In a recent whistleblower lawsuit against the Illinois-based Momence Meadows Nursing Center (MMNC) and its former owner, a jury opted to impose fines of over $28 million. After a nine day trial, MMNC was found guilty of mistreating elderly and disabled residents, Medicare/Medicaid fraud and billing government sponsored programs for medically unnecessary, nonexistent or substandard services.
There are strict federal and state laws in place to ensure standards are met within skilled nursing facilities around the country. The laws cover nursing facility staffing procedures, medical treatment, daily nutrition, patient safety, facility cleanliness and much more. These guidelines were developed so that patients and their family members could expect a licensed nursing facility to provide consistent quality care. Unfortunately, that expectation is unrealistic within many nursing home facilities, proving once again just how valuable whistleblowers are in the fight against fraud and abuse.
The Momence Meadows Whistleblowers
Whistleblowers have the unique ability to provide inside information about fraudulent or abusive acts within the workplace. In the case of MMNC, two nurses formerly employed by the facility chose to come forward and file a qui tam lawsuit. The whistleblowers, Vanessa Absher and Lynda Mitchell, worked as nurses at MMNC for several years.
MMNC is a 140-bed skilled nursing facility that accepts both elderly and disabled patients. Being a long-term care provider, MMNC’s residents are mostly comprised of Medicare and Medicaid recipients. As medical services were provided to beneficiaries, MMNC received its reimbursement by filing claims with the government sponsored healthcare agencies.
According to allegations contained in the whistleblower lawsuit, both Absher and Mitchell claimed MMNC residents routinely received medical services that were considered “grossly substandard”. In addition, the whistleblowers claimed MMNC billed Medicare and Medicaid for services that were medically unnecessary, poorly provided or not provided at all.
Absher and Mitchell also furnished authorities with a shocking and detailed list of allegations, exposing the repeated abuse and neglect of MMNC residents. These acts of abuse led to pain, suffering and an overall decline in health for many patients. Some of the allegations against MMNC included:
- Failure to administer prescribed medications and therapies
- Failure to provide food to meet nutritional requirements
- Failure to provide a sanitary environment for patients, often allowing them to lay in their own excrement for days
- Fostering unsanitary conditions facility-wide, which eventually led to patient infections such as bedsores and scabies
- Failure to treat patients for infectious conditions that resulted from unsanitary conditions within the facility
- Failure to meet minimum staffing requirements, often operating with just one nurse on the floor
- Allowing a patient to take illegal drugs with staff members
- Administration of a dangerous medication without the patient’s knowledge (Both nurses allege that a resident was given medication to prevent the contraction of hepatitis, as her roommate was infected with the disease. The patient was unaware she was being exposed to the disease and was not informed that she was being given a medication to prevent her chances of infection.)
Allegations of Fraudulent Activity at Momence Meadows
As if the patient dangers were not enough, Absher and Mitchell also alleged that MMNC administration and staff participated in a long list of fraudulent activities to cover up the facility violations. These acts included the falsification of medical records, submission of false and fraudulent Medicare/Medicaid claims and the cover up of illegal conditions from state/federal inspectors.
The whistleblowers, both of whom worked as MMNC nurses, claimed they were told to falsify patient and medication administration records to show that services were provided. They were also directed to falsify staffing records to make it look as if MMNC was complying with minimum staffing requirements. Additionally, Absher and Mitchell claim they were told to “rechart” patient records to conceal incidents that occurred within the facility which led to patient injury, illness or death.
The Momence Meadows Whistleblower Lawsuit
After being exposed to the disturbing violations, Absher and Mitchell allegedly complained to MMNC management. They reported incidents of inadequate patient care, failure to provide meals and prescribed medications, unsanitary conditions of the facility and MMNC’s failure to comply with federal and state quality of care standards.
After voicing their concerns, MMNC allegedly retaliated against Ms. Mitchell by subjecting her to verbal abuse and workplace hostility. She alleged that she was told to “shut her mouth or she could be terminated if she continued to complain.” She was fired three days after an MMNC patient died.
After learning of Ms. Mitchell’s termination, Ms. Absher chose to resign her position with MMNC. In response, both Absher and Mitchell alleged that MMNC attempted to prevent other nursing facilities from hiring them and even filed bogus charges against them with the Illinois Department of Professional Regulation. Under the whistleblower provisions of the False Claims Act, workplace retaliation is illegal.
After consulting with their False Claims Act attorney, Absher and Mitchell filed their own whistleblower, or qui tam, lawsuit against MMNC. Tried before a jury, a verdict was returned in favor of the whistleblowers and the federal government. MMNC was ordered pay over $28 million to the government. For coming forward with crucial information in this case, the whistleblowers will split a relator’s share of over $7 million.