Daily Editors' Notes

Who's buying your loyalty?

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Elizabeth Leis Newman
Elizabeth Leis Newman

If you live outside of my great native state of Virginia, you may have missed the news about the indictment of former Gov. Robert McDonnell (R) and his wife, Maureen.

You can read the back story here, but essentially the ex-governor and his wife are accused of taking expensive gifts, vacations and loans from the head of Star Scientific, Jonnie R. Williams Sr., in exchange for special treatment from the state. Among the $140,000 in items the couple would have to forfeit, if convicted, are a blue Armani jacket and two matching dresses, Louis Vuitton shoes, and two gold Oscar de la Renta dresses.

In one example of how the McDonnells accumulated so many gifts, according to the indictment, Maureen McDonnell told Williams “that she needed dresses and accessories for her daughter's upcoming wedding and for her and Robert McDonnell's upcoming anniversary party. JW paid for the entire luxury shopping trip for Maureen McDonnell and spent approximately $10,999 at Oscar de la Renta, approximately $5,685 at Louis Vuitton, and approximately $2,604 at Bergdorf Goodman.” Williams was seated next to the governor at the Union League Club event later that evening, as was promised, the record says.

Well, we've all been there. Who among us hasn't panicked over appearances? Nary a day goes by that I am not hounding McKnight's editors about upgrading our stables for the comfort of the team of horses and footmen that get me to work, or having anxiety as to whether Vera Wang will be able to make alterations in a speedy fashion for my LeadingAge PEAK suit.

While in truth the McDonnells' alleged excess may make us shake our heads, it did remind me of the slippery slope many in business or politics can fall down when it comes to gifts. No one really begrudges the facility that allows a hospice company to bring in pizza for staff — as long as that fits with facility policy. The problem is often when that pizza becomes a nice dinner, which becomes a golf outing. These are also bigger issues when your business depends on taxpayer-funded reimbursements, as most skilled nursing facilities do.

That's why we have the Anti-Kickback statute, which Ask the Legal Expert John Durso has written, relies on “bad intent.” Modest grocery gift cards as incentives for those in capitated managed Medicaid programs, for example, don't violate the law, the OIG ruled recently, because it's unlikely to result in fraud. The OIG also issued an opinion that says it's okay to pay an agency for skilled nursing referrals. 

The best ways for skilled nursing facilities to stay out of the crosshairs of violating the law is to make sure all staff know how and what to report, and to give examples of what can and cannot be accepted. It's also about forming and sticking with a policy based on what you and your team intrinsically know to be ethical. If the allegations against the McDonnells are true — and they vehemently say that they are not — I guarantee you they did not wake up one day planning on trading access for gifts. Rather, on a smaller scale, it's that they ignored the “still small voice of conscience” embedded in most of us.

Elizabeth Newman is Senior Editor at McKnight's, and has neither a horse nor a Vera Wang suit.

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Daily Editors' Notes

McKnight's Daily Editor's Notes features commentary on the latest in long-term care news. Entries are written by Editorial Director John O'Connor on Monday and Friday; Staff Writer Tim Mullaney on Tuesday, Editor James M. Berklan on Wednesday and Senior Editor Elizabeth Newman on Thursday.

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