Frustrations of a persecuted provider boil over

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Frustrations of a persecuted provider boil over
Frustrations of a persecuted provider boil over
   First they came for the communists,

   And I didn't speak out because I wasn't a communist.

   Then they came for the trade unionists,

   And I didn't speak out because I wasn't a trade unionist.

   Then they came for the Jews,

   And I didn't speak out because I wasn't a Jew.

   Then they came for me

   And there was no one left to speak out for me.

   — Martin Niemuller (1892-1984)

What happens when a government and society create an evil enemy of the state?  They begin by calling them monsters, a drain on society that is guilty of heinous crimes, and they use the legal system and media to prosecute them publicly without due process!  You have all seen the headlines:

       “Nursing Home causes the death of innocent patient.”

       “Patient develops bed sore in nursing home.”

       “Patient attacks patient causing serious injury.”

       “Nursing Home patient falls and dies in Nursing Home.” 

       “Nursing Homes drain the state budget.”

       “Nursing Homes defraud the government of Medicare funds.” 

       “Nursing Home sued for poor care.”

       “Nursing Home cited by state for … !”

On and on and on! The TRUTH never seems to matter, only the synthetic story is reported. Ethics, integrity, honor, justice … forget it!

Who are these people we have let define us and why do we cower in the hope that they aren't referring to us? What will you do when they come knocking on your door? They will come and nothing you have done will help you defend your business, staff, residents, families or your reputation. Let me share with you our story and see if you can imagine if it could happen to you.

In 2007, a county prosecutor went to the public media, announcing an investigation into the deaths at a local nursing home. He called in investigators from APS (Adult Protective Services) and began calling families soliciting complaints. They called the state and demanded a survey be redone. The state spends four weeks looking over every document.

The survey team was lead by a supervisor who was eventually convicted of taking bribes from one of our competitors. Surveyors write a 200-page survey document and suspend our admissions. Within three weeks, the state does its follow-up survey and deems our facility in compliance, with zero deficiencies.

Then, the local prosecutor receives an award from a senior organization against abuse! He later runs for judge and is elected. The APS investigators report findings without even talking to our facility. We pursue legal avenues to force APS to establish similar protocols as the OIG for a fair opportunity to defend these allegations, which were based solely based on innuendo and hearsay evidence.

The judge dismisses the case as he believes that the APS has no real legal position and cannot cause any damage to our business. APS is not required to establish investigative protocols or policies to prevent false accusations.  Millions of dollars are spent on legal fees and lost revenue.  

As the case develops, the State Attorney General's office begins a complete investigation. The local prosecutor had no jurisdiction. Yes, that's right: They had no jurisdiction! After an extensive investigation, the office of the Attorney General brought no charges!

They informed the federal government that there was no case to pursue. Six months later, the federal government writes a letter demanding $8 million be paid back due to “worthless services.” We prepare a legal response costing over $300,000 and submit it to the government. After reviewing all our information and expert testimony, the federal prosecutor comes back with a $500,000 settlement offer and says the alternative is the state would proceed to file the first lawsuit of its kind in Kentucky.

On July 18, 2011, they file a lawsuit stating “Nursing Home Provided Worthless Services,” even though the prosecutor knew the charges were false.

The news media jump all over the case and present the facts with the obvious focus on the “Evil Nursing Home”! It did not matter that our state surveys were excellent or that our facility was Joint Commission-accredited, or even that our patient satisfaction was over 90%. It did not matter that we had cared for over 600 patients every year and complaints had always been less than 1%.  It did not matter that we had thousands of pages of documentation from caring physicians and other professionals supporting our care.

The government officials want their money and more than that, they want us gone. They know we cannot afford to fight the government. The federal prosecutor's office never set foot in our facility. They never talked to the thousands of families that knew our efforts.

They relied on the flawed “5 Star Rating” and not only attacked this one facility but all of our facilities. Imagine caring for close to 8,000 patients per year and having two pending lawsuits? I have to state the obvious: “We take care of sick people!” Yes, and they have falls, get skin breakdown, infections and so many other care challenges. Why is that so surprising? 

The truth is that most issues are documentation and not even care-related. That's how they attack us. A flawed and cumbersome system surrounded by laws and regulations. Charting for dollars, not patient outcomes. A system that doesn't work and healthcare that isn't paid for by Medicaid! The look on our families' faces when we tell them that reimbursement is under $8.00 an hour and that they are paying a bed tax for the state to generate revenue.

Oh that's right, were not allowed to tell them that information. I could go on but you and I both know the truth!

Will you wait till they come knocking on your door? I choose to fight but I can hear the slow whisper “Don't do it … settle. Everything will calm down because they need us!”

Barry Bortz is CEO of Carespring Health Care Management, based in Loveland, OH.

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