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Ambulance service sues Augusta nursing home over non-emergency calls

Augusta Chronicle - 4/14/2019

April 14-- Apr. 14--An ambulance service has filed suit against an Augusta nursing home alleging its staff has ignored repeated explanations that it can only provide emergency transportation and the home should repay $151,281 that Medicare won't reimburse.

Regional Services, which operates South Star Ambulance Service, filed the Richmond County Superior Court lawsuit Monday against Pruitthealth -- Augusta Hills, which is located on Cumming Road in west Augusta. The lawsuit alleges that the home bills Medicare for patients services and could apply for reimbursement for non-emergency ambulance transport, a program in which South Star is not enrolled, according to the lawsuit.

The lawsuit contends South Star personnel repeatedly advised Pruitthealth -- Augusta Hills that it is only an emergency ambulance service, but the nursing home continues to use South Star as a non-emergency transport services. From Aug. 1, 2016, to Sept. 11, 2018, the home owes South Star more than $150,000 for services, the company contends.

A spokeswoman at the home said she could not comment.

Pruitthealth -- Augusta Hills has the lowest rating of any Augusta nursing home, according to the most recent inspection reports filed with the Centers for Medicare & Medicaid Services. Of out a possible five stars, five stars being the top rating, Pruitthealth -- Augusta Hills scored one star, which is much below average, for overall quality. The staffing rating for the home was much below average concerning the average time each registered nurse has for each patient daily -- 17 minutes. The state average was 24 minutes and the national average was 40 minutes.

In other quality measures, the home fell short: 31.7 percent of short-stay residents who were hospitalized after admission compared to 20.9 percent for Georgia and 22.3 percent for the nation. And the percentage of long-stay, high-risk residents with pressure sores was 11.5 percent compared to 6.6 percent for Georgia and 5.5 percent for the nation.

Pruitthealth on Cumming Road is one of the corporation's 180 homes in Georgia, Florida, South Carolina and North Carolina. Pruitthealth -- Augusta Hills scored well in the corporate quality report. The home also had no health deficiencies noted during its latest government inspection on Nov. 29.

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