Wingate Healthcare Blames Contractor for False Medicare Claims

The owners of Haverhill’s Wingate nursing home, which agreed yesterday to pay $3.9 million to settle Medicare fraud claims, is blaming a “a third party contractor” for filing “inflated therapy reimbursement claims” with the government.

Wingate Healthcare is among five companies paying more than $133 million to settle healthcare invoices sent to the federal government “based on unreasonable, unnecessary, or unskilled therapy, or on therapy that never occurred.” Besides Wingate Healthcare, claims were brought against RehabCare, now a part of Kindred Healthcare, of Louisville, Ky., Essex Group Management, Fundamental Administrative Services, and Frederick County (Maryland).

“We have worked closely with the U.S. Attorney’s office since this issue was raised in 2011 and continue to improve our compliance program, which has been in effect for over 15 years, ensuring improved oversight of our third party contractors and continually adopting best practices in the industry,” said Kathy Campbell, Wingate’s vice president of clinical services.

At the end of December, Haverhill city councilors approved a Wingate subsidiary’s downsized, 64-unit assisted living complex off North Avenue. The special permit, issued to Continental Wingate Development Company of Needham, allows the company to build an assisted living and memory care complex on eight acres of land near the existing Wingate at Haverhill nursing home. Councilors unanimously rejected the project last February, but the developer filed suit in Essex County Land Court.

“This settlement concerns a third party contractor and associated Medicare billing and not patient care. We are confident that all of our patients have and continue to receive the care that they need. This is supported by the key industry quality measures, as reported by the federal government, including length of stay and re-hospitalizations. When compared to most other nursing homes, Wingate’s patients have shorter lengths of stay and lower rates of hospital readmission, which demonstrates that they are receiving comprehensive rehab services required to safely return home. Not only are these the most important quality measures, they are central elements of improving our patients’ quality of life and reducing costs, the primary goal of health care reform. Wingate has long prided itself on providing our patients with the highest level of care needed so that they can return to their normal lives,” Campbell said.

2 thoughts on “Wingate Healthcare Blames Contractor for False Medicare Claims

  1. Kathy Campbell appears to NOT be addressing the fraud claims. She is tooting the horn or the facility for taking such good care of patients….. Patient care may be top notch, but the issue is that Wingate has been accused of and has agreed to pay back nearly four million dollars to settle FRAUDULENT MEDICARE CLAIMS. This is THEIR third party contractor, for whom Wingate is responsible and who they hired to file and process claims. Someone at Wingate did NOT do their due diligence in the first place, or they took their eye off the billing ball and allowed erroneous billing to take place.

    • Good points. I am surprised there was no checks and balances program put into place to keep an eye on these contractors. But, I ma sure they never expected this to hap[pen. Just like the city of Haverhill never expected Quorum management to be cooking the books at the old Hale hospital.