The home-care industry is actively fighting the perception that it is fraud-ridden, but the job doesn't get any easier.
NBC Nightly News exposed abusive or crooked home-care schemes on its Nov. 14 broadcast as part of its "Fleecing of America" series, which reveals taxpayer rip-offs.
Worse, three felons recently told a congressional panel how easy it was for them to defraud Medicare and Medicaid.
A former home-care agency owner, whose voice and appearance were altered to keep him anonymous, explained how he went into the business 17 months after serving time in prison for dealing drugs. His business experience, which consisted of running a nightclub, was enough to qualify for a home health license, and he cheated Medicare out of about $5.6 million through his Southern California-based agency.
Another congressional witness was a nursing home billing specialist who ran a $7 million supply scam. The testimony convinced the Senate Special Aging Committee that healthcare fraud is indeed widespread and easy to carry out.
While June Gibbs Brown, HHS' inspector general, gave a preview of the ex-home-care agency owner's testimony to an audience of about 8,000 at the National Association for Home Care's annual meeting in San Francisco in October, she said the next wave of healthcare fraud isn't so small-time. The FBI has been tracking the entrance of organized crime into the arena of healthcare cheats, since it's easy to get away with and lucrative, she said.
Snowdocs.We've heard about the Canadian "snowbirds" who flock south each year to get sun and medical attention in the United States. Now comes news that the migration of Canadian physicians to a better life and practice in this country is rising.
According to Canadian government figures, 777 doctors left Canada in 1994. Some will go back to their country, but the figures are a continuation of an upward trend in the emigration of physicians and graduate medical students from Canada in the past four years.
"I don't think it's at the level yet where I would view it as a major problem," said Bill Webber, M.D., a member of the Canadian Medical Association's committee on physician resources. "I view it as a concern."
Many exile Canadian physicians say they came to the United States because they were discontented with Canada's medical system and its future. Others came because they could make more money here. And some came for new professional challenges and opportunities, according to a survey by Synergy Recruitment and Immigration Co., Vancouver, which assists physicians who have decided to make the move to the United States.
James Beresford, an obstetrician, moved to a community teaching hospital outside Boston after 16 years in Ottawa as a department head at Civic Hospital. "I've kept a close watch on the Canadian system since I left three years ago and I don't hear any good things coming out of Canada, or at least out of Ontario," Beresford said.
Sweet symbol.There are flowers, trees, rising suns and oak leaves, but four-hospital Baptist Health Systems of believes its new corporate logo-a pineapple-will give people a warm and fuzzy feeling.
"We hope visitors and patients will look to our pineapple as a mark of excellence, knowing that no matter which Baptist Health Systems facility they use, they'll receive outstanding quality care and service in friendly and comfortable surroundings," said Brian Keeley, Miami-based BHS' president.
As any pineapple lover knows, the prickly skinned tropical fruit has been the symbol of hospitality since the 14th century.
"A pineapple on an innkeeper's door in Renaissance Europe and early America served as a welcome sign to travelers," said Keeley, an executive who has won several awards for his administrative skills. Now, however, he has to be considered healthcare's most knowledgeable expert on pineapples.
But pineapples aren't new to Keeley or to Baptist Hospital, BHS' flagship facility in Miami. Since 1960, when the 513-bed hospital opened, a pineapple fountain has been running at Baptist's entrance.
Big business.Oak Brook, Ill.-based Advocate Health Care's recent ranking as the 11th-largest employer in the Chicago area took Outliers by surprise. But even more telling is that the system would jump to sixth-largest if government employers were excluded from Chicago's top 25 employers as ranked by MODERN HEALTHCARE's sister publication, Crain's Chicago Business.
The U.S. government, Chicago public schools, the city of Chicago, and Cook County ranked first through fourth respectively in the Crain's listing. The state of Illinois was eighth. Aside from the government sectors represented, those ahead of Advocate included such area corporate heavyweights as Sears, Roebuck & Co. (fifth); Motorola (seventh); Ameritech (ninth); and Dominick's Finer Foods (10th).
Advocate, with 17,607 employees, edged out powerhouses United Airlines (12th), Abbott Laboratories (13th) and AT&T (14th). Rush-Presbyterian-St. Luke's Medical Center of Chicago, with its 8,126 employees, was the only other healthcare system to crack the list, coming in at 22nd. As mergermania progresses in healthcare, Advocate and other healthcare systems are likely to break even more employment ceilings.
Senior housing, young designers.As St. Joseph Hospital and Health Center in Bryan, Texas, prepares for increased demand for geriatric services, it's receiving youthful advice.
Texas A&M University, College Station, sent 17 students to work with administrators from the 185-bed facility on a seven-week program to develop master plans for a geriatric community village. Eight student teams presented different solutions for the village utilizing a 21.4-acre site adjacent to the hospital. Watkins Carter and Hamilton Architects of Houston advised on the development of the project.
The plans focus on a continuum of care that includes independent living, day-care assisted living, skilled nursing, home-care services, Alzheimer's and hospice care. Under the direction of George J. Mann, professor of health facilities design at the university, most students incorporated a park-like setting in their plans with walking paths, ponds and an outdoor area for concerts and performances. Some plans included a "village mall" with restaurants, banks and other public services.