An Illinois jury hit a skilled nursing facility (SNF) with a $29 million verdict after agreeing with allegations by former employees that the SNF knowingly provided worthless services to its residents and submitted over 1700 false claims to the government for their care.  The jury found that the government suffered losses of over $3 million in connection with the false claims, which are trebled—or multiplied by three— under the False Claims Act.  For each of the 1700-plus false claims, the jury awarded the maximum civil penalty of $11,000.  The jury also awarded the two former employee whistleblowers a total of over $400,000 in damages. 

The case was filed by two nurses who had worked at the SNF and alleged that they had repeatedly complained to management about the poor care provided to residents and of violations of the False Claims Act.  Among other allegations, the two whistleblowers said in their complaint that residents routinely went without medical care and food as well as the prescribed medications needed for their mental and physical well-being and to alleviate pain.  In addition, the whistleblowers alleged that the SNF destroyed and forged records in order to make it appear that residents received appropriate care, instructed staff to either not enter negative information or alter entries regarding negative aspects of patient care, and forged staffing sheets to conceal inadequate staffing at the facility.

While this case presents an extreme example, it also highlights the importance of responding promptly to employee complaints of potential False Claims Act violations.  As we wrote last month, federal law requires nursing facilities and skilled nursing facilities to have in place robust compliance programs by March 23, 2013.  A compliance program containing the elements required by this law would include mechanisms for responding to internal complaints like those made by the whistleblowers in this case.

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Photo of Michael R. Bertoncini Michael R. Bertoncini

Michael R. Bertoncini is a principal in the Boston, Massachusetts, office of Jackson Lewis. He is a member of the Healthcare industry group and a member of the Higher Education group.

With a background as a former Deputy General Counsel, Michael understands first-hand…

Michael R. Bertoncini is a principal in the Boston, Massachusetts, office of Jackson Lewis. He is a member of the Healthcare industry group and a member of the Higher Education group.

With a background as a former Deputy General Counsel, Michael understands first-hand the competing demands and unique challenges faced by in-house counsel. Before joining Jackson Lewis, he was responsible for all labor and employment law matters for the largest fully integrated community care hospital system in New England. Michael provides timely, practical advice that helps clients achieve their strategic goals while ensuring compliance with legal obligations.

With deep experience in a broad range of industries, Michael has a keen interest in the healthcare, higher education, museum, and arts & music sectors. He is dedicated to supporting clients in these areas, leveraging his extensive experience to address the specific challenges faced by institutions and organizations in these fields.

Michael regularly partners with clients to establish positive employee relations. In labor relations matters, he negotiates collective bargaining agreements on behalf of organized clients, represents clients in labor arbitrations and National Labor Relations Board proceedings, and counsels clients with respect to rights and obligations under collective bargaining agreements and applicable labor and employment laws. He also has extensive experience in advising organizations responding to corporate campaigns and negotiating neutrality agreements.

Michael’s privacy and data security practice focuses on advising clients on complying with HIPAA and other state and federal privacy and data security laws. He reviews and develops policies and procedures, written information security plans and integrated compliance programs to ensure his clients meet their obligations under privacy and data security laws. Michael represents clients in investigations of alleged data breaches and advises them on reporting obligations.. He also conducts workplace training programs on HIPAA compliance and related privacy and data security topics.