Gentiva and Kindred Hospice Fraud Settlements: Old Conduct Behind New Company Names

Gentiva and Kindred hospice fraud settlements reach back to alleged conduct at businesses that changed owners before the government announced a resolution. Odyssey, Avalon and SouthernCare operated hospices accused of billing for ineligible patients or unnecessary care, or paying for referrals. Their histories explain the hospice fraud allegations behind the later company names.

What Was the Gentiva and Kindred Settlement?

Gentiva’s settlement announced on July 17, 2024 covered alleged hospice eligibility violations, retained overpayments and a separate referral arrangement. The signed settlement agreement states the total as $19,428,570. The Department of Justice identified Gentiva as successor to Kindred at Home and named operations doing business as Avalon, Kindred, SouthernCare and SouthernCare New Beacon.

Medicare hospice eligibility requires a physician’s certification that the patient has six months or less to live if the illness runs its normal course.

The agreement brought together nine whistleblower actions. The government and Tennessee had joined the Avalon cases, alleging pressure to increase admissions and census, discouraged discharges, and incomplete or inaccurate information reaching certifying physicians. Internal warnings and audits allegedly identified problems, yet payments stayed with the business. That connects hospice eligibility fraud to what management did after someone questioned a patient’s enrollment.

The dates differ by location. Avalon’s Nashville and Chattanooga allegations covered 2010 through 2020. SouthernCare’s Youngstown, Ohio allegations reached from 2021 through 2023. The agreement also covered SouthernCare operations in Daphne, Mobile and Demopolis, Alabama, and South Bend, Indiana. Beyond Medicare and Medicaid, it addressed alleged ineligible-patient claims to CHAMPVA in Youngstown and TRICARE in Daphne.

The Odyssey Companies Behind the Kindred Locations

Three Odyssey entities appear in the agreement under Kindred location names. Their Medicare certification numbers connect the operating company to the location and the period of alleged ineligible-patient billing and retained overpayments.

An employee might remember Kindred. The operating company on the government’s agreement still says Odyssey. Both names matter when matching a billing history to the business that submitted it.

The Gadsden Referral Arrangement

SouthernCare New Beacon’s Gadsden, Alabama component concerned alleged payments to a consulting physician intended to induce Medicare hospice referrals. The agreement identifies an October 1, 2016 through October 1, 2022 period and says New Beacon disclosed the arrangement to the inspector general in March 2023. Those hospice referral kickback allegations concern who brought patients into the business and what the physician received.

Odyssey, Curo and Gentiva Hospice Settlements Across Acquisitions

The Odyssey, Curo and Gentiva hospice settlements cross acquisitions that combined different operations and ownership interests. The sequence explains how their names came to appear together in the later agreement.

VistaCare to Odyssey to Gentiva

Odyssey acquired VistaCare in March 2008. Gentiva Health Services bought Odyssey in August 2010. Kindred Healthcare then acquired Gentiva in February 2015, following the transaction announced the previous October. The announced combination used the Kindred at Home name for its home health and hospice business.

Odyssey’s place in the chain matters beyond the old corporate logo. Its continuous-home-care settlement came after Gentiva bought it, while the alleged billing period came before the purchase. The later agreement’s Odyssey operating-company names show why an old employer name can remain useful long after the acquisition announcement.

Kindred at Home and Curo Come Together

In 2018, Humana, TPG Capital and Welsh, Carson, Anderson & Stowe acquired Kindred Healthcare, separating Kindred at Home from the specialty hospital business.

The same buyers announced their agreement to acquire Curo Health Services in April 2018. They expressly planned to merge Curo with Kindred at Home’s hospice business. The later settlement agreement dates Curo’s entry into the Kindred at Home enterprise to July 2018 and identifies Avalon, SouthernCare and SouthernCare New Beacon among Curo’s operating names.

That combination brought the Curo and Odyssey paths into the same enterprise. An Avalon admission record and a Kindred claim could belong to operations with different histories before that combination.

Humana Buys the Balance, Then Sells a Majority

In August 2021, Humana bought out its investment partners in Kindred at Home. Its annual filing records the completed purchase.

In August 2022, Humana sold a majority interest in the hospice and personal-care operations to Clayton, Dubilier & Rice and kept a minority stake. The business took the Gentiva name. The sale announcement described those divisions becoming a standalone operation.

Why Hospice Buyers Want Scale

Hospice acquisitions can give healthcare companies broader referral coverage and lower costs.

A historical case study, Odyssey Healthcare: Issues of Fiduciary Malfeasance and Class Action Suits, published in the Journal of Finance Case Research in 2008/2009, described why scale mattered to Odyssey’s strategy. A broad geographic footprint helped large hospice providers serve nursing-home and assisted-living chains seeking consistent health care across their locations. Larger operations could negotiate purchasing discounts and spread overhead, information systems and marketing costs across more patients.

The enforcement questions arise inside those operations, where someone decides whom to admit, what to document and what to bill.

Odyssey, SouthernCare and Curo Settlements Before Gentiva

The earlier resolutions covered eligibility, care-level and referral allegations. Medicare paid for hospice care these patients allegedly did not qualify to receive, or for a level of care they did not need.

