Academy Health Center, Inc., on behalf of the federal government, filed a Medicare whistleblower lawsuit claiming the residents of the Oxford Health and Rehabilitation Nursing Home were allegedly provided inadequate care.

The lawsuit claims that from 2005 to 2012, the nursing home residents in the Lumberton, Miss. facility suffered substandard treatment and grossly deficient services including bed sores, falls, dehydration, overmedication or under-medication, malnutrition, and other physical, mental and emotional injuries.

The nursing home facility’s owner and landlord, Academy Health Center Inc., blew the whistle on the following defendants:

• Georgia not-for-profit group Hyperion Foundation
• Georgia resident and former Hyperion president Julie Mittleider
• Georgia-based nursing home management company AltaCare Corporation
• AltaCare Chief Executive Officer Douglas Mittleider
• Long Term Care Services Inc.
• Sentry Healthcare Acquirors Inc.

The lawsuit claims that Hyperion contracted out the facility’s management with AltaCare. Hyperion allegedly sent claims to Medicare and Medicaid for services that were either never performed or were seriously substandard. The facility is accused of failing to provide proper nutrition, failing to provide necessary medications, failing to properly staff the facility, and diverting Medicare and Medicaid payments to other companies run by Douglas or Julie Mittleider.

These actions left the facility in disrepair with no sufficient means to pay for food, electricity, pest control, or cleaning, the lawsuit claims.

“Residents of nursing homes are some of our most vulnerable citizens,” said Acting Assistant Attorney General Chad A. Readler, head of the Justice Department’s Civil Division. “Nursing home operators who bill Medicare and Medicaid for providing their residents with grossly deficient services will be held accountable.”

Medicare Whistleblower Case Highlights Importance of Oversight

Under the qui tam provisions of the False Claims Act, which allows the company to file suit on behalf of the federal government share in any recovery of  funds,  Academy’s role in exposing the fraud undoubtedly was appreciated in this Medicare whistleblower case, but their share of the money has not been decided.

“When operators of nursing homes harm our most vulnerable citizens and break the law by defrauding our government for grossly substandard or worthless services, we will bring to bear all the resources of the Federal Government in order to rectify these terrible actions,” said D. Michael Hurst, Jr., U.S. Attorney for the Southern District of Mississippi. “I commend our attorneys and investigators for resolving this travesty with one of the largest healthcare fraud settlements involving a single nursing home. We will continue the Department of Justice’s long-standing commitment to protecting the elderly.”

The Medicare Whistleblower Lawsuit is United States ex rel. Academy Health Center, Inc. v. Hyperion Foundation Inc., et. al., Case No. 3:10-cv-552-CWR-LRA in the U.S. District Court for the Southern District of Mississippi.