Bayada Teams Up with CareBridge to Better Manage Health Care Costs

Bayada Home Health Care and CareBridge announced Tuesday that the two companies are teaming up to better manage health care costs.

A nonprofit, the Moorestown, New Jersey-based Bayada provides a range of in-home care services to older adults, children and individuals living with disabilities across 22 states and more than 345 locations. The large home-based care provider also operates in seven other nations.

Meanwhile, CareBridge is an end-to-end technology platform designed to help states and health plans manage patients receiving home- and community-based services.

“As more Americans age, health plans face the challenge of managing health care costs for a growing population of high-risk members, while helping them achieve a better quality of life and outcomes,” Bayada Chief Strategy Officer Heather Helle said in a statement. “Pairing Bayada’s deep expertise and insights around community health needs and patterns, with CareBridge’s technology-enabled intervention approaches, allows health plans to better predict the risks facing the most vulnerable in society and keep them safe at home, where they thrive best.”

Through the partnership, Bayada will gain access to CareBridge’s portfolio of data analytics tools and other technology designed to manage complex patient populations.

On its end, CareBridge will be able to glean insights from Bayada’s on-the-ground operations. The provider has over 26,000 nurses, home health aides, therapists, medical social workers and other home health professionals in its network.

“We couldn’t think of a better first partner to introduce our technology into home health care than Bayada,” CareBridge CEO Mike Tudeen said in a statement. “As the population continues to age and the demand for home health care increases, it’s important to have collaboration and integrated solutions to ensure care is delivered with quality, efficiency and cost-effectiveness.”

Adults older than 65 account for up to 20% of all emergency department visits and 36% of all hospitalizations, despite representing just 13% of the U.S. population, according to The Journal of Gerontology.

Those statistics suggest there’s a vast need for improved care coordination and predictive modeling in home-based care. 

Nashville, Tennessee-based CareBridge formally launched in early January after announcing an initial $40 million funding round. The startup’s advisers include former U.S. Senate Majority Leader Bill Frist and other well-known in-home care operators, including Bayada’s David Baiada.

CareBridge was formed following the strategic acquisition of HealthStar and Sinq Technologies.

Its investors include Oak HC/FT and GV, the venture capital arm of Google’s parent company.

Prior to serving as CareBridge CEO, Tudeen was CEO of PopHealthcare, a risk-adjustment and complex care company that sold to Guidewell in 2017. He also previously served as CEO of INSPIRIS, an in-home complex care company that sold to Optum in 2011.

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Bayada CEO David Baiada: The Surge Is Real — And It’s Happening to Us

At one point during the spring COVID-19 surge, Bayada Home Health Care and its in-home care workers burned through a year’s worth of personal protective equipment (PPE) in a single week.

Since then, the Moorestown, New Jersey-based home health, hospice and personal care services provider has largely mastered the PPE problem. Now, its biggest challenge is battling through COVID-19 fatigue — a daunting task as new infection numbers continue to climb.

To get an update on Bayada’s current operations, Home Health Care News recently caught up with CEO David Baiada. In addition to the coronavirus, Baiada also touched on a few highlights of 2020 while looking ahead at strategic priorities for next year.

One of the largest in-home care providers in the U.S., Bayada employs more than 26,000 nurses, home health aides, therapists, medical social workers and other professionals. Its global footprint spans 345 locations, with international locations in Canada, Germany, India, Ireland and three other countries.

You can HHCN’s conversation with Baiada below, edited for length and clarity.

HHCN: How is your team at Bayada doing as we speak here toward the end of November?

Baiada: I’d say we’re doing as well as we can, given the circumstances. There’s clearly a lot happening in the community, a lot happening in organizations like ours. But more than ever, we feel a sense of purpose and commitment to playing our part in keeping people safe, healthy and independent at home. The current environment only shines a brighter spotlight on that opportunity and responsibility.

Everyone has seen the headlines about daily new infection numbers across the U.S. Are you seeing that impact on the ground within your operations?

Oh, yeah. We see all the same formal data, of course, that is available to everyone. But we also have lots of informal indicators that we keep an eye on, whether it’s activity with our referral sources or volume through our COVID command center. We look at the volume going into our call center teams, people with questions about exposure and protocols, etc. We’ve seen increases in these informal indicators that are consistent with what you’re seeing in the news and in the formal data.

