Submitted false claims in billing to Medicare and Medi-Cal programs
By U.S. Attorney’s Office, Northern District of California
Tranquility Incorporated, a corporation doing business as San Miguel Villa which is a 190-bed skilled nursing facility located in Concord, CA, has agreed to pay $2.3 million to settle allegations that it submitted false claims by billing the Medicare and Medi-Cal programs for grossly substandard nursing home services it provided to its residents between 2012 and 2017, announced United States Attorney Stephanie M. Hinds and Department of Health and Human Services Office of Inspector General (HHS-OIG) Special Agent in Charge Steven J. Ryan. (See settlement)
The settlement resolves allegations that from 2012 to 2017 San Miguel Villa submitted, or caused to be submitted, claims to the Medicare and Medi-Cal programs for payment of its services that were grossly substandard and failed to meet minimum required standards of skilled nursing care in multiple ways. The United States alleges that nursing home residents at San Miguel Villa were overmedicated with psychotropic drugs, suffered excessive falls, were exposed to resident-on-resident altercations, and experienced other mental and physical harm.
“Residents of nursing homes are among the most vulnerable in our community, and they rely on Medicare and Medi-Cal programs to provide the care and services they must have,” said United States Attorney Stephanie M. Hinds. “Nursing homes are entrusted to impart competent and quality care to their residents. This case demonstrates that when federal funds are provided but substandard care is delivered, this office is committed to seeking accountability.”
“Nursing homes are intended to be places of comfort and healing, but the provision of substandard care jeopardizes the residents’ health and safety,” stated Steven J. Ryan, Special Agent in Charge with HHS-OIG. “HHS-OIG and our law enforcement partners are staunchly dedicated to investigating allegations of inadequate care at Medicare- and Medicaid-certified nursing homes.”
Assistant U.S. Attorney Gioconda Molinari investigated the matter with the assistance of Paralegal Lillian Do and Auditor Garland He. The United States Attorney’s Office initiated the investigation with assistance from HHS-OIG as part of its ongoing commitment to ensure that nursing home residents receive the necessary skilled nursing home services that they are entitled to and require. The United States Attorney’s Office acknowledges and thanks HHS-OIG as well as the California Department of Justice’s Division of Medi-Cal Fraud and Elder Abuse for their assistance in investigating this matter.
Working in conjunction with the United States Department of Justice Elder Justice Initiative, the United States Attorney’s Office runs an Elder Justice Task Force to identify and investigate nursing homes that provide grossly substandard care, and to support the efforts of state and local prosecutors, law enforcement, and other elder justice professionals who combat elder abuse, neglect and financial exploitation. If you or a loved one is experiencing abuse at a nursing home, please contact the California Long Term Care Ombudsman Crisis line at 1-800-231-4024, or the National Elder Fraud Hotline at 1-833–FRAUD–11 (or 833–372–8311).