A nursing home located in New Rochelle, N.Y. will pay $2.2 million to settle allegations that the business and its owner submitted more than 62,000 inflated claims to the New York State Medicaid Program.
Ralex Services Inc., doing business as Glen Island Center for Nursing and Rehabilitation, and owner, Leah Friedman, will return the money to Medicaid and the state. New York will receive more than $1.3 million of the total restitution funds, according to New York Attorney General Eric T. Schneiderman's office.
According to allegations made by both the state and federal government, the 182-bed Glen Island nursing home submitted the false claims to New Yorks Department of Health from April 2002 to November 2006.
The inflated claims used Medicaid reimbursement rates that falsely logged the degree of care required by many Glen Island residents. The defendants exaggerated residents diagnoses, conditions and required treatments in the reports. They routinely stated that residents were receiving treatments, including for oxygen and suctioning, when such treatments were neither required nor given, according to the Attorney General's office.
The defendants further attempted to cover up the fraudulent submissions by making false entries and forgeries into Glen Island residents medical records. These falsified records were later turned over to the Attorney Generals Medicaid Fraud Control Unit.
One false score sheet, for example, designated a resident as needing daily oropharyngeal suctioning, a treatment which clears secretions from airways of patients, when in fact the resident did not need or receive the treatment. By routinely inflating patient scores, Glen Island received higher Medicaid reimbursement rates.
The settlement follows the 2011 conviction of former Glen Island Administrator Eufemia Fe Salomon-Flores, who pleaded guilty to felony grand larceny and admitted that she had submitted information to the Department of Health that falsified the type of care residents received. She served a 1- to 3-year state prison sentence, lost her Nursing Home Administrator license and has been excluded from participating in the states Medicaid program.
Marlon Legaspi pleaded guilty in December 2011 to a misdemeanor count of attempted tampering with physical evidence. Maria Eufemia Salomon-Rosanes, a niece of Fe Salomon-Flores, pleaded guilty to the same misdemeanor charge in March 2012.
The agreements one with the state and one with federal authorities followed an investigation by the Attorney Generals Medicaid Fraud Control Unit and the United States Attorneys Office for the Eastern District of New York.
The investigation started after allegations were lodged by whistleblower Carolyn Hinestroza, a former assistant director of nursing at the facility.
