Nurses Fight Back and Win

I’ve represented nurses for over 35 years.  I’ve listened as hundreds of nurses describe their struggles with administrators determined to cut corners to make money.  They tell of staffing problems that make it impossible for them to provide the care their patients desperately need.  When the nurse complains too loudly, she finds herself fired or reported to the Nursing Board on trumped up charges.  As North Carolina law provides little recourse for mistreated employees, nurses often leave the profession for better jobs.  But two nurses recently made headlines.  They fought back and made quite a lot of money doing it.

Vanessa Absher and Lynda Mitchell worked for several years as nurses at the Momence Meadows Nursing Center in Illinois.  Medicare and Medicaid covered the care for most of the patients at the 130 bed skilled nursing facility.  The nurses complained of dismal conditions at the home.  Often, patients did not receive medication, food, or water.  They lay for days in their own excrement.  They developed bed sores, scabies infections, and blood poisoning.  Management ordered staff to falsify patient records, medication charts, and staffing records to hide patient injuries and deaths.  When the nurses objected, the owner ordered them to “shut your mouth.”  Management finally fired one of the nurses.  The other one quit.  Neither gave up.

The nurses filed an action under the federal and state False Claims Acts.  They alleged that Momence had fraudulently billed the government for care that it did not provide to the patients.  They also claimed that Momence fired them for blowing the whistle on the draconian conditions at the home. 

As Momence would soon learn, the law imposes extreme penalties for filing fraudulent claims for government money.  Assume the defendant files a false Medicare claim for $25.00.  Initially, the penalty is three times the amount of the false claim.  Now, the defendant has to reimburse the government $75.00.  But, an additional penalty of up to $10,000 can be added for each false claim. 

Based on these laws, the jury returned a verdict of over $28 million against Momence.  Because whistleblowers are entitled to a share of the damages awarded, the nurses’ share could total more than $7 million, plus court costs and attorney fees.  This is in addition to the $400,000 that the jury awarded the nurses in connection with their own claims against the defendant.

It took almost nine years for the nurses to get a jury verdict in the Momence case.  Appeals can tie up the courts for several years to come.  And the nurses may have a bit of trouble collecting their money.  Courts earlier ruled that Momence’s insurance company was not liable for the damages.  Accordingly, the defendants’ assets are the sole source of funds for the verdict.  Fortunately, the defendants can’t discharge the debt in bankruptcy court.  And the government will help the nurses collect the damages.  Even the Mafia has paid up when the government demands its money.

North Carolina has its own False Claims Act.  It provides for treble damages and penalties of up to $11,000 for each false claim.  Whistleblowers can receive up to 30% of damages collected.  In addition, any whistleblower who suffers retaliation from his employer-defendant is entitled to reinstatement and twice the lost back pay.  Again, the employee is entitled to attorney fees and court costs.

The state and federal False Claims Acts give nurses and other health care workers powerful weapons to use in fighting back against employers who commit health care fraud – even in North Carolina.