Federal fraud, abuse monetary recoveries in assisted living up more than 600% over last year

Share this content:
Federal fraud, abuse monetary recoveries in assisted living up more than 600% over last year
Federal fraud, abuse monetary recoveries in assisted living up more than 600% over last year

Total monetary recoveries by state Medicaid Fraud Control Units in assisted living-related fraud, abuse and neglect criminal and civil cases increased by 641% from fiscal year 2016 to FY 2017, according to a new report from the Department of Health and Human Services Office of Inspector General.

Overall criminal convictions and civil settlements and judgments related to assisted living saw increases, too.

Efforts by the MFCUs resulted in a total of 24 criminal convictions, 15 civil settlements or judgments and $1,252,120 in criminal and civil recoveries related to assisted living in FY 2017, according to the OIG. That compares with a total of 19 convictions, one settlement and $168,991 in recoveries in FY 2016.

Assisted living resident abuse or neglect investigations by the units led to 13 criminal convictions and criminal case recoveries of $157,249 during FY 2017, plus one civil settlement or judgment of $8,450.

These statistics compare with 17 criminal convictions for abuse or neglect and recoveries of $65,735 for criminal abuse and neglect cases during FY 2016. There weren't any civil settlements or judgments for assisted living resident abuse or neglect in FY 2016.

Investigations of Medicaid fraud in assisted living by the units in FY 2017 led to nine criminal convictions and criminal case recoveries of $123,880, plus 14 civil settlements or judgments with recoveries totaling $962,541, the report noted.

Investigations of fraud in assisted living by the MFCUs in FY 2016 led to two criminal convictions and criminal case recoveries of $9,380, plus one civil settlement or judgment of $93,876, according to the OIG.

At the end of FY 2017, 167 criminal cases and two civil cases related to assisted living resident abuse or neglect remained open, according to the OIG, and 38 criminal cases and 11 civil cases involving assisted living-related Medicaid fraud remained open.

The new report also details abuse, neglect and fraud cases and outcomes related to other types of facilities as well as programs and providers.

Personal care services attendants and agencies were involved in “significantly more convictions” for fraud than any other provider type in FY 2017, according to the OIG. Of the 1,157 fraud convictions for the year, 523, or 45%, involved personal care services attendants and agencies.

Nurses aides were involved in more convictions for patient/resident abuse or neglect than were any other provider type in FY 2017, according to the report. Nurse aides accounted for 112, or 30%, of the total 371 patient/resident abuse or neglect convictions across all settings.

Overall, MCFUs reported a total of 1,528 convictions for fraud, abuse or neglect, as well as 961 civil settlements and judgments, and almost $1.8 billion in criminal and civil recoveries during the year, the OIG said.

The District of Columbia and all states except North Dakota have MFCUs.

See the McKnight's Senior Living article about the FY 2016 report here.

close

Next Article in News

Sign up for newsletters

In Focus

April 18

Spreading thanks

Houston and North Greenbush, NY 

Residents of Brazos Towers at Bayou Manor, a senior living community in Houston, recently held a virtual "gratitude party" for residents of Eastwyck Village of North Greenbush, NY, to thank them for their assistance after Hurricane Harvey.