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Nursing Home Fraud: an Increasing Problem in New York and Across U.S.

The owner of three nursing homes in the South was recently convicted of Medicare and Medicaid fraud. Federal authorities reported that residents of the three facilities were living in abysmal conditions, with insufficient food, little heat or air conditioning, piles of garbage, mold and mildew, and rodent infestations.

Despite these horrific living conditions, the owner of the facilities had billed more than $32.9 million to Medicaid and Medicare for the nursing home residents' care. Instead of spending that money on residents, he used the money for himself, buying new homes and luxury cars and taking lavish vacations.

This story demonstrates how nursing home fraud is becoming an increasing problem in New York and across the U.S. - and how it often is linked to the issue of nursing home neglect and abuse. Those who have loved ones in nursing homes need to understand the problem of nursing home fraud and be able to recognize signs that a nursing home may be committing fraud.

What Is Nursing Home Fraud?

To receive payments from Medicare and Medicaid, nursing home owners agree to provide residents with safe and sanitary living conditions, nutritious meals, medical care and daily living assistance. Billing for these services but failing to provide them constitutes fraud.

Nursing homes can commit fraud in a variety of ways. They can "upcode," classifying a patient as needing extremely high levels of care when the patient does not actually require that much care. The nursing home can bill for name brand medication and equipment, but use cheaper replacements. The nursing home can also simply not provide services it claims to have provided at all.

Signs That a Nursing Home Is Committing Fraud

Common signs that a nursing home is committing fraud include:

  • Unsanitary or unsafe living conditions
  • Malnourished or dehydrated residents
  • Billing for patients who have died
  • Offers of free items in return for a Medicare or Medicaid number
  • Using inferior medicines or equipment while billing for more expensive ones
  • Upcoding
  • Billing for services not provided

Do You Suspect Nursing Home Fraud in NY?

Nursing home residents are among the country's most vulnerable populations. They often cannot advocate for themselves and rely on others to ensure that their interests are protected. If you suspect that a loved one has been a victim of nursing home neglect or abuse or that the nursing home is committing fraud, do not hesitate to seek the assistance of a qualified nursing home abuse lawyer near you.

Contact Trolman, Glaser, & Lichtman, PC

Trolman, Glaser & Lichtman, P.C.
747 Third Avenue, 23rd Floor | New York, NY 10017
| Phone: 212-750-1200 | Toll Free: 1-888-484-5529 | Fax: 212-980-4011 | Email | New York Law Office

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Contact trolman, glaser & lichtman, PC

747 Third Avenue, 23rd Floor | New York, NY 10017|Phone: 212-750-1200|Toll-Free: 1-888-484-5529|Fax: 212-980-4011|Email