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Care homes used untrained rehab workers while collecting millions from Medicaid

Seven adult care homes in North Carolina collected more than $8.4 million in Medicaid funding while employing untrained caregivers, some with serious criminal histories, Reveal from The Center for Investigative Reporting has found.

Medicaid-funded caregivers in North Carolina are required to receive at least 80 hours of training within six months of being hired and can’t have criminal convictions for drug trafficking or other specific crimes.

But Reveal found many workers in the homes who said they received little to no training and identified several with criminal convictions that should have barred them from providing Medicaid-funded care.

The workers were participants in a drug rehab program called Recovery Connections Community . Rather than get treatment for their addictions, participants were required to work more than 16-hour days without pay, bathing, feeding and caring for elderly and disabled patients in care homes.

Jason Weinstock, a former Medicaid fraud prosecutor and investigator for the U.S. Health and Human Services Department’s inspector general, said this arrangement raises serious red flags. If he had received this information when he was a prosecutor, Weinstock said he would have opened an investigation.

“The criminal record thing is pretty concerning,” he said. “Any payments that are made for services by facility employees who have prohibited criminal histories or don’t have the required training are impermissible payments.”

Reveal could not determine whether the homes billed Medicaid for the rehab workers’ labor. If the homes knowingly skirted the rules by billing for the services of unqualified workers, they could face fraud charges. Even if they did not know, they could be forced to repay the government for any improper payments.

“No matter what, that money should go back,” Weinstock said.

The payments spanned a six-year period. Administrators from four of the care homes denied they billed Medicaid for unqualified workers. They told Reveal that all the rehab workers were properly trained and vetted.

“While I can certainly appreciate your desire to find Medicaid fraud or inadequate training, you’ll find neither here,” Chris Damiani, CEO of Integrity Senior Properties Investments, which owns three of the homes, wrote in an email.

Fred Leonard, owner of Cedarbrook Residential Center, said all rehab workers received the proper training.

“Cedarbrook has never worked any personal care aide past the six month timeframe without ensuring their participation in the 80 hour class,” he wrote in an email.

An administrator from the Marjorie McCune Memorial Center declined to comment on the home’s Medicaid billing practices. The other homes did not respond to requests for comment.

However, at least 15 participants who stayed in the program longer than six months told Reveal that they never received the required training. Participants who left the program prior to six months said they received little training or none at all.

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