When the U.S. attorney in Miami last month charged 122-bed Larkin Community Hospital, its current and former owners, executives and some of their relatives with defrauding Medicare and Medicaid, several of the defendants already knew the drill.
The South Miami, Fla.-based for-profit hospital's co-owner, president and CEO, Jack Michel, is familiar with the False Claims Act process, having been a whistle-blower who successfully sued rival Miami Beach-based South Shore Hospital and Medical Center, winning nearly $170,000 from the $900,000 civil settlement.
In its lawsuit against the hospital, Michel and others, the government alleged that the defendants paid and accepted kickbacks and illegally sent long-term-care patients from assisted-living centers they controlled to the hospital for unnecessary treatment.
Michel's partner in some of the nursing homes is Rabbi Morris Esformes, a millionaire owner of long-term-care facilities in Florida, Illinois and Missouri. Some of Esformes' facilities have come under fire from state and federal authorities. In 2001 four elderly women died of heat-related causes in a suburban St. Louis facility Esformes sold before its license could be revoked. He was fined $43,000 by federal authorities.
Former Larkin owner James Desnick, who lost his Illinois medical license in the 1990s and later bought Doctors Hospital of Hyde Park in Chicago out of bankruptcy before returning it to the same condition, has seen his share of government troubles as well. Desnick and Doctors paid nearly $20 million to settle civil False Claims Act lawsuits resolving kickback and fraud allegations there and the investigation resulted in several criminal convictions, although Desnick was never criminally charged.
When Desnick bought Larkin for $11 million with the Island Trust, which is headed by President John F. Kennedy's nephew, Anthony Kennedy Shriver, in 1997, he purchased it from Birmingham, Ala.-based HealthSouth Corp., whose own fraud-related troubles would not surface for several years.
The hospital also has a rich legal pedigree. Its original owner was the late Miami developer and mob associate Cal Kovens, who served time with co-conspirator Jimmy Hoffa for illegally using cash from the Teamsters union pension fund to build Larkin and two other area hospitals, 264-bed Plantation (Fla.) General Hospital and North Miami (Fla.) General Hospital, now 392-bed Parkway Regional Medical Center.
The nurse shortage isn't this bad
An Alaska woman pleaded guilty to stealing the identities of at least two nurses to obtain nursing licenses and jobs at schools and hospitals, including a job as coordinator of occupational health nursing at Fairbanks (Alaska) Memorial Hospital.
Becky Nadine Hunter pleaded guilty earlier this month in U.S. District Court in Anchorage to 21 criminal counts, including identity theft, lying to the government, mail and wire fraud, and concealing assets. She faces as many as 120 years in prison.
Soon after hiring Hunter in February 2000, Fairbanks Memorial fired her for lying on her application. She then surrendered her three nursing licenses to the state. Prosecutors alleged that she used more than 20 aliases to defraud individuals and companies.
Assistant U.S. Attorney Karen Loeffler in Anchorage says Hunter was expelled from the University of Portland (Ore.) School of Nursing in 1992 and never completed her nursing degree. In addition to misrepresenting herself as a nurse, Hunter allegedly forged documents saying she was a bone-marrow transplant patient in order to obtain free air travel.
Accountants no more
So you think you know what GAO stands for? Often inaccurately called the Government Accounting Office instead of its real name, the General Accounting Office, the congressional watchdog agency has long labored under a name that ill suits its real role. Under a law signed by President Bush July 7, the agency's name has changed, but its acronym has not. Only time will tell if the change adds to the confusion or clarifies matters.
The new name is the Government Accountability Office. Along with the name change, the law creates a new compensation system for the agency; instead of paying employees according to the federal employee pay system, the agency will pay based on performance and other factors. The GAO can also offer workers early retirement and buyouts. Sponsors say the change will give the agency greater flexibility to attract and retain talent as well as flexibility with its budget during lean years.
Changes to the agency came as a result of legislation proposed a year ago by Rep. Jo Ann Davis (R-Va.) and Sen. George Voinovich (R-Ohio). The agency was created in 1921 primarily to audit the spending of federal agencies, but its duties have been expanded to include program evaluation and policy analysis.
The name change "reflects what we do. We're not accountants," says Laura Kopelson, a spokeswoman for the GAO.
They're no Commies
At least GAO is a short acronym. The healthcare industry has earned a well-deserved reputation for nearly matching the military in the universal acceptance of impenetrable, lengthy shorthand. Few, however, are tougher on the tongue than ACEHSA-otherwise known as the Accrediting Commission on Education for Health Services Administration. The pronunciation alone is a bit tricky-it's a-KEE-sa.
Now, just when Modern Healthcare has finally managed to commit this name, acronym and pronunciation to memory, ACEHSA's leaders have decided to change the official title. Forthwith, ACEHSA will now be known as the Commission on Accreditation of Healthcare Management Education, or CAHME. And that is not pronounced like the derogatory abbreviation for a card-carrying member of the Communist Party, either; it's more like "kammy."