Va. Nursing Homes' Settlements Hidden

By Gilbert M. Gaul
Washington Post Staff Writer
Monday, August 8, 2005

In April 2004, the U.S. attorney's office for eastern Virginia agreed to what it calls an innovative settlement with a 177-bed nursing home in Fredericksburg. Instead of slapping Beverly Healthcare with a big fine for allegedly providing poor care, it required the owners to invest that money in nursing home improvements, including hiring more employees and a consultant.

All of that might be useful information for patients and families considering the facility. But as part of their settlement, government attorneys agreed not to publicize the case.

It wasn't the first time. In the past four years, the U.S. attorney's office in Alexandria has settled federal allegations of poor care with the owners of seven Virginia nursing homes and two management companies.

In each case, the government agreed to keep the settlements confidential unless the nursing homes decided to go public. Only two have.

Without a promise of confidentiality, U.S. Attorney Paul J. McNulty said, the nursing homes would not agree to the settlements. "Consequences of publicity have to be taken into consideration," he said.

Beverly Healthcare's owners agreed to release details of the settlement after a Washington Post reporter requested it from the U.S. attorney.

Although it is not uncommon for private lawyers to keep settlements secret, the idea that federal prosecutors would withhold information about nursing home quality has confused and angered some advocates.

"I didn't know there were settlements," said Joani F. Latimer, the state's long-term-care ombudsman. "This is the first I've heard of it."

David L. Sadowski, executive director of the Crater District Area Agency on Aging, which provides the elderly with services in the Petersburg region, said: "I'm surprised the U.S. attorney would do that.

"What bothers me is when bureaucrats make these decisions and keep them in some file drawer. It's defeating to the public."

The Virginia settlements appear to run counter to a recent federal effort to make nursing home care more transparent. Since 2003, Medicare has published online information about staffing levels and deficiencies at . In addition, a few U.S. attorneys in other states have listed nursing home settlements on their Web pages.

The issue of disclosing settlements under the False Claims Act, the law used in the cases against the nursing homes, has attracted attention in Congress. Sen. Charles E. Grassley (R-Iowa) introduced a bill this year that would require the Department of Justice to report details of settlements exceeding $100,000.

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