Delayed Discharges Sample Clauses

Delayed Discharges. During 2008 to 2012 (the “Relevant Period”, Elant engaged in a practice of delaying or postponing discharges of short-term residents, who were clinically ready to leave the facility, against the wishes and/or without the informed consent of the residents and their families; Elant's goals in delaying discharges were to maintain revenues derived from residents receiving rehabilitation services, and to keep census in the Elant Homes above the 95% occupancy level necessary under Medicaid rules to permit an operator to receive daily Medicaid reimbursement and hold a bed open for a resident in the hospital or temporarily away from the facility; Elant nursing home administrators were directed by Elant senior management to limit scheduled or "planned" discharges of short-term, rehabilitation residents to two or three residents per week and to engage in various practices that improperly prolonged resident stays and avoided discharges, including but not limited to, providing residents with additional services that were not clinically necessary, avoiding residents and their families who were actively seeking discharge, and delaying the completion of paperwork necessary for processing and effectuating discharges; these discharge practices pertained primarily to residents covered by Medicaid and Medicare; as a result of the above-described discharge practices, Elant billed Medicaid and Medicare for services that were not medically necessary in violation of 18 NYCRR § 515.2(b)(I)(c); in connection with these discharge practices, Elant also failed to disclose to residents that delays were due to low census levels or to improve Elant's finances and therefore resulted in the inability of residents to make informed choices as to their dates of discharge, showed a disregard for residents' rights in violation of 18 NYCRR § 515.2(b)(I)(c) and § 518.1 (c), and Public Health Law§§ 2803-c(a),(e) and (g), and abused the Medicaid program in violation of 18 NYCRR § 515.l(b)(l);