In March 2020, DOJ implemented the National Nursing Home Initiative (“the Initiative”) to coordinate and enhance civil and criminal efforts to pursue nursing homes that allegedly provide substandard care to their residents. DOJ noted in its announcement of the Initiative that it had already begun investigating approximately 30 nursing facilities in nine states. However, since that announcement, DOJ’s FCA activity as part of this project has been limited. But earlier this week, DOJ announced the filing of one of its first FCA complaints resulting from an investigation launched as part of the Initiative. This case also comes in the wake of the White House’s announcement earlier this year of new initiatives by CMS to enhance the quality of care at nursing homes. In light of both DOJ and White House priorities in this space, this complaint could reflect DOJ’s intention to step up its use of the FCA to police quality of care at nursing homes.
DOJ’s complaint alleges that the American Health Foundation (“AHF”), its affiliate AHF Management Corporation, and three affiliated nursing homes provided grossly substandard skilled nursing services, in the form of “general care deficiencies,” filthy physical facilities, failure to achieve infection control or provide sufficient mental health services, inadequate staffing, and the provision of unnecessary drugs.
This complaint serves as another warning shot to providers that DOJ will continue to use data both to identify targets for...
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