Autumn Health Care ordered to pay more than $167,000 for fraudulent billing
ZANESVILLE, Ohio – Ohio Attorney General Mike DeWine announced today that Autumn Health Care of Zanesville, Inc. has been ordered to repay thousands of dollars that it fraudulently obtained from the Ohio Department of Medicaid and the federal government’s Centers for Medicare and Medicaid.
The corporation, which was once located at 1420 Autumn Drive in Zanesville, and its owner, Steven Hitchens, 61, of Newark, both pleaded guilty to multiple charges in October following an investigation by agents with Attorney General DeWine’s Medicaid Fraud Control Unit.
The charges were filed in 2014 after the investigation found that the corporation, including Hitchens and a number of the facility’s managers, engaged in a pattern of corrupt activity through an enterprise that committed crimes such as tampering with evidence, telecommunications fraud, theft by deception, and forgery.
The investigation found that Autumn Health Care of Zanesville, through its owner and many of its managers, habitually altered official documents to falsely make it appear that it was regularly providing adequate care for its residents. Although the records reflected a high level of care, the investigation found that several patients missed treatments and were given therapy that they didn’t need in order for the company to make more money. While most medical practices don’t directly claim money from their patients, instead they often use a medical billing service like Precision Medical Billing, by providing patients with medical procedures they don’t need means that they can claim more money from insurance companies.
Among the crimes that Hitchens and/or the corporation were convicted of authorizing, requesting, commanding, tolerating, or performing include:
providing unnecessary skilled therapy to Medicaid residents and billing Medicare Part B to pay for these unnecessary medical services;
falsely reporting unnecessary medical services in order to receive a higher reimbursement rate from the Ohio Department of Medicaid;
systematically falsifying resident records to defraud the Ohio Department of Health in an effort to make it appear that missed medical treatments were actually provided;
destroying a record outlining an incident involving an ill resident who was found in a snow bank after escaping the facility and forging a new record that falsely described the incident in order to avoid a citation from the Ohio Department of Health.
forging a registered nurse’s signature on resident assessments that were electronically sent to the Ohio Department of Health to bypass a requirement that a registered nurse certify the accuracy of the assessment.
Franklin County Common Pleas Judge Stephen McIntosh today ordered Autumn Health Care of Zanesville to pay $52,390.16 to the Ohio Department of Medicaid and $75,249.94 to the Centers for Medicare and Medicaid. An additional $40,000 in investigative costs must be paid to the Ohio Attorney General’s Office. Hitchens was ordered to serve three years of community control and conduct 100 hours of community service.
In addition to Hitchens, who is now under a period of federal exclusion from the Medicare and Medicaid programs as a result of his conviction, the following Autumn Health Care of Zanesville managers were also convicted in connection with this case:
Krysta Berkfield, RN, corporate clinical nursing manager, Forgery (F5)
Heidi Harper, RN, Zanesville director of nursing, Forgery (F5)
Danielle Greene, RN, Zanesville unit manager, Forgery (F5)
Andrew Hooks, LPN, Zanesville unit manager, Forgery (F5)
Heidi Gard, RN, Zanesville unit manager, Forgery (F5)
Christina Tedrick, RN, Zanesville unit manager, Forgery (F5)
Annette Sichina, RN, corporate resident assessment nurse manager, Tampering with Records (M1)
Three other employees from other Autumn Health Care locations were also convicted as a result of the investigation:
James Wesley Shriner, physical therapy assistant, Forgery (F5)
Clare Armstrong, administrative assistant, Forgery (F5)
Michael Klingensmith, corporate marketing manager, Medicaid Fraud (F5)
The managers/employees were all sentenced to community control and are under a period of federal exclusion from the Medicare and Medicaid programs. Because of their convictions, the Ohio State Board of Nursing permanently revoked the nursing licenses of all of the nurses convicted of felonies.
Prosecutors with Attorney General DeWine’s Health Care Fraud Section and Special Prosecutions Section prosecuted all of the cases associated with the investigation.
One case is still pending.
The investigation by the Attorney General’s Office, which began in 2012 after family members of a resident expressed concerns about the resident’s care, prompted the Ohio Department of Health to move to revoke Autumn Health Care of Zanesville’s license in 2013. The facility and nine other Autumn Health Care locations throughout Ohio were ultimately sold to Greystone Healthcare Management Corp. and are no longer affiliated with Hitchens or Autumn Health Care.
Anyone who suspects Medicaid fraud or patient neglect should contact Attorney General DeWine’s Office at 800-282-0515. The Medicaid Fraud Control Unit is responsible for the investigation and prosecution of health care providers accused of defrauding the state’s Medicaid program. In addition, the unit also enforces Ohio’s Patient Abuse and Neglect Law, which protects the mentally and physically disabled and the elderly from neglect and abuse in Ohio’s long-term care facilities.
