Consulate Health Care will have to defend itself again over a 2017 judgment.
Three years ago, after a 22-day trial, a jury issued a $347.8 million judgment against Consulate Health Care, Florida’s largest nursing home chain. A year later it was overturned.
Now, an Appeals court partially reversed the judgment, lowering it to $255 million. While a huge drop, it is still meaningless, because it will never be paid.
Consulate was accused of upcoding therapy billing at a few of its nursing facilities. Except that at the time, these facilities were apparently operated by a different company that subsequently purchased Consulate and took on its name. I hate to say it, but upcoding is a grey area and has been a fact of life for years. No longer, however, with PDPM. However, if egregious upcoding occurs, providers should pay the price of their transgressions. Just go after the right provider. We are all taxpayers, after all.
What is even more absurd is for Consulate to have to fight this when it is fighting, along with all skilled nursing providers, to keep its patients healthy and alive, and for sufficient cash flow to remain solvent during the coronavirus pandemic. And, with costs higher to deal with the virus, legal bills will be a waste of finite resources.
I still question whether juries ever really understand the intricacies of Medicare reimbursement (I doubt it), and are just swayed by the plaintiffs’ portrayal of providers as greedy profiteers. Some things never change, even in a pandemic.
