According to a Department of Justice press release, issued October 24, 2016, Daybreak Partners, LLC, a holding company for a number of subsidiaries that operate and manage skilled nursing facilities throughout Texas, has agreed to pay $5.3 million to resolve allegations that they billed Medicare and Medicaid for materially substandard nursing services.

The settlement resolves allegations that some of the skilled nursing services provided at four nursing facilities Daybreak owned and managed were materially substandard and/or worthless because Daybreak: (a) failed to follow appropriate fall protocols for several residents; (b) failed to follow appropriate pressure ulcer and infection control protocols for several residents; (c) failed to properly administer medications to several residents to avoid medication errors; (d) failed to follow doctors’ orders for several residents; (e) failed to provide appropriate mental health treatment to several residents; (f) failed to answer several residents’ call lights promptly; (g) failed to institute appropriate infection control measures for several residents; (h) failed to provide a habitable living environment, adequate equipment, and needed capital expenditures; and (i) failed to investigate and report serious incidents to appropriate authorities on several occasions.

The Daybreak skilled nursing facilities involved in the allegations were Deerings Nursing and Rehabilitation, L.P. in Odessa, Texas; Mansfield Nursing and Rehabilitation, L.P. in Mansfield, Texas; Marine Creek Nursing and Rehabilitation, L.P.  in Mineral Wells, Texas; and Mineral Wells Nursing and Rehabilitation, L.P. in Mineral Wells, Texas.

“In addition to our responsibility to preserve federal tax dollars, we have a special obligation to protect the most vulnerable members of our community,” said U.S. Attorney John Parker of the Northern District of Texas.  “This settlement reflects our commitment to ensuring that medical providers for our ailing friends and family are not paid for substandard services.”

Under the qui tam provisions of the False Claims Act, whistleblowers with information about similar fraud against the government may bring a civil case on behalf of the United States. If successful, the government can recover three times the amount the defendants fraudulently billed the government and monetary penalties for each false claim submitted.  The whistleblower, who originally filed the case, is entitled to 15-30% of the government’s recovery as well as their attorney’s fees.  To report similar fraud, contact Frohsin Barger & Walthall.