CLEVELAND, Tenn. — Federal prosecutors claim a Medicare fraud scheme at Cleveland, Tenn.-based Life Care Centers of America was cooked up and enforced by management.

According to recently unsealed court records obtained by the Chattanooga Times Free Press, managers are accused of instructing therapists to assign patients to the highest level of therapy regardless of what was needed.

The “Ultra High” level and can pay a provider as much as $564, while the lowest rate of therapy pays $231.

The whistleblower lawsuits claim managers set the number of therapy minutes “sometimes over the express objections and recommendations of therapists.” And they pushed therapists to approach patients “seven to eight times a day to meet the number of assigned minutes.”

The lawsuits claim that employees who questioned the policies were often fired within weeks.

The suits also claim that company founder and sole shareholder, Forrest Preston, forbade his own compliance department from conducting unannounced inspections.

Life Care is the nation’s largest private nursing home company with more than 200 facilities in 28 states.

Company representatives declined comment to the newspaper, referring reporters to a letter stating that Life Care’s therapy programs improve patients’ conditions and quality of life.

According to court documents, in 2005, Preston, Chief Operating Officer Cathy Murray and Senior Vice President of Rehabilitation Services Michael Reams formed the “Rehabilitation Opportunity Committee” to increase Medicare revenue through higher therapy levels and more days spent in the facilities.

Court documents claim that Murray frequently told her employees that “their job was to make money for Forrest Preston.”

Prosecutors claim that companywide fraud began as early as 2006 and persisted until at least 2011. During that period, Life Care received $4.2 billion in Medicare reimbursements.

By 2008 Life Care was billing 68 percent of its Medicare therapies at the Ultra High level, nearly twice the national average of 35 percent, according to documents.

That same year, two former employees in separate cases filed whistle-blower lawsuits against the company. Those suits have since been consolidated.

Glenda Martin, a registered nurse and former staff development coordinator at the company’s Morristown location, and Tammie Taylor, a former occupational therapist at the company’s Lauderhill, Fla., site, are listed as the whistleblowers in the case.

If found guilty, Life Care could face hundreds of millions in fines.__