Odyssey’s Earlier Eligibility Case

In July 2006, the Justice Department announced that Odyssey had paid $12.9 million to resolve allegations of Medicare claims for patients who were not terminally ill during 2001 through 2005. A former employee who audited patient records brought the whistleblower case.

In the complaint, the whistleblower alleged that her audits identified patients who did not qualify for hospice. Her account described the response to that work:

In her account, the auditor flagged ineligible patients and Odyssey did not want to hear it.

SouthernCare’s Earlier Eligibility Settlement

SouthernCare paid $24.7 million in the settlement announced in January 2009. The government alleged false claims for patients who were ineligible for hospice. Two whistleblowers brought the cases, and the resolution included a corporate integrity agreement requiring compliance work after the payment.

SouthernCare would later appear among Curo’s hospice brands.

Odyssey’s Continuous-Home-Care Settlement

Odyssey agreed to pay $25 million in the March 2012 resolution. This time the allegations concerned continuous home care that was unnecessary or did not meet Medicare requirements during January 2006 through January 2009. Gentiva bought Odyssey after that period ended.

Continuous home care addresses an acute crisis requiring skilled nursing at home. The Department of Justice described its payment as several hundred dollars a day above routine services. That made the care level a consequential hospice billing decision: the question was what the patient needed and what nursing care the hospice actually provided.

A whistleblower complaint alleged that Odyssey charged Medicare for continuous care while assigning the same nurse to another patient at the same time. That allegation makes the staffing schedule part of the story. The care entered on a claim can be compared with where the nurse was assigned to work. The settlement announcement reported more than $4.6 million for the former-employee whistleblowers.

Curo and Hospice Plus Referral Payments

Curo’s April 2017 corporate settlement was $12.21 million, resolving allegations brought by whistleblowers. The Department of Justice said Curo had bought Hospice Plus, Goodwin Hospice and Phoenix Hospice in September 2010 and consolidated them under the Hospice Plus brand.

The alleged referral arrangements crossed that purchase date. From 2007 through 2012, the government alleged, payments to a physician housecall company took the form of sham loans, a free equity interest, stock dividends and free rental space. A separate alleged scheme ran from 2007 through 2014 and involved cash, gift cards and other valuable items for medical providers and facilities supplying referrals.

Here the ownership date sits inside the alleged conduct windows. The physician arrangement, its payment history and the patients referred through it explain the case more clearly than the brand alone.

SouthernCare’s Pennsylvania Settlement

SouthernCare’s December 2018 settlement was $5,863,426. It concerned Pennsylvania facilities and alleged medically unnecessary or inadequately documented hospice care from January 2009 through December 2014. The government alleged admissions of patients who were not terminally ill and lacked appropriate supporting documentation.

Two former employees brought the whistleblower cases.

The Same Practices Appeared at Other Hospice Companies

VITAS and Caris illustrate the recurring practices outside this acquisition history. VITAS’s October 2017 settlement was $75 million, resolving the government’s case and three whistleblower cases. The government alleged ineligible-patient billing, bonuses tied to enrollment without regard to terminal illness, and continuous home care that was unnecessary, unprovided or below Medicare requirements.

Caris’s June 2018 settlement was $8.5 million. A nurse formerly employed by Caris brought the whistleblower case. The Department of Justice alleged that admissions and census targets drove enrollment, while internal audits, the chief medical officer and nurses raised eligibility concerns. It alleged that billing continued and overpayments stayed with the company.

For someone who has seen an audit ignored, the connection is concrete: what staff found, who heard it and what happened to the claims afterward.

Kindred’s Compliance Penalty Followed Earlier Audit Findings

Kindred paid more than $3 million for failing to comply with a corporate integrity agreement, according to the Department of Health and Human Services’ Office of Inspector General semiannual report covering October 2016 through March 2017. The agreement followed allegations involving medically unnecessary hospice services and continuous or crisis care for patients who were not experiencing a crisis.

The inspector general said its unannounced visits found ongoing violations. Required internal audits in 2013, 2014 and 2015 found that Kindred and its predecessors had failed to implement required policies and procedures. Poor claim-submission practices produced significant errors and Medicare overpayments.

Kindred had promised to fix its billing. Its own audits kept finding problems, and it paid again.

What an Insider’s Records Can Connect

An insider’s records can connect an old operating name to a specific patient, claim and management decision.

An Avalon whistleblower complaint alleged that a nurse’s report of no patient decline and questions about terminal eligibility drew a demand for stronger documentation. The same filing alleged that employees prepared patient-chart notes for nurses who were on vacation. Those are specific allegations about how the clinical record was produced, in a business later included in the Kindred and Gentiva history.

Someone who worked through a sale may know which managers continued giving instructions, which clinical concerns reached them and what happened to billing afterward. That knowledge gives the acquisition dates their practical meaning. Our work with hospice whistleblowers starts there. A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

Your Old Employer’s Name Still Matters

If you watched admission pressure, unsupported billing or referral payments continue through a hospice acquisition, speak with our whistleblower experts about what carried over. We build your strongest hospice whistleblower case from what you know about the operation and bring in hospice fraud whistleblower lawyers who understand cases involving successive owners. We stay beside you as the case develops, with the patient care, the payments and the decisions inside the business at its center.