Fla. Assisted Living Facility Charged with Medicaid Fraud

October 22, 2004

Florida Attorney General Charlie Crist and State Attorney Curtis Golden announced the filing of a civil complaint against North Florida Living Facilities Inc., doing business as Willow Grove Assisted Living Facility in Pensacola, for fraudulently billing the Florida Medicaid program.

As part of the Operation Spot Check program, an investigation by the Attorney General’s Medicaid Fraud Control Unit and various agencies reportedly revealed that Willow Grove received Medicaid funds for assistive care services while failing to provide minimum required staffing levels, billing for services not rendered and employing convicted felons to provide personal services to disabled Medicaid recipients.

The Operation Spot Check investigation revealed that from at least January 2002 to March 2002 and from May 2003 to August 2004, the facility did not provide minimum staffing for resident care. From September 2001 to August 2004, the facility reportedly utilized convicted felons, which violates state law. The facility also billed the Florida Medicaid Program for days when recipients were absent from the facility.

Although criminal charges have resulted from previous Spot Check operations around the state, this is the first lawsuit generated from an Operation Spot Check investigation. It is also the first time monetary penalties have been sought to remedy violations of law.

The Attorney General is seeking more than $15,000 in damages. The Willow Grove civil complaint was filed under the Florida False Claims Act, which provides for up to triple damages, along with civil penalties of up to $10,000 per false claim.

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