Several Maryland entities are united in order to form what is called “strike forces” and address the “systemic obstacles” of long-term care. This is a critical example of overreach.
The new law enforcement unit is the direct result of a nursing home investigation that found it provided fraudulent care to Medicaid beneficiaries.
The Elkton Nursing and Rehabilitation Centre attracted the attention of authorities in 2022 following complaints. According to a press release from the Attorney General's Office, investigations by the state's Medicaid fraud and vulnerable victims' units revealed that the facility violated Maryland's false health claims law by providing “substandard” care to residents.
Severe staffing shortages, defects in wound care, many preventable falls, and regulatory violations were found during investigation.
The facility was ordered to pay a settlement of approximately $1.3 million. About a third of that ($400,000) will be directed towards quality improvement plans that OAG will monitor for three years through third-party vendors. The balance of $889,000 will be paid in compensation.
The actions taken to clarify these issues were fundamental in the formation of strike forces.
“The strike force will simultaneously carry state long-term care resources at one facility to provide real-time support to residents,” Zach Shirley, the Attorney General's Medicaid fraud and vulnerable victims unit, told McKnight's Long-Term Care News on Thursday.
However, long-term care executives have questioned the need for such a task force.
The state is already a few years behind, noted Kevin Heffner, president and CEO of LifeSpan Network, the largest association of senior care providers in the Mid-Atlantic state.
“It's effectively the third research agency based on the fact that the nursing home industry is already highly regulated,” he said on McKnight on Thursday. “It creates a lot of challenges for providers in terms of thinning out staff and producing resources. It's an incredible burden for residents' care.”
Last week, Hefner explained that a lifelong member in rural Maryland was visited by 10 lawyers representing the OAG. This facility was cited for lacking required 3.0 nursing hours at 0.2. This is a flaw that could hit the facility's reputation.
The building is one of the county's three nursing homes and faces important staffing challenges, Hefner noted.
Workplace government
Strikeforce consists of Maryland's Medicaid Fraud and Vulnerable Victims Unit, the Department of Human Services, the Department of Adult Services, the Department of Adult Protection Services, and the state's Long-Term Care Ombudsman Program.
While new to Maryland, the task force has previously been launched by other government agencies as a way to combat fraud.
For example, in 2009, the Department of Justice worked with the Department of Health and Human Services to form a strike for the Medical Fraud Prevention and Enforcement Action Team as a way to detect medical fraud.
DOJ also created a Covid-19 fraud enforcement task force in May 2021 to crack down on pandemic-related fraud. Since its inception, criminal charges have been pursued against more than 3,500 defendants. Civil enforcement measures have led to over 400 private settlements and decisions. And more than $1.4 billion in seizures and confiscations occurred.