How does what you’re seeing now compared to what you saw in March and April?

Well, I think the data feels similar. The surge is real — and it’s happening to us. I think, though, there are a lot of things that are very different. Clearly, we feel more prepared for what to do about that surge. We feel like we’re in a much better position around our understanding of protocol, around PPE availability, sourcing and distribution. We now know how to adapt our business and communication processes to navigate periods of surge. So, I’d say on the one hand, we’re seeing all the same indicators. But we do feel better prepared.

The only thing that advantage of preparation and experience might be offset by is just a sense of fatigue. In society at large and in an organization on the front lines like ours, I think there’s a sense of fatigue. You know, “Wow! We got to go through this again? It was hard enough the first time.” That’s something we spend a lot of time thinking about.

The No. 1 challenge early on seemed like getting enough personal protective equipment. I think you guys pointed out that you had gone through a year’s worth of PPE in a week. How’s that situation now?

We feel quite good about our supply levels and distribution, in addition to access to future supplies through our vendors. Clearly, we’re still concerned about the cost burden. We’re also not a supply-chain organization. Real-time fulfillment and distribution to our clinicians in the home is a constant learning experience. But relative to the spring, we feel much more prepared and well-supplied than we were then.

What would you say the No. 1 challenge is then? Is it staffing and making sure that those folks who are feeling the fatigue are supported?

Yes. Again, I think it’s the, very broadly stated, sense of fatigue. That fatigue is rooted not just in the constant unpredictability of the care situation we face with our clients, partners and our staff, but also the situations that our team members are facing in their personal lives. I’m talking about, for example, having kids and the unpredictability of school situations. People may have friends and loved ones facing COVID-19 in one form or another. There’s unpredictability around whether it’s okay to go to a restaurant or not outside of work. I mean, these sorts of things create a lot of energy-drain on people.

As a nonprofit, Bayada is a very mission-focused organization. I know the financial impact of COVID-19 isn’t your top concern. Still, can you talk a little more about the financial challenges?

Financially or otherwise, this has been anything but what we expected 2020 to be. Like most organizations that provide home- and community-based services of any type, we faced a lot of financial ambiguity and stress early on, particularly as we saw volumes drop precipitously over the course of just a few weeks. But I do think the bigger story here is a long-term view on how the spotlight is being shined on the importance of staying safe and healthy at home. That’s everything we represent and stand for.

So in the long run, we’re seeing more opportunities to be a meaningful part of the future health care delivery system. That’s real and important. Being the driving force in health care’s future, to me, is huge. It’s a beneficial long-term financial story, but more importantly a beneficial long-term societal health and wellness story.

What have been the most helpful federal or state-level measures enacted for Bayada? The Provider Relief Fund? Certain Medicare waivers?

We operate in 23 states and eight countries. We’ve experienced all the interesting flavors of federal and local support. I think the thing that has been most important but least consistent is the recognition that our front-line workers are our most important resource in the fight against COVID-19. I’m talking about thinking creatively about how to ensure organizations have the funding to be able to adequately pay front-line workers and recognize them for rising above, for answering the call of duty to help people at home in a period of uncertainty.

Bigger picture, a lot of attention is being paid to how you virtualize health care. Everyone is trying to figure out how to, you know, improve outcomes and experiences at a lower cost through use of virtual care and telemedicine. I think the spotlight that COVID-19 is placing on the opportunity to be more creative around virtual care — and the ways in which the government is creating regulatory relaxation or reimbursement structures to support that — is super, super important.

Can you talk a little bit more about that international presence? I can’t really imagine how difficult it must be to manage U.S. operations across multiple states, then have to think about what’s going on in India, for example.

It clearly adds a level of complexity. Every town, city, state, country is different, whether it’s domestic or international. But at Bayada, we really think about running our various locations at the local level. We have a lot of great social entrepreneurs. Whether they’re in Indiana or India, it’s all about having a team that’s committed and aligned with a common purpose. All of our locations have had to be creative, flexible and determined to figure out how to adapt to a crazy environment.

Let’s press pause on COVID-19 for a second. And I want to talk about some of the bright spots for Bayada in 2020. What are your highlights of this year? For example, I know Bayada recently announced a big JV partnership with Baptist Health in Florida.

