Review of February, 2014 Exclusion Cases: Focus on Nursing Homes Remains High and the Cost of Violations Rise

I. OIG Targets Nursing Homes

Last year almost half of the exclusion violation matters reported by the Office of the Inspector General (OIG) involved nursing homes and rehabilitation facilities. This trend is continuing. Last month, the OIG reported five new cases on its website. Three of the five involved nursing homes. A fourth involved a non-profit school providing short-term stabilization and residential services to people overcoming emotional, behavioral or developmental challenges. It is impossible to say at this point what factors have led to the high percentage of cases involving facilities that provide some form of residential care. However, it certainly seems clear at this point that facilities providing services of this nature are well advised to actively begin screening – or to find a third party who can help them do it – if they haven’t already done so.

II. Cost of Violations Rising

A final note on the early returns is that the cost of exclusion violations seems to be going up. Civil money penalties for the year 2015 were averaging about $170,000.00 per matter. While this appears to compare with the year 2014’s average, it largely exceeds it. It actually represents about a 50% increase above the average in 2014, if the two large settlements from that year were factored out.

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Paul Weidenfeld, Co-Founder and CEO of Exclusion Screening, LLC, is the author of this article. He is a longtime health care lawyer whose practice has focused on False Claims Act cases and health care fraud matters generally. Contact Paul should you have any  questions at: pweidenfeld@exclusionscreening.com or 1-800-294-0952.