Attorney General Schmitt Reaches Settlement with St. Louis County Nursing Home for Alleged Medicaid Fraud
Missouri Attorney General Eric Schmitt announced that Life Care Center of Bridgeton, on October 29, 2020, has entered into a civil settlement agreement with his Medicaid Fraud Control Unit for failing to provide necessary care to residents and submitting false claims to MO HealthNet, the Missouri Medicaid program.
“The Medicaid Fraud Control Unit of the Attorney General’s Office works with local jurisdictions and statewide agencies to root out Medicaid fraud and hold those responsible for that fraud accountable,” said Attorney General Schmitt. “This case is yet another example of the MFCU’s incredible work on behalf of the people of Missouri.”
The skilled nursing facility failed to provide the necessary care for three residents’ pressure ulcers, or bedsores. Two of the residents’ pressure ulcers were so severe that the residents’ bones were exposed.
Bridgeton Operations LLC d/b/a Life Care Center of Bridgeton (“Bridgeton”) will pay MO HealthNet restitution and penalties amounting to $150,000. Bridgeton’s false claims for its failure to provide all necessary care to three residents amounted to $6,176.60. The nursing facility has also agreed to pay a civil monetary penalty of $143.823.40.
Nursing facilities submit claims to MO HealthNet for a per diem fee in exchange for providing all necessary care to each resident. The Attorney General’s Medicaid Fraud Control Unit found Bridgeton submitted claims for thirty eight dates of services from May 1, 2018 through September 1, 2018 for three residents when care was not documented as provided in whole. The failure of a nursing facility to document that it provided necessary care to residents in whole, including all treatment, services, and supplies, for which it bills MO HealthNet amounts to a false claim for each date of service.
This case was prosecuted by the Attorney General’s Medicaid Fraud Control Unit, Assistant Attorney General Brad Crowell and Investigators David Dresel and De’Nel Holliday, and with the assistance of the Missouri Department of Health and Senior Services.
The Missouri MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $2,818,808 for Federal fiscal year 2021. The remaining 25 percent, totaling $939,601 is funded by the State of Missouri.