Yeah, we’re proud of the Baptist relationship. I think it’s an amazing organization and a part of Florida where Bayada doesn’t currently have a presence. We’re also excited by how that relationship is a positive indication of something that we’ve been helping foster for many years — really strategic thinking by health systems. Systems are more often thinking about the ways in which we can align with them, strategically. They want to bring best-in-class home- and community-based capabilities into their networks.

It’s hard to predict the future right now, but what’s in store for Bayada in 2021, in terms of priorities, growth plans and other strategic initiatives?

I will try to set COVID aside, though, it is an undercurrent that runs through everything that we’re doing and thinking about.

Our first and most important priority is people. How do we continue to attract, engage, develop and support amazing people and teams committed to delivering amazing services? We’re hugely focused on talent — all things talent.

The second is that we’re thinking a lot about digital transformationI. In addition to what’s instigated by COVID, how do we begin to accelerate how we invest in things like automation and artificial intelligence? How do we invest in the clinical virtual health tools and technology to really transform the way our services are delivered over the next 10 years?

Then third, how do both of those first two things — talent and digital transformation — support our continued growth as a mission-driven social entrepreneurial growth company.

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How Home Health Agencies Can Build Stronger Relationships with Senior Living Operators

During the COVID-19 crisis, senior living communities and long-term care facilities have sometimes been wary about letting outsiders onto their premises, including home health and hospice clinicians.

That has repeatedly been a major challenge and point of concern for home health providers over the past several months, at times even leading to significant dips in revenue and worsening health conditions for patients.

In some cases, however, COVID-19 has been a catalyst to better relationships between home health and senior living operators. The keys to those successful relationships have been communication and a commitment to best practices.

“We do stay in constant communication with our partners,” Izzy Porter, a senior living program manager for Bayada Home Health Care, told Home Health Care News. “That coordination and collaboration is, I think, what really helps us stay successful in keeping our clinicians [and residents] safe.”

Moorestown, New Jersey-based Bayada is one of the largest nonprofit providers of home health and post-acute care services in the U.S. The company provides a range of in-home care services to adults and children across 345 locations in 22 states as well as seven other countries.

Its senior living partnerships have grown stronger throughout the pandemic, according to Porter.

While Porter’s job has intensified with COVID-19, the results of her work have gone a long way.

With less exposure to the outside world, senior living residents have been more susceptible to muscle weakness and subsequent falls. That’s why, on Bayada’s end, it has worked so hard to keep its employees safely entering facilities to see patients.

“We are seeing a lot of residents who aren’t necessarily impacted with COVID itself,” Porter said. “But what we are seeing is some of those secondary effects due to different communities adjusting their visitation schedules or disallowing residents to go and see family. So we’re seeing a lot of people who are a little bit deconditioned because they’re not engaging in the activities that they used to.”

Karen Garland — the regional director of Exton, Pennsylvania-based Vantage Point Retirement Living — has witnessed similar issues, she told HHCN.

“[Seniors] have been quite isolated,” Garland said. “They have been limited in their ability to have people visit because of certain restrictions or safety measures. And obviously, when you live in one of these areas, or one of these settings, it’s supposed to be about family involvement.”

Vantage Point Retirement Living provides residential options to seniors in Pennsylvania, Delaware and Maryland. As a part of its network, the company offers active adult, full service retirement and senior living communities.

Garland will serve as the executive director of Arcadia at Limerick Pointe, one of Vantage Point’s newest senior living communities. Limerick, Pennsylvania-based Arcadia at Limerick Pointe is a faith-inspired senior living community offering independent living, supportive personal care and memory care.

It is set to open later this year, with support from Bayada to facilitate home health services.

Instead of accepting the emotional and physical toll that comes with COVID-19 as just another reality during a pandemic, Bayada and Vantage Point employees have worked hard at making their relationship work for the betterment of their seniors’ situations.

“With COVID, we wanted to partner with people who have really been right in the trenches like Bayada has,” Garland said. “Whether it’s been in home health, assisted living or personal care, they’ve been right there [through it all].”

When looking at home health providers to partner with, Vantage Point considers many things, but especially staffing. That way, when things get tough, the home health provider is able to fill staffing gaps with ease and has the resources to keep caring for seniors inside of communities in a safe manner.

