Western Pennsylvania-based chain of skilled nursing homes agrees to $15M settlement

  • Sarah Boden/WESA

(Pittsburgh) — A western Pennsylvania-based chain of more than 50 skilled nursing homes has agreed to pay $15,466,278 to resolve claims that it provided medically unnecessary rehabilitation therapy to residents in order to generate revenue.

According to court filings, two whistleblowers will share $2.8 million of the settlement, with the rest going to the federal government. The U.S. Attorney’s Office in the Western District of Pennsylvania alleges that Guardian Elder Care, headquartered in Jefferson County, pressured therapists to treat residents who did not want or need therapy, including people who were in hospice.

Federal authorities allege that some Medicare claims submitted by Guardian Elder Care sought inflated reimbursement amounts for “unreasonable and unnecessary rehabilitation therapy influenced by financial considerations rather than patient needs.”

U.S. Attorney Scott Brady said elder fraud is not uncommon, espeically in western Pennsyvlania, which per capita has one of the oldest populations in the country.

“[But] we don’t usally see it on the scope that Gaurdian Elder Care engaged in,” Brady said. “They were the largest independment provider of skilled nursing services in Pennsylvania.”

Brady’s office would not say how much Gaurdian alledgely billed Medicare for fraudulent services.

The settlement is not an admission of guilt by Guardian Elder Care. A spokesperson for the company said, “Resident care remains our first priority and we are committed to meeting our obligations under this agreement.”

Guardian Elder Care facilities include locations in Allegheny, Beaver, Greene, Indiana, Fayette, Washington and Westmoreland counties.

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