Ex-Employee Blows Whistle on California’s Largest Nursing Home Provider

False Claims Act , Healthcare Fraud

Following an investigation that arose from a whistleblower suit, the corporate owner of four San Diego-area nursing homes has agreed to pay $6.9 million to resolve multiple fraud allegations. The sister facilities, owned by Los-Angeles based Brius Management Co., purportedly paid illegal kickbacks to cultivate patient referrals and subsequently file numerous false claims to Medicare and Medi-Cal for the newly-acquired beneficiaries.

Brius, the largest skilled nursing provider in the state of California, owns the four homes in question: namely, Point Loma Convalescent Hospital, Brighton Place of San Diego, Brighton Place of Spring Valley, and Amaya Springs Health Care Center. The four facilities entered into Deferred Prosecution Agreements (DPAs) in 2016; during which, they admitted to having paid kickbacks to discharge planners at a San Diego hospital, in return, receiving a number of new patients to their facilities. Any consequent bills that arose from referrals obtained through such deceitful methods would have constituted fraud; however, Brius assumed no liability during their agreement to settle.

The admissions provided by the nursing homes in the 2016 DPAs specifically absolved Brius of any guilt, defending that their parent company was unaware of the illegal kickback scheme. However, Brius is no stranger to being in the limelight for its role in similar matters, including two recent FBI investigations; in a 2014 case against the company, California State Attorney General Kamala Harris even referred to the owner as a “serial violator.” It is uncertain whether the practices employed at these nursing homes is standard at other facilities under the Brius name, but the company conceded as part of the settlement to enter into a corporate integrity agreement with the Inspector General – an initiative that will hopefully hinder any further fraudulent activity.

Still, some aspects of the statements offered by the nursing homes clearly implied a certain amount of cooperation from Brius, such as in the case of the excessive misuse of company credit cards to pay for massages, gift cards, sporting events tickets, and even a cruise vacation – all purchased in efforts to woo the discharge planners into providing unnecessary referrals. These reported transgressions were brought to light by a former employee of one of the nursing homes; under the qui tam provisions of the False Claims Act, she was able to utilize her knowledge of the scheme to filed suit on behalf of both the United States and the State of California. Due to her valuable role in the recovery of federal funds, she was rewarded with a twenty percent dividend of each settlement.

Whistleblower Justice Network Can Help You

Whistleblower Justice Network partners with whistleblowers to bring similar schemes to light, in efforts to restore justice and prevent those who intentionally commit fraud from preying on our nation’s most vulnerable – the elderly, the needy, and the sick.

If you have meaningful information regarding nursing home fraud that you believe is in violation of the False Claims Act, Whistleblower Justice Network can help. Working alongside world-class legal counsel, we will ensure you are protected to the fullest extent of the law and that you receive credit for the information you bring to the U.S. government. Partnering with whistleblowers is all we do. Visit us at www.whistleblowerjustice.net, or call us at 844-WJN-4ALL.

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