Medicaid

Lakeridge Villa Health Care Ctr. v. Leavitt, 2006 U.S. App. LEXIS 27338 (6th Cir. 2006)

Lakeridge is an Ohio nursing home that participates in Medicare and Medicaid. When it was surveyed, it was found out of compliance with several provider requirements. It was fined a civil monetary penalty of $80,300. The fine was upheld and affirmed on appeal. Among the violations cited were “one violation of 42 C.F.R. § 483.25(h)(2), creating immediate jeopardy, and violations of 42 C.F.R. § 483.13, 483.25, 483.25(c), and 483.25(d)(2), not producing immediate jeopardy.” The most serious violation related to section 483.25(h)(2), which requires facilities to provide adequate supervision and assistance devices to prevent accidents. One of the facility’s arguments in response was that no actual harm resulted. The Court found that actual harm is not required for the nursing home to violate a provider agreement. The Court rejected the nursing home’s argument that the fine was excessive. Similarly, it rejected the argument that a fine cannot be imposed while the facility is implementing a plan of correction.

Note: Below, the ALJ determined that 42 C.F.R. § 483.25 was violated by not providing care consistent with that provided in the plan of care for each resident.

Published by
David McGuffey

Recent Posts

Medicaid Estate Recovery – 50 States

The Estate Recovery Rules vary from State to State. The federal minimum requires states to…

3 days ago

Rights of the ward; impact on voting and testamentary capacity; O.C.G.A. § 29-4-20

Georgia Guardianship law presupposes that the guardian must act in the best interests of the…

1 week ago

Georgia Medicaid Applicants No Longer Required to Apply for Other Benefits

Medicaid is the payer of last resort so applicants have, historically, been required to apply…

2 weeks ago

2026 Community Spouse Income and Resource Allowances

Effective January 1, 2026, the Community Spouse Resource Allowance will increase to $162,660.00. The combined…

2 weeks ago

Temporary medical consent guardianship; O.C.G.A. § 29-4-18

In some cases, no one can be found who will consent to medical procedures for…

2 weeks ago

Conduct of emergency guardianship hearing; limitations on emergency guardianship; O.C.G.A. § 29-4-16

If an emergency guardianship is warranted, O.C.G.A. § 29-4-16 sets the requirements for how the…

2 weeks ago