A nursing home facility that operates across the Capital Region is paying over $21 million to settle claims they billed the federal government for programs that were unnecessary, or never performed.

The Grand Health Care, known formally as Strauss Ventures LLC, operates 12 skilled nursing facilities, including in Albany, Oneida, Madison, Columbia and Herkimer counties.

Prosecutors alleged that from Jan. 1, 2014 through Sept. 30, 2019, The Grand knowingly submitted false claims for rehabilitation therapy. This included bills for more therapy that was necessary, or in some cases where the therapists did not provide the amount of therapy documented, the U.S. Attorney’s Office said.

The Grand admitted that the now-former managers of the facilities implemented quotas for how long each person needed to stay at the facility and wanted to ensure that patients received the most services to result in the maximum billing from Medicare. This resulted in some Medicare beneficiaries staying for longer than necessary.    

In some instances, supervisors did not personally evaluate or treat patients. They also falsified the number of therapy minutes in The Grand’s electronic recordkeeping system.

“Today’s settlement protects patients and taxpayers by ensuring that medical treatment is dictated by patient need and not by financial motive,” said U.S Attorney Carla B. Freedman in a statement. “Skilled nursing facilities provide important services to a vulnerable population, and we will continue to hold them accountable when they provide patients with unnecessary services and falsify records.”

Around $4 million of the settlement will go to two former employees that were whistleblowers to alert authorities to the wrongdoing.

NewsChannel 13 reached out to The Grand for comment. We will let you know if we hear back.