Vantage Point also wants home health workers to understand — and be a part of — the senior living community.

Bayada’s openness to sitting down with senior living providers’ executives and finding out how they can service their communities better has been “very important” to Vantage Point, Garland said.

“We have certain policies and procedures in place to ensure the safety of our members — and that is very, very big,” Garland said. “So we’re looking to partner with people who are open minded, who are aware of best policies and best practices, and who will be excited to learn about our community and our company.”

From Porter’s standpoint, that means reaching out to Bayada’s senior living partners on a daily basis.

“For me, it makes me feel a lot better when, if there’s a small change,” Porter said. “I get an email from the community itself, because then everyone is on the same page.”

Bayada’s goal is to be the eyes and the ears of its senior living partners’ communities. Its caregivers and clinicians strive to be there to help with anything, from personal assistance to screenings.

Its methods have enabled it to maintain its partnerships with facility-based providers nationwide — and more importantly, keep prioritizing seniors’ health within those communities.

“Our plan isn’t to be just a provider,” Porter said. “Our plan is to make it so that residents see us and they feel like we are part of the community, because we have dedicated teams that are in these communities. We’re limiting people’s visits between different places, which does help to prevent the spread. But it also helps to make people feel a little bit more at ease.”

Senior living providers have become more interested in home- and community-based care themselves over the years. Over half of the U.S.’s largest nonprofit senior living organizations now offer some sort of home- and community-based services, according to a recent report from LeadingAge and Ziegler.

Nearly 65% of the largest 25 providers offered some sort of home- or community-based service.
Garland and Porter will discuss COVID-19’s impact on aging services providers and seniors during a Wednesday webinar.

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Bayada, Baptist Health Announce New Joint Venture

Bayada Home Health Care — one of the largest nonprofit providers of in-home care and post-acute care services in the country — is expanding its already massive footprint.

It’s doing so at a time when the need for home-based care is at an all-time high.

On Thursday, the Moorestown, New Jersey-based company announced it is forming a new joint venture with Baptist Health, a faith-based, mission-driven health system in Northeast Florida. The new JV will be known as “Baptist Home Health Care by Bayada” and begin operations in early 2021, pending licensing and regulatory approvals.

“This partnership enables Baptist Health to provide a wider array of in-home services to help people with multiple chronic conditions as well as patients recovering from an illness, injury or recent hospitalization,” Joe Mitrick, president of transitional care for Baptist Health and the hospital president of Baptist Beaches, said in a statement. “The demand for high-quality home health care services is rising, and there has never been a better time to build on our legacy of care for the community.”

As an overall system, Baptist Health comprises Baptist Medical Center Beaches, Baptist Medical Center Jacksonville, Baptist Medical Center Nassau, Baptist Medical Center South and Baptist Clay Medical Campus. The system also runs Wolfson Children’s Hospital, Northeast Florida’s only children’s hospital.

Bayada — which transitioned to nonprofit status in 2018 — provides a range of in-home care services to adults and children via its 345 total locations. Its U.S. footprint spans 22 states, with additional areas of operation in Canada, Germany, India and four other countries.

Among the strategic advantages, Baptist’s new joint venture with Bayada will allow the system to care for more of its patients in the home setting, something it had already been doing for 25 years.

An increasing number of health systems and hospitals are forging similar relationships with home-based care operators, which are generally better positioned to navigate the series of regulatory and payment changes currently taking place.

Teaming up with home health organizations also often gives systems an edge when it comes to avoiding costly readmissions.

“Health systems and hospitals have a vested interest in the success of their patients after they are discharged,” Bayada CEO David Baiada said in a statement. “With 45 years of home health care expertise grounded in our values of compassion, excellence and reliability, we are recognized as a valuable resource to help keep patients safe at home and out of the hospital.”

Nearly half the nation’s hospitals are getting lower payments for all Medicare patients this year because of their history of readmitting patients, Kaiser Health News recently reported. The penalties are part of the Hospital Readmissions Reduction Program, created under the Affordable Care Act.

Those penalties come at a time when systems and hospitals are already financially stressed, as many have had to postpone or cancel elective procedures due to the COVID-19 virus.

