Professional Family Care Services: One Aide, Two Patients, the Same Hours

In the Professional Family Care Services VA settlement, the company agreed to pay $45,487 to resolve allegations that it billed for home care using falsified timesheets, including hours an aide claimed for two patients at once. The government said the aide failed to provide the time and quality of care those bills represented. For someone who schedules caregivers or handles their billing, the contradiction is familiar ground: who actually did the work, and what did the agency charge for it?

Professional Family Care Services, Inc. provided home-health services in southeastern North Carolina, including care for veterans. The company was based in Fayetteville. The U.S. Attorney’s Office for the Eastern District of North Carolina announced the civil settlement on December 15, 2021. The Department of Veterans Affairs was the payer, and its Office of Inspector General assisted in the investigation.

What the VA Paid For

Against $11,274 in VA payments, Professional Family Care Services agreed to a $45,487 civil settlement. The payments covered fifteen claim forms for services the company said its employee had provided between October 2015 and December 2016. The employee was a certified nurse aide. The patient was an Army veteran who was living with her during the period described by the government.

According to the Justice Department, the company based its bills on falsified timesheets the aide supplied. Some showed her caring for the veteran and another patient at exactly the same times. That was the alleged connection between the aide’s records and the company’s requests for government money: the timesheets supported claims for work the department said she had failed to provide.

We see the absurdity in what the government alleged: one aide’s time billed as though it could be spent twice. Same aide. Same hours. The veteran allegedly went without care that taxpayers paid for.

The department explained that the False Claims Act lets the government recover triple what it lost, plus civil penalties. Here, the company agreed to a civil settlement over allegations that it used falsified timesheets to bill for the veteran’s care.

The Veteran’s Care and the Employee’s Criminal Case

In its settlement announcement, the Justice Department also described the aide’s separate criminal case: she had been convicted of wire fraud earlier in 2021 for misconduct involving the veteran. Professional Family Care Services separately agreed to resolve the government’s civil billing allegations.

In its account of the veteran’s care, the department said that he spent several months living with the aide while she purportedly provided home-health services through the company. He was admitted to the hospital with severe bedsores and was extremely malnourished. He died within a few days of admission.

The government’s allegation about the care was specific: the aide had failed to provide both the time and the quality of care required under the VA program. The allegations about billing concerned the records used to charge for that care.

For an insider, this is why the work behind a timesheet matters. A form can describe hours of attention while the person meant to receive that attention goes without it.

How a Timesheet Becomes a Government Bill

According to the Justice Department, Professional Family Care Services used the aide’s falsified timesheets to bill the VA. The aide supplied the hours; the agency submitted the claims.

That relationship matters to people working in different parts of an agency. A caregiver knows the work performed. Someone handling home healthcare schedules can recognize overlapping assignments. A billing employee sees how the recorded hours reach a claim. We connect those views of the same service when examining a potential whistleblower case.

The Department of Health and Human Services’ Office of Inspector General made a related point in its 2016 advisory on Medicaid personal-care services. It described pre-signed timesheets, workers overseas and services supposedly provided in different locations at the same time. It explained that documentation alone can make personal-care fraud difficult to detect. Someone who knows where the worker or patient actually was can bring a fact the paperwork conceals.

False Timesheets in Other Home-Care Cases

Other home-care cases show how an agency can turn a false account of a caregiver’s work into a payment claim. The payer in the following cases was Medicaid. The common thread is the time and service being billed.

In the Family First Home Health Care case, a former employee’s complaint alleged that the company fabricated dates, times and signatures:

The allegedly forged signatures made the form look supported by both sides of the care relationship. Knowledge that the patient had moved could expose the invented visit anyway.

In its March 2024 settlement announcement, the Justice Department described Family First allegations that included claims during patients’ hospital stays and visits attributed to aides away at college or out of state. Each places a concrete fact about a person alongside the service claimed in that person’s name.

At Home Care Group provides another comparison. The Justice Department alleged that caregiver schedules were altered to bill Oregon Medicaid for hours of in-home medical and nonmedical care that had not been performed. There, the alleged manipulation reached the schedule itself. Across these cases, the useful question is who created the account of the work and how that account became a bill.

What Evidence Is Needed to Prove Fraud?

For a timesheet-based home-care case, the useful evidence connects the actual worker and care delivered with the time claimed, the agency’s bill and the government payment. In the Professional Family Care Services allegations, the overlapping timesheets and the claims they supported supplied that connection.

The comparison reaches beyond whether a form has been completed. In the cases discussed here, the contradiction could be another patient assigned to the same hours, a caregiver away at college or a patient already in the hospital. The question we pursue with you is how your knowledge of the work fits the company’s requests for payment and the decisions behind them. We follow the service through what was authorized, recorded, billed and paid, with the payer’s requirements in view. A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

You Know Whose Hours Were Billed

If you handled schedules, delivered care or prepared VA home-health bills that misrepresented the work, speak to one of our Whistleblower Experts about whose hours were billed. We build the case with you around the actual care, the false time records and the claims, and bring in home health care fraud whistleblower lawyers who know VA billing cases. We stay beside you as your partners through the case, so your knowledge of the work has experienced advocates behind it.