A healthcare provider in Baton Rouge, La., will pay the biggest civil settlement by a single nursing home for "failure of care," an area of increasing interest to U.S. attorneys nationwide. General Health System, which no longer owns the nursing home, will pay $750,000 to resolve allegations that the home billed Medicare and Medicaid for services that were not rendered or were provided "in a grossly deficient manner" from 2000 to 2002. Meanwhile, the state attorney general's office began a criminal investigation involving possibly falsified patient records at the home, which does business as 128-bed Regency Place Care Center. General Health System, which no longer operates any nursing homes, agreed to stay out of the business for at least seven years as part of the settlement. The system's flagship is 436-bed Baton Rouge General Medical Center.
So far, "failure of care" cases under the False Claims Act have been restricted to nursing homes, but federal officials and healthcare lawyers have said the theory will be applied to hospitals in the coming years. "This is the largest failure-of-care settlement in the nation, and I hope it will provide a deterrent to other providers," said U.S. Attorney David Dugas in Baton Rouge. The size of the settlement -- substantially larger than any to date -- partly stems from the nursing home's failure to fulfill a previous plan of correction, Dugas said. General Health System settled without admitting wrongdoing. A spokeswoman said officials believe the nursing home provided "appropriate care to its residents at all times." Despite the failure-of-care charges, the investigation focused on alleged billing deficiencies, she said. The settlement protects General Health System from civil but not criminal charges. -- by Mark Taylor