Judge allows nursing homes to continue fight over $5 million staffing bill

A federal judge has allowed a nursing home chain to fight a $5 million claim from a temporary staffing firm, finding that the vendor made “credible” claims that billings lacked documentation of staffing changes.

Utah-based Nursa initially sued Oxford Valley Health in U.S. District Court, seeking payment of unpaid bills accumulating over just over a year, including $4.2 million in nurse placement fees and about $781,000 for late payment. Interest continues to accrue.

Oxford Valley in March replied with a major lawsuit of its own, alleging that the software-based staffing agency failed to live up to its end of the 2022 contract by billing for work shifts in which “a significant portion… did not have any clock in/out records or any other form of documentation certifying that the physician performed work during the billed shifts.”

This summer, Nurse asked the court to dismiss Oxford’s claim, saying Oxford must dispute any “accounting discrepancies” within the time limit provided in the agreement. Nurse’s proposal went further, arguing that nothing in her agreement with Oxford prevented the HR app from charging fees for services that were not provided.

Judge Anne Marie McIff Allen of the U.S. District Court for Utah rejected Nurse’s attempt to shift blame to the provider in a short but forceful six-page order dated Oct. 21 denying a motion to dismiss the case.

She cited language in the agreement that required Nurse to document the job ID, physician name, start time, end time, break length, hours worked, billing amount and total billed amount. Nurse said such documentation “will accurately reflect completed and verified (manual or automated) shift reports” from her application.

“Assuming that this allegation is true, as the Court should at this stage, Nurse did not ‘document… the start time, the end time, the length of the break (if any) (and) the total number of hours worked… as she agreed to do,'” McIff Allen wrote.

“Nursa focuses only on whether the documentation has been “verified.” However, even assuming that the documentation is verified, it must accurately reflect the information from the completed shift reports,” she continued. “The counterclaim alleges that Nurse billed for services without time records or other documentation to show that any physician worked the shift. Thus, rather than billing based on documentation that “accurately reflects the work performed. . . shift reports,” Nursa allegedly issued an invoice on some other basis.

A spokeswoman for the staffing app said late Monday that the company was preparing a response to the judge.

“Nursa partners with thousands of healthcare providers throughout the United States. We are fully transparent about our terms of service up front and throughout the duration of each contract. The vast majority of our customers have no problem making on-time payments, which is critical to ensuring nurses are compensated for the life-saving care they provide,” the spokeswoman said. McKnight Long Term Care News. “Unfortunately, when our efforts to resolve overdue accounts are rejected and when an institution declares its intent to evade payment for services rendered, we are left with no choice but to seek legal assistance. We are very confident in our position and hope to resolve this issue through the court system.”

Meanwhile, an Oxford Valley spokesperson said the case will now move to discovery and the class certification process. The provider’s lawyer previously reported this. McKeith it was pursuing its case as a class action because “we, like many others, feel that we have been taken advantage of by people like Nursa, who threatened, and then did, cut off our access to their services as soon as we raised concerns about regarding significant over-invoicing.

Among the main concerns raised by Oxford Valley was the interim application’s use of a 48-hour account verification window. Accounts not disputed at the time were considered automatically verified by the staffing company.

At the time the case was filed, the New Jersey operator had three facilities in Arizona and Nevada; The company recently added 11 healthcare facilities in Pennsylvania as part of Guardian Healthcare’s bankruptcy restructuring.

He argued that the bills were inflated by $4.2 million, meaning that Nurse “knew or should have known that she was seeking payment from Oxford for medical services that were not provided.”