[Hat tip to ProPublica, our favorite investigative journalists for the facts used in this post. If you aren’t familiar with them, visit their site and donate!]
After reading a story on ProPublica about the Carlton Palms group home and its owner, AdvoServ, I did a quick Google search. Just how bad can a state licensed group home be? If the headlines are correct, it is truly a house of horrors. Headlines such as “Carlton Palms, State Settle after Girl’s Death,” “Teen’s Death, Abuse Complaints, Arrests Bring State Pressure…,”and this, “Bound to Bed: A Girl’s Agonizing Death.”
After years of gruesome reports, the State of Florida’s Agency for Persons with Disabilities still isn’t taking serious action. At one point the state wanted Carlton Palms to shut its doors to new patients until it could protect the safety of it’s existing patients. Carlton Palms apparently hired a lobbyist to convince the state that such action wasn’t necessary, however.
Normally we write about whistleblowers and the need to stop fraud and corporate greed. There is often a link between greed, Medicare fraud and patient safety.
Carlton Palms’ owner, AdvoServ, is a for profit company and receives Medicare and Medicaid monies. Many of the residents in group homes don’t have private insurance or deep pockets to pay for their care. They rely on tax dollars to pay for their treatment. Typically, these are some of the most vulnerable patients.
Because these folks often have severe developmental disabilities, some have real difficulty in protecting themselves and voicing complaints about their care (or in certain cases, lack of care.) We often must rely on investigative journalists and overworked state agencies to be their voice or tell their stories.
There is another way to help stop patient abuse. Whistleblowers.
Certainly we represent whistleblowers in state and federal False Claims Act cases and help them both stop fraud and earn the maximum cash awards. Many Medicare fraud cases involve double billing or billing for medically unnecessary services. Sometimes, however, Medicare care involves poor patient care. And then there is Carlton Pines – abusive care (assuming you can use those two words together.)
Medical providers that abuse patients shouldn’t be paid for those services. Only the state or feds can criminally prosecute those folks but whistleblowers can shine a light on these problems and stop the wrongdoers from getting paid.
The premise is simple. Hit them in their wallets. Poor patient care equals Medicare fraud.
We were shocked to read that sometimes these group providers charge as much as $350,000 per year to care for just one child with severe developmental disabilities. That is our tax dollars and for that type of money, these kids should be getting great care.
According to ProPublica, the problem isn’t confined to Carlton Palms or AdvoServ, although they appear to be one of the worst offenders.
In our own research we have found many other tales of horror. Throughout the country, kids and vulnerable adults are being abused in group homes. Most workers in these facilities deserve angel wings but with low pay and little incentive to provide proper care, these facilities also attract unqualified staff. Worse, the profit motive also removes incentives to improve patient care. (Carlton Palms owner AdvoServ is owned by a private equity firm, Wellspring Capital Management.)
Whistleblowers who come forward with information about abuses within the Medicare and Medicaid program have the satisfaction of knowing they stood up and did the right thing.
Not enough? The False Claims Act has a powerful anti-retaliation provision that can pay double wages and legal fees for whistleblowers who are punished for coming forward.
Whistleblowers can also receive 30% of whatever the government receives from wrongdoers. With triple damages and penalties up to $11,000 for each wrongful certification (bill) to Medicare, awards can add up.
There is one caveat to this story. Calling a Medicare fraud hotline won’t get you the big award and may not even get a proper investigation going. Under the False Claims Act, whistleblowers must file a sealed lawsuit in federal court. That is the only way to get an award and the best way to be protected from retaliation.
Need more information? Visit our Medicare Fraud page for whistleblowers or contact attorney Brian Mahany at or by telephone at (414) 704-6731 (direct).
MahanyLaw – America’s Whistleblower Lawyers