At nursing homes operated by Atlanta-based SavaSeniorCare, the pressure to meet financial targets for years was so great that nursing home residents were kept longer than they needed to stay and given therapies they didn’t need, whistleblowers claimed. At other Sava homes, the financial pressures led to understaffing, leaving vulnerable residents sitting in urine and feces and having their calls for help unanswered.
A decade after the whistleblowers started coming forward, the federal government announced on Friday that SavaSeniorCare would pay $11.2 million to settle multiple False Claims Act cases with allegations stretching over years. The national senior care chain also agreed to engage an independent monitor to review the quality of care provided at Sava facilities through a new “Corporate Integrity Agreement.”
“Nursing home residents should not be at the mercy of nursing home operators that put their own economic gain ahead of the needs of the residents, and we will continue to aggressively pursue those operators who bill Medicare and Medicaid for substandard care,” said Acting U.S. Attorney Jennifer Arbittier Williams for the Eastern District of Pennsylvania.
Sava operates 15 senior care facilities in Georgia, according to its website, and dozens more across the country. Some of its Georgia homes were hit with deadly outbreaks during the pandemic, including Dunwoody Health and Rehabilitation, where 29 residents died of COVID-19, according to reports filed with the Georgia Department of Community Health. Inspectors found the facility failed to provide proper infection control and tracking of the COVID-19 outbreak, which resulted in dozens of residents and staff being infected with the virus. Family members told the AJC the facility never seemed to have enough staff.
SavaSeniorCare said in a statement that it denied any wrongdoing and spent 10 years and millions of dollars defending its position in the whistleblower cases. “Nevertheless, the cost of continuing to litigate would have exceeded the settlement payment,” the company said. “We believe it is the right time to put these matters behind us as we begin to recover from the pandemic.”
The amount of the settlement was “based on the company’s ability to pay,” the Department of Justice said. If Sava’s finances improve in the future, it may have to pay more.
“We applaud the DOJ for taking these important steps to hold a nursing home corporation accountable when there are serious allegations of substandard care and fraud,” said Richard J. Mollot, executive director of The Long Term Care Community Coalition. “Georgia and the rest of the country have seen a significant growth in large corporations and private investment firms owning nursing homes. Unfortunately, state and federal regulators have been largely unwilling to hold these owners accountable for corporate malfeasance, even when it results in resident harm and wasted taxpayer dollars.”
The allegations in the False Claims Act cases filed by the whistleblowers dated back to 2008. After being presented with the whistleblowers’ allegations and evidence, the government intervened in the cases. Whistleblowers usually earn a portion of any settlement that the government receives, based on their claims.
The allegations related to poor care claimed Sava failed at some of its homes to have sufficient staff and didn’t provide the necessary care to prevent pressure ulcers and falls, while also failing to appropriately administer medications to some of the residents.
“Though the financial settlement is modest, we believe that its coupling with a corporate integrity agreement based on years of alleged failures to provide decent services and maintain adequate staffing sends a message to the industry — and hopefully our state regulatory agencies — that these practices will not be tolerated,” Mollot said.
Rita Hayward was working at a Sava nursing home in Tennessee in 2009 and 2010 as the social services director and a discharge planner. She said in her whistleblower suit that the home’s administrator directed staff to alter records to make it appear that residents required more care than they actually needed.
After a wave of concerns across the industry that nursing homes were relying on excessive therapy services to pad profits, Medicare switched to a new reimbursement system in 2019 called the “Patient-Driven Payment Model.” That system doesn’t reward high volumes of therapy like the old system did. Now, some advocates worry that residents might get less therapy or services than they need.
Sava said that it is looking forward to working with the quality of care monitor that is part of its Corporate Integrity Agreement. “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,” Sava said.
OUR REPORTING
The AJC tracks False Claims Act cases involving health care providers and identified a number of actions related to unnecessary therapy services by nursing home providers in recent years. Among the settlements:
Longwood Management and affiliated nursing homes in July 2020 agreed to pay $16.7 million
Saber Healthcare in April 2020 agreed to pay $10 million
Guardian Elder Care Holdings in February 2020 agreed to pay about $15.5 million
Signature Healthcare in June 2018 agreed to pay more than $30 million
Life Care Centers of America in October 2016 agreed to pay $145 million
Kindred/RehabCare, a contract therapy provider, in January 2016 agreed to pay $125 million
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