The United States Files False Claims Act Complaint Against Brentwood, Tennessee – Based Vanguard Healthcare, LLC
Complaint Also Names Six Vanguard Nursing Facilities and Director of Operations
The United States has filed a False Claims Act lawsuit against Vanguard Healthcare LLC, and six of its nursing homes and related entities, as well as Vanguard’s Director of Operations, announced David Rivera, U.S. Attorney for the Middle District of Tennessee and Principal Deputy Assistant Attorney General Benjamin C. Mizer, head of the Department of Justice Civil Division.
The six Vanguard facilities include Boulevard Terrace, LLC operating as Boulevard Terrace Rehabilitation and Nursing Center in Murfreesboro, Tennessee; Vanguard of Crestview operating as Crestview Health and Rehabilitation in Nashville, Tennessee; Glen Oaks, LLC operating as Glen Oaks Health and Rehabilitation in Shelbyville, Tennessee; Imperial Gardens Health and Rehabilitation, LLC, which previously operated Imperial Gardens Health and Rehabilitation, LLC in Madison, Tennessee and has ceased operations; Manchester Health Care Center, in Manchester, Tennessee, which is operated by Vanguard of Manchester, LLC; and Vanguard of Memphis, LLC, operating as Poplar Point Health and Rehabilitation in Memphis, Tennessee. The lawsuit also names Vanguard’s former Director of Operations, Mark Miller.
“We are committed to combating elderly abuse, neglect and financial exploitation. We will continue to hold accountable those who profit from the care of elderly Medicare and Medicaid beneficiaries, including nursing home operators, while providing non-existent or grossly substandard care.” said U.S. Attorney David Rivera.”“Our seniors rely on the Medicare and Medicaid programs to help care for them with dignity and respect,” said Benjamin C. Mizer, Principal Deputy Assistant Attorney General. “It is critically important that we confront nursing home operators who put their own economic gain over the needs of their residents. Operators who bill Medicare and Medicaid while failing to provide essential services will be held accountable."
The lawsuit alleges that the defendants were responsible for the submission of false claims to Medicare and TennCare for skilled nursing home services that were either non-existent or grossly substandard. The lawsuit also alleges that the defendants submitted required nursing facility Pre-Admission forms with forged physician and nurse signatures. Vanguard Healthcare, LLC is headquartered in Brentwood, Tennessee and has 14 long-term care nursing home providers operating around the United States.
The United States' complaint alleges that between January 1, 2010 and December 31, 2015, five of the Vanguard facilities failed to provide the most basic and essential skilled nursing services to their residents. These facilities include Boulevard, Crestview, Imperial, Glen Oaks and Poplar Point. The lack of adequate care at the Vanguard facilities included chronic staffing shortages and shortages of critical medical supplies, failure to provide standard infection control, failure to administer medication to residents as prescribed by their physicians, failure to provide wound care as ordered by physicians, failure to adequately manage residents’ pain, and providing unnecessary and excessive psychotropic medications to residents and using unnecessary physical restraints on residents. As a result, Vanguard residents suffered pressure ulcers, falls, dehydration, and malnutrition, among other harms.
The United States' complaint further alleges that Mark Miller, who served as the Director of Operations for Vanguard from September 2011 through August 2014, knew that resident care at the Vanguard facilities was non-existent or grossly substandard but failed to correct these problems.
The United States’ complaint also alleges that from September 2012 through April 2014, the Boulevard Terrace, Glen Oaks, Imperial, Manchester and Poplar Point facilities fraudulently submitted falsified pre-admission forms to TennCare, in order to receive payments from TennCare, which the company was ineligible to receive.
On May 6, 2016, the Vanguard corporate entities named in the government's complaint filed voluntary petitions for relief under Chapter 11 of the Bankruptcy Code, which were administratively consolidated in the Middle District of Tennessee.
This matter was investigated by the U.S. Attorney’s Office for Middle District of Tennessee, the Commercial Litigation Branch of the Justice Department’s Civil Division, the Department of Health and Human Services’ Office of Inspector General, the Tennessee Attorney General’s Office and the Tennessee Bureau of Investigation Medicaid Fraud Control Unit. This action is supported by the Elder Justice and Nursing Home Initiative, which coordinates the Department’s activities combating elder abuse, neglect and financial exploitation, especially as they impact beneficiaries of Medicare, Medicaid and other federal health care programs. For more information about the Department’s Elder Justice Initiative, see https://www.justice.gov/elderjustice/.
The claims asserted against the defendants are allegations only, and there has been no determination of liability.
The lawsuit is captioned United States vs. Vanguard, et al., case no. 3:16-cv-2380 (M.D.Tenn 2016).