Assisted living community hit with False Claims Act lawsuit for $1.1 million in Medicaid claims
The Maryland attorney general is seeking civil penalties and treble damages to the state in a lawsuit against an assisted living community he says submitted false Medicaid claims totaling $1.1 million over more than four years.
The May 22 complaint, brought against the 62-bed Kris-Leigh Catered Living of Severna Park and its owners under the Maryland False Health Claims Act, alleges that the community sought payment from the state for services that were not provided — such as legally mandated resident health and medical assessments and implementation of resident medication plans — or for services that “were so grossly substandard that the care was worthless and effectively without value.”
Chronic understaffing, underqualified or untrained staff members, or ignored citations from the Maryland Office of Health Care Quality or complaints from staff and residents, according to the lawsuit, led to undiagnosed heart attacks, malnourishment, falls necessitating emergency department visits, bed bugs, black mold and an elopement that resulted in a resident with dementia being struck and killed by a car.
“Yet Kris-Leigh knowingly misled the Medicaid program by falsely certifying that each of the claims it submitted to the Medicaid program for reimbursement was for services that were medically necessary, actually provided and in full compliance with all state and federal regulations as to the requisite standard of care owed to the residents in their charge,” Attorney General Brian E. Frosh said in a press release. The claims go as far back as January 2013.
Kris-Leigh did not respond to a request for comment from McKnight's Senior Living by the publication deadline, but in a statement to the Capital Gazette, one of the community's owners, Richard Ainsworth, said: “The allegations filed against Kris-Leigh Assisted Living at Severna Park regarding the delivery of services to our very small Medicaid waiver client base are strongly opposed. We have engaged substantial legal counsel to litigate the terms and conditions of the accusations. As a result, we expect positive outcomes for the organization and the residents involved in this matter.”
Ainsworth owns the community with Helen James Ainsworth, according to the complaint.