BRUNSWICK, Maine — The owner of several Brunswick assisted living facilities will pay $300,000 to resolve a federal lawsuit charging it allowed a subcontractor, RehabCare Group East, Inc., to routinely submit inflated Medicare claims for rehabilitation.
In March, Bangor nursing home Ross Manor agreed to pay $1.2 million to resolve similar allegations concerning claims for therapy purportedly provided by RehabCare Group East, Inc. The rehab provider was part of similar settlements in Massachusetts, Minnesota and Missouri.
Rousseau Management Inc. owns Horizons Living and Rehab Center, Skolfield House, and Dionne Commons in Brunswick and previously provided administrative management services to Amenity Manor nursing home in Topsham.
Rousseau Management subcontracted with RehabCareGroup East, Inc., a subsidiary of Kindred Healthcare, Inc., to provide rehabilitation therapy at Horizons Living and Rehab Center and Amenity Manor, according to a release from Massachusetts U.S. Attorney Carmen M Ortiz.
The federal government charged that before Oct. 1, 2011, Rousseau submitted or caused the submission of inflated Medicare claims for providing “unreasonable, unnecessary, unskilled rehabilitation therapy, or therapy that was not provided at all,” Ortiz said.
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The federal government alleges that even after Oct. 1, 2011, Rousseau Management failed to prevent a number of other practices of RehabCare Medicare reimbursement, including automatically placing patients in the highest reimbursement level and reporting that time spent providing unskilled palliative care was time spent on skilled therapy
“This settlement is another in a series of resolutions involving inflated Medicare billing at skilled nursing facilities,” Ortiz said in the release. “We continue our efforts to ensure that the provision of care in nursing facilities is based on patients’ clinical needs and not tied to the inflated financial interests of the companies providing care.”
“These defendants allegedly made decisions based on profitability, rather than on patient care,” Vincent B. Lisi, special agent in charge of the Federal Bureau of Investigation in Boston, said in the release. “These actions not only affect patients, but have a ripple effect on taxpayers who pay into the system. The FBI will continue to work with all of our law enforcement partners to make sure those who abuse the health care system are brought to justice.”
A phone call Friday morning to Rousseau Management president Mitchell Rousseau was not immediately returned.
Last year, Rousseau announced a $12 million plan to convert the 69,000-square-foot hotel on the former Brunswick Naval Air Station to assisted living. Rousseau said at the time that he hoped the project would be completed by August 2015.
The project is under construction, according to Steve Levesque, executive director of the Midcoast Regional Redevelopment Authority, which is charged with redeveloping the former base.
BDN Health Editor Jackie Farwell contributed to this story.