On February 27, 2019, the Department of Justice announced that Vanguard Healthcare, LLC and related Vanguard companies agreed to pay more than $18 million to resolve claims made by the United States and the State of Tennessee that Vanguard illegally billed for services provided by Vanguard-owned skilled nursing facilities that were either grossly substandard or so far below the standard of care that they were deemed to be worthless. The United States brought its claims under the False Claims Act, and the State of Tennessee proceeded under Tennessee Medicaid False Claims Act.
Among the allegations were claims that the Vanguard-owned skilled nursing facilities:
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Failed to administer medications as prescribed;
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Failed to provide appropriate wound care;
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Failed to implement standard infection control, leading to urinary tract and wound infections;
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Failed to take measures, such as turning and repositioning, to prevent pressure ulcers; and
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Used unnecessary physical restraints on residents.
The United States and the State of Tennessee filed the suit in United States v. Vanguard Healthcare, LLC, et al., No. 3:16-cv-02380 (M.D. Tenn.) against a number of Vanguard companies, Vanguard’s majority owner and CEO, William Orand, and Vanguard’s former director of operations, Mark Miller. Orand and Miller agreed to pay $250,000 as part of the settlement.
Along with the settlement, the Vanguard corporate defendants and Orand further agreed to enter into a chain-wide, quality of care Corporate Integrity Agreement with the United States Department of Health and Human Services, Office of Inspector General, which will be in effect for five years. The agreement requires Vanguard to retain a government-selected quality of care monitor in addition to other compliance obligations.
