The Meridian Senior Living lawsuit

A Medicaid lawsuit of 60 million dollars has struck Meridian Senior Living and Affinity Living Group. The whistleblower lawsuit, unsealed Friday, May 13, 2022, alleges that Meridian Senior Living Group and related entities intentionally submitted false claims to the Medicaid program in North Carolina.

The suit claims Meridian facilities overcharged for personal care services provided in their special care units, including those for Alzheimer’s disease and other special needs disease. It points to the principal owner, who says they billed the maximum allowed, regardless of the actual care given at their adult care facilities in North Carolina.

Background of the Meridian Senior Living Lawsuit

The Meridian Senior Living lawsuit started when a whistleblower made severe allegations. The lawsuit was unsealed Friday, alleging that Meridian Senior Living Group and Affinity Living Group were involved in a Medicaid fraud scheme in North Carolina.

Entities Involved: Meridian Senior Living Group and Affinity Living Group

Meridian Senior Living and Affinity Living Group were major players in the senior living industry. Meridian operates many adult care facilities nationwide and focuses on caring for seniors, especially those with Alzheimer’s disease and other dementias. Affinity also ran several senior living facilities, particularly in North Carolina.

These companies greatly influenced the industry because of their size and reach. However, the whistleblower lawsuit brought to light concerns about their practices, which led to questions about their integrity and the quality of care provided in Meridian facilities.

The Nature of the Fraud Allegations

The fraud allegations against Meridian and Affinity were serious. This whistleblower lawsuit claimed that the companies were involved in improper billing practices.

Specifically, the suit accused them of submitting false claims to Medicaid for personal care services that were either exaggerated or not provided at all. For example, Meridian facilities were said to have billed the maximum allowed amount, regardless of the actual time spent caring for residents in the defendants’ special care units.

These units were at the center of the lawsuit. The accusations painted a picture of unethical behavior, with companies more focused on earning profits than on providing the necessary care.

The $60 Million Lawsuit Details

This $60 million lawsuit against Meridian and Affinity was indeed a big deal. The case accused these companies of defrauding the U.S. and the state of North Carolina by submitting false Medicaid claims. Both sides had strong arguments, with the plaintiffs saying the fraud was deliberate, while the defense claimed it was just a mix-up with Medicaid billing rules.

Legal Arguments and Claims

The plaintiffs leaned heavily on the False Claims Act, a federal law that targets fraud against the government. They argued that Meridian knowingly defrauded Medicaid for personal care services in its special care units, which means charging for more care hours than were provided.

This lawsuit also claimed that Meridian didn’t follow North Carolina’s Medicaid billing rules, especially when calculating the maximum allowed charges. On the other hand, Meridian and its related entities defended their actions by saying that their billing practices were in line with state regulations and that any mistakes were due to the complicated nature of billing, not fraud.

Evidence Presented in the Case

The evidence against Meridian was quite challenging to ignore. Whistleblowers from within the company revealed that they often billed Medicaid for more hours than their staff actually worked. Financial records, such as budgets and audited statements, showed that the facilities didn’t have enough staff to provide the care they were charging for.

Internal logs and employee documents presented even more issues by showing a clear mismatch between the services documented and the hours billed. This evidence made the plaintiffs’ case even stronger.

The Impact on Residents and Medicaid Program

This lawsuit might have had serious consequences for the company, any resident in their care, and the Medicaid programs as a whole. The allegations of fraud show how cutting corners to earn more profit can negatively impact people who rely on these services. The lawsuit highlighted how fraud might affect the quality of care for patients who could’ve been cured with the wasted resources.

Quality of Care Concerns

Residents in the defendants’ special care units likely suffered the most from this fraud. The lawsuit showed that understaffing was a major issue at Meridian facilities.

When there aren’t enough caregivers, residents don’t get the attention they need. This lack can lead to serious problems such as neglect, poor hygiene, and missed medical treatments.

Also, the lack of staff members means that residents who need extra help and monitoring are at a higher risk of health issues. The understaffing likely created a stressful environment for residents and the few employees trying to keep up.

Financial Implications for Medicaid

Overbilling for services that weren’t provided wasted millions of dollars that could have been used to help other Medicaid recipients who genuinely needed care. The fraud can put an enormous strain on the Medicaid program and taxpayers in the state of North Carolina because it takes money away from other important services.

Plus, this allegation makes Medicaid spend more on oversight and investigations. These incidents can make taxpayers lose trust in Medicaid and make it more difficult for the program to do its job well.

Legal Precedents and Broader Implications

The lawsuit is part of a bigger trend of legal battles against Medicaid fraud and nursing home abuse. This claim isn’t the first case of its kind, and the review shows ongoing problems in the healthcare industry. It highlights how widespread and harmful fraud can be—financially and for the care residents receive.

Comparison to Similar Cases

When we compare the Meridian case to others, like the one against Vanguard Healthcare, we can see some clear similarities and differences. Both instances involved billing claims for services that weren’t provided or were below standard.

In the Vanguard case, the company was accused of charging for nonexistent or poorly delivered services. This proceeding is similar to the Meridian case, where the facilities overbilled their special care units.

However, while Meridian focused a lot on the impact of understaffing in these units, other cases might focus more on fabricating services altogether. These cases often result in hefty fines or even criminal charges. However, each case has its own unique details, which affect how it’s handled.

Implications for the Nursing Home Industry

If the Meridian lawsuit had been successful, it could have led to big changes in the nursing home industry in North Carolina and other parts of the U.S. There might have been reimbursement, more regulatory scrutiny, and a push for stricter rules, which might have made nursing homes rethink their actions to avoid similar legal troubles.

Conclusion

The $60 million lawsuit against Meridian Senior Living in North Carolina revealed serious issues in the nursing home industry. With the principal owner at the center of the allegations, it opened everyone’s eyes and showed how fraud can harm residents and the Medicaid Program.

It’s important to hold these facilities accountable. Constant vigilance is a must to prevent similar situations from happening in the future and ensure that nursing homes provide the care they promise. If your loved one has suffered abuse or neglect at a nursing home, get in touch with our nursing home abuse lawyers today.