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Jury Awards $115 Million to Whistleblower in False Claims Case Against Florida Nursing Home Facility

Occasionally, whistle-blowers win in cases where the government has not intervened. Such was the case early last month when a federal jury in Florida awarded a nurse, Angela Ruckh, $115 million to settle her False Claims Act suit against her employer (LaVie Management and later CMC II). Ms. Ruckh had alleged that the company had engaged in a fraudulent scheme against the government that was “encouraged by senior officers.” Moreover, Ruckh stated that the scheme actively encouraged employees to falsify claims submitted to the government. The original False Claims Act lawsuit was filed back in 2011. Ruckh began working for Lavie Rehab, a skilled nursing facility, back in February of that same year. After working for a short time, Ruckh discovered what she believed were fraudulent activities being committed by senior officers at the facility.

Ruckh discovered these fraudulent activities through her work which involved helping to train minimum data set (MDS) coordinators. (MDS forms generate a code that determines how much Medicare pays each facility.) Ruckh alleged that there was a treatment disparity between Medicare and Medicaid patients. The former nurse claimed that LaVie treated patients who were on Medicaid as if they did not have a payer source. This lead to different treatment for patients with the same condition based solely on which program they were covered under. Specifically, Ruckh alleged that Medicare claims were based on upcoding.

Ruchk also alleged that Lavie Rehab “ramped up” therapy for patients based on monetary considerations. “They would take 88 to 92 year old people with multiple major health problems — heart problems, dementia, kidney failure, some of whom were on hospice care at the end of life — and they were giving them the highest amount of therapy under the Medicare guidelines. People who could only sit up straight for two minutes without passing out were subjecting them to 720 minutes, 12 hours of therapy a week,” Ruchk said. A statistician was used to help bolster Ruchk’s claims. He used a random sample of Medicaid and Medicare patients and reviewed Ruchk’s claims of upcoding and “amping.” Another nurse and auditor, Shirley Bradley, concluded that on the basis of these findings Medicaid patients were generally ignored and received no or inferior care. “They [LaVie Rehab] didn’t create care plans for the Medicaid patients because that would have been a road map to show that they weren’t providing the care needed. It made no sense to them to produce a plan that would show the care that they were not providing. It would have been a road map showing the disregard for the patient,” said Bradley.

Ruchk’s award of $115 million was determined by the number of submitted false claims. Each false claim is subject to a monetary penalty of between $5,500 and $11,000. If you have chosen to disclose False Claims Act violations to the government it is also advised that you contact a False Claims Act lawyer. A False claims act attorney can advise you in such matters and will work to protect your rights under the law.