On September 14, 1998, the U.S. Department of Justice filed a lawsuit under 31 U.S.C. § 3729 (the False Claims Act) against Greenbelt Nursing and Rehabilitation Center in Greenbelt, Maryland. The Center's parent corporations, Northern Health Facility and Extendicare Health Services, were also named defendants. The suit was filed in the U.S. District Court for the District of Maryland.
The government alleged that the Center had failed to comply with the provisions required for facilities filing claims for Medicare and Medicaid bills, and its lack of compliance indicated a failure to provide adequate care to residents. The claim was prompted by reports from the State of Maryland, which surveyed the facility in January 1998 and found it to be out of compliance with Medicaid provider participation requirements and with standards of proper patient care.
After several attempts to revise its policies, Greenbelt successfully demonstrated to the State of Maryland and the federal Health Care Financing Administration its compliance with Medicare provider requirements, and its certifications were reinstated in July 1998.
Despite the reinstatement of the facility's Medicare provider status, a U.S. Department of Justice investigation into the Greenbelt's noncompliance continued. An August 1998 visit to the facility revealed that it was still failing to meet Medicare program requirements and failing to provide adequate care to patients.
The government's complaints about Greenbelt's deficiencies in care included a failure to provide adequate health care, to administer medication properly, or to provide wound care. Greenbelt also failed to meet residents' nutritional needs. Furthermore, staff training was insufficient. As such, the government alleged that Greenbelt's submission of claims for payment to Medicare and Medicaid programs for January - August 1998 violated the False Claims Act, in that the claims falsely represented compliance with conditions for payment under the Nursing Home Reform Act. The government asked the court for preliminary injunctive relief and monetary damages as a penalty.
On September 14, 1998, the court (Judge Alexander Williams, Jr.) approved the parties' Joint Motion for Preliminary Injunctive Relief. The Motion provided for Greenbelt to comply with the Nursing Home Reform Act, in particular those portions regarding Medicaid and Medicare payments. The parties agreed to a have a monitor supervise the enforcement of the modifications. In addition, the Motion called for improvements in basic care and resident safety, as well as nutrition and wound care, assessments and care plans, and activities. The use of physical and chemical restraints would be used only in appropriate situations, and psychiatric, nursing and medical care would be available whenever necessary. Finally, the parties agreed to employ a sufficient number of adequately trained staff. U.S. v. Northern Health Facilities, Inc., 25 F. Supp. 2d 690 (D. Md. 1998).
On December 7, 1998, Greenbelt Nursing home filed a crossclaim against the government. Greenbelt sought a court order enjoining the government from terminating its participation in the Medicare and Medicaid programs, arguing that it may have to close if it stopped receiving such payments. After a hearing on December 9, 1998, the court (Judge Williams) denied the plaintiffs' Motion for a Temporary Restraining Order on December 28, 1998. Northern Health Facilities v. U.S., 39 F. Supp. 2d. 563 (D. Md. 1998).
On January 5, 1999, the parties put forth a joint motion to rescind the injunction, which the court (Judge Williams) approved on January 7, 1999. The court further ordered the Temporary Manager and Monitor to immediately cease their activities as prescribed by the Order. Subsequently, on May 19, 1999, the parties entered a joint Motion for Settlement Order, which the court (Judge Williams) approved on May 21, 1999. The case was closed on the same day.Laura Uberti - 06/22/2006