“We are committed to partnering with organizations like Baptist Health to meet the post-acute care needs of patients and other community residents, advancing Bayada’s mission to help millions of people experience a better quality of life in their own homes,” Baiada’s statement continued.

In addition to its core home health and post-acute care services, Bayada also offers non-skilled home care and private-duty nursing services to high-tech pediatric clients. It also delivers physician house calls.

Earl Evans — executive director of Baptist AgeWell, which provides enhanced primary care for adults 65 and older — said Bayada’s mission-driven mindset made it a perfect JV match.

“Baptist Health and Bayada’s culture and values are strongly aligned,” Evans said in a statement.

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Future Leader: Sharon Vogel, Division Director of Strategy and Innovation of Skilled Nursing, Bayada Home Health Care

The Future Leaders Awards program is brought to you in partnership with PointClickCare. The program is designed to recognize up-and-coming industry members who are shaping the next decade of senior housing, skilled nursing, home health and hospice care. To see this year’s future leaders, visit Future Leaders online.

Sharon Vogel, division director of strategy and innovation of skilled nursing at Bayada Home Health Care, has been named a 2020 Future Leader by Home Health Care News parent company Aging Media Network.

To become a Future Leader, an individual is nominated by their peers. The candidate must be a high-performing employee who is 40-years-old or younger, a passionate worker who knows how to put vision into action, and an advocate for seniors, and the committed professionals who ensure their well-being.

Vogel sat down with HHCN to talk about her leadership style and the future of home-based care.

HHCN: Can you tell me a little bit about your current organization and role?

Vogel: My title is the division director of strategy and innovation within the skilled nursing unit. The skilled nursing unit comprises our adult nursing and pediatric practices. It’s the largest unit at Bayada.

My typical day-to-day varies. But in a nutshell, I would say I’m responsible for translating our strategy into a strategic plan and executing against that plan. A lot of my day-to-day involves project management, engaging with initiative leads and stakeholders. I also partner very closely with our practice president, Melinda Phillips, who is a visionary. Often, it’s just about translating that vision into a tactical plan. How do you message that vision, generate excitement, help rally everyone around that vision? A typical day has meetings around any one of those areas that I just described.

What drew you to this industry?

My parents actually owned and operated assisted living facilities in South Florida for over 30 years. I had been working in hospital administration consulting and decided to take a year off and work with my family while applying for business school. I remember my mother introducing me to a nurse who told me I should look into home health and that “brick and mortar” wasn’t the future of care for seniors.

At the time, senior care was what I was interested in. Admittedly, back then, the only exposures to home health I’d had were the visiting nurses that came to administer wound care. I didn’t really appreciate the wide spectrum of services that could be delivered in the home setting until I came to Bayada. I had the opportunity to meet David Baiada and intern for the company.

It was a no brainer — people want to be home. With the advances in medicine and technology, more and more of that care is able to be delivered there.

On a personal level, it’s ironic that my parents were in the assisted living business, because my entire life, I’ve told them I would never “put them in a home.” When the time came, I would want to ensure that they could age in place. Home health care is 100% aligned with my own personal beliefs, values and what I wanted to experience for my loved ones as well.

How would you describe your leadership style?

I would say empowering, collaborative and relatable.

Looking back at the traits and styles of leaders that I’ve admired most in my career, one thing is that they’ve always entrusted me with very important work and giving me the runway to prove that I can do it. I know how important that empowerment was for my own development, so I try and do the same for my team. I’ll always be collaborative, and roll up my sleeves, if needed, to help them. I chose the last term, relatable, because I like to keep it real. I oftentimes will be vulnerable, as a leader, with my team. I think it’s important to let people know that you’ve been there and don’t always have the answers.

I’ve gotten a lot of positive feedback through the years. There’s a quote: “At the end of the day, they may forget what you said, but they will never forget how you made them feel.” That really resonates with me.

What’s your biggest lesson learned since starting to work in this industry?

The single most important lesson I’ve learned is that your brand promise is dependent on the people representing your company. For home health care, in particular, that starts with attracting and retaining great people. It also means being selective about who you choose to partner with.

