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A nonprofit nursing home in Wynnewood settles an overbilling lawsuit for $819,000

Philadelphia Inquirer - 7/29/2022

Jul. 30—Saunders House, a nonprofit nursing home in Wynnewood that is in the process of being sold, has agreed to pay $819,000 to settle allegations that it overbilled Medicare for physical therapy, the U.S. Attorney in Philadelphia announced Friday.

The settlement is based on a False Claims Act lawsuit filed in 2015 by a physical therapist assistant alleging that Saunders House billed federal health-care programs for "medically unnecessary rehabilitation therapy to residents to maximize revenue and without prioritizing clinical needs," the U.S. Attorney's news release said.

"Focusing on profits over the needs of individual patients violates the public trust and creates a potential for harm of some of the most vulnerable among us," U.S. Attorney Jacqueline C. Romero said.

"It also shifts taxpayers' funds away from the vital services of law-abiding therapy providers. We thank the whistleblower for helping to make the government aware of these allegations," she said, adding that Saunders House cooperated with the government's investigation. "That cooperation was taken into account when determining an appropriate resolution of these allegations."

Saunders admitted no liability and decided to settle to help facilitate its pending sale, according to a statement provided by its attorney, Paula G. Sanders, of Post & Schell PC.

"We believe that our actions were appropriate in all cases, as we relied upon our contracted therapy company to provide medically necessary therapy services to our residents," Sanders said.

The 2015 lawsuit, filed by physical therapist assistant Gerard Carson, also named his employer, an outside contractor to nursing homes, and four other Philadelphia-area nursing homes. A summons was issued to them on Wednesday, giving them 21 days to respond to the original complaint.

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