In April of this year, the Medicaid Fraud Control Unit (MFCU) prosecuted Vicky Williams, a CNA who had been employed at Beth Abraham Health Services Facility, for falsifying records of a resident at the home. The resident in question was at risk for wandering and elopement, and in fact did elope from the facility early one morning just before 2:00 a.m. Nurse Williams, despite the fact that the resident was not even on the premises, documented hourly checks as routine for the hours of 3:00 a.m. to 7:00 a.m.
The mission of Medicaid Fraud Control Unit is to identify and prosecute providers who attempt to defraud Medicaid. The MFCU tries to prevent a facility or provider from billing Medicaid recipients for services not rendered, as well as to prevent falsification of records, among other aspects of the Unit. Ultimately the MFCU exists as much to protect Medicaid recipients as it does to prosecute the fraudulent providers. The case of Nurse Williams illustrates just such a scenario, as she falsified the resident’s records while claiming to have provided services not rendered.
Additional recent actions by the MFCU, as well as other actions against New York nursing homes, can be found in the Long Term Care Community Coalition Quarterly Enforcement Newsletter.