For many people, in-home care isn’t something that they’ve necessarily been exposed to or needed to use, until something has happened to them or to a loved one. All of a sudden, you’re welcoming a complete stranger into your home, arguably one of the most intimate parts of your life. Their impression of in-home care ultimately boils down to their experience with the caregiver in their home, the clinician in their home and maybe whoever they’re interacting with at the local office level. Everyone is an ambassador for the industry, and we’re also ambassadors of the organization. I can’t underscore enough how important it is to attract and retain people that are not only great at what they do but also love what they do.

If you could change one thing with an eye toward the future of home-based care, what would it be?

I would say that payers need to fix the reimbursement model for home care services. It’s not just about how we’re getting paid, but it’s also about building flexibility on how to allocate funds so that we can fully be empowered to do what’s best for the patient. As home care providers, we’re closest to the patient, no one knows better than us what their needs are. If we see needs beyond nursing care, such as psychosocial needs, for example, we should have the flexibility to use funds to deliver those services.

I really think that the hospice reimbursement model provides a great blueprint for this. You get a per diem rate that allows you to provide interdisciplinary care and to develop a care plan that’s unique for the patient and their family.

What do you foresee as being different about the in-home care industry — looking ahead to 2021?

I might have answered this differently if we hadn’t been going through the COVID-19 pandemic. I think one of the silver linings of the pandemic, at least for the home health care industry, has been a newfound awareness of just how much care can be delivered in the home setting.

I think that referral partners like hospitals and skilled-nursing facilities will look for more ways to strategically partner with home health care agencies as a result of this. I also know that home health providers have appreciated the flexibility of doing more things virtually and employing telehealth. I hope to see that some of the waivers and flexibility that have been granted on a temporary basis during this time can become permanent in 2021.

In a word, how would you describe the future of home-based care?

Bright. I think we are poised to continue to have a very bright future.

To learn more about the Future Leaders program, visit the Future Leaders homepage. .

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Bayada, Universal Health Services to Launch New Joint Venture Focused on the Home

Bayada Home Health Care on Thursday announced plans to form a new joint venture with Universal Health Services Inc. (NYSE: UHS), one of the largest providers of hospital and health care services in the country.

Broadly, the goal of the newly announced JV is to meet the increased future demand for in-home care across both organizations’ markets, helping more people recover at home after recent illnesses, injuries or hospitalizations.

King of Prussia, Pennsylvania-based UHS has over 400 acute care hospitals, behavioral health facilities and ambulatory centers across the U.S., Puerto Rico and the U.K. Employing over 90,000 workers, UHS recorded net revenues of $11.3 billion during 2019, an increase of 5.6% year-over-year, according to the company’s most recent financial filing.

On its end, Moorestown, New Jersey-based Bayada has more than 300 U.S. locations, with additional locations in Germany, India, Ireland, New Zealand and South Korea. Among the nonprofit provider’s offerings are home-based nursing, rehabilitative, therapeutic, hospice and assistive care services.

Bayada recorded 2019 revenues of $1.5 billion in 2019, with the company’s pediatric home health business accounting for roughly one-third of that total.

For UHS, the JV with Bayada will enable the company to “significantly expand” its home health care services and offerings, bringing more care to more patients along the full continuum of care.

Across the United States, health systems and hospitals have increasingly embraced the concept of home-based care.

In part, the push toward the home is due to the coronavirus and the need to reinforce care capacity. While U.S. hospitals handled the initial COVID-19 surge fairly well, many are quickly becoming overwhelmed in emerging hotspots, including Texas, Florida and California.

As a result, some have even opted to launch hospital-at-home programs, with Minnesota’s North Memorial Health’s partnership with Lifesprk being the most recent example.

However, even before the coronavirus, a growing wave of health systems and hospitals had started teaming up with home health providers due to financial and operational struggles. Running home health care segments during a shifting, more complex payment landscape requires ample time and resources, so many organizations see outsourcing services as their best option.

“It’s a definite trend,” Mark Kulik, managing director at mergers-and-acquisitions advisory firm The Braff Group, previously told Home Health Care News. “The theme is [that] it’s hard to be great at everything. Your core competency as a hospital is acute care. Home care is very different.”

News about UHS’s JV with Bayada comes less than a week after the U.S. Department of Justice (DOJ) announced UHS and one of its facilities had resolved False Claims Act allegations in a $122 million settlement.

This is a developing story. Check back later for further updates.

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