Carespring spokeswoman Kim Majick said the allegations are more than five years old and Carespring made changes that brought it into compliance. “We feel that we did in fact provide these services and have chosen to move forward in the legal process,” she said.
The U.S. attorney’s office in Lexington did not respond to questions.
Carespring has two local nursing homes: Dayspring of Miami Valley in Clark County near Fairborn, and Hillspring Health Care and Rehab in Springboro.
A review of state records found Dayspring had above-average family and resident satisfaction scores, while Hillspring’s scores were below average. The number of citations at both facilities was below average for Ohio.
The federal complaint alleges Carespring received more than $100,000 in Medicaid and Medicare payments for insufficient care provided to six residents at its Villaspring nursing home in Kentucky between July 2004 and December 2008.
The Kentucky Cabinet for Health and Family Services investigated and substantiated allegations of resident abuse or neglect to at least 25 other Villaspring residents during that time, the lawsuit said.
The Centers for Medicare & Medicaid Services fined Villaspring at least twice for noncompliance during that period, according to the lawsuit.
The lawsuit seeks to recoup payment for all erroneous, inflated or improper claims, plus punitive damages. Carespring faces civil penalties of $5,500 to $11,000 for each alleged false claim.
Villaspring received Medicare payments totaling $16 million for the years 2004 through 2008.
The federal government’s prosecution of fraud has trended upward in recent years. For fiscal years 2006 to 2010, federal fraud settlements and judgments totaled $12.1 billion, according to Department of Justice data. That’s up from $7.4 billion for the years 2001 to 2005. Most of that fraud has been in health and human services.
Early this year, Dayton-based CareSource, a managed care organization, agreed to a $26 million settlement but admitted no wrongdoing in a federal whistleblower lawsuit alleging CareSource defrauded Medicaid by failing to conduct health assessments of large numbers of special-needs children.
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