In my last post I gave numbers of referrals to and from local Doctors. I have researched the data, and according to the website, the numbers come from the Federal Government. I can not confirm the source, but it appears to be based on Medicare billing.
I have recently been directed by a government official to a Wall Street Journal site that posts the amount doctors billed Medicare for in 2012. According to an official from CMS, it is easier to navigate than the CMS site. According to the Wall Street Journal website, Dr. Larry Joe Russell billed Medicare for 5000 patient visits. That's ninety six visits a week if he works fifty two weeks a year. Keep in mind that Dr. Russell also accepts Medicaid ,private insurance and cash patients. That's a lot of patients. According to the Wall Street Journal Page, Dr. Russell saw more Medicare patients than all but two other doctors in the county.
According to the NC Medical Board, in 2012 Dr. Russell supervised nine nurse practitioners, and one physicians assistant. Using the information from the Wall Street Journal website together with Dr. Russell this group had 13,575 patient visits. That's 261 patient visits a week, and that's a conservative number based on the information provided. Keep in mind that they also see patients other than Medicare. According to the website that totals around $856,893.04 Medicare dollars. That's $16,478.71 cents a week, not considering any business other than Medicare.
In my opinion, that seems excessive at any level. I understand that doctors, nurses and physicians assistants have a right to make a living. It just stands out that according to the WSJ website, Dr. Russell was the number one Medicare biller under family practice physicians, with over $419,425.00 in 2012. Next look at physicians assistants, Martha K. Hoffman, Dr. Russell's Pa. is second on the list with $60,089.00. Last if you look at nurse practitioners, Denise Hunt was #1 at 138,333.00 , #2 was Linda Brooks at $104,658.00, # 4 was Deborah Whitmire Pittillo at $62,461.00 and at #5 was Alicia K Younger at $45,772.00. Four out of the top five Medicare billers are supervised by Dr. Larry J Russell.
Out of two hundred family practice physicians, Dr. Russell is the thirteenth highest Medicare biller in the State of North Carolina. I realize that this doesn't actually prove anything illegal. I don't know Dr. Russell personally, but I know people who do. Based on what I do know, Dr. Russell is not seeing all these patients as a community service. I also know that he does not actually " see " all of these patients.
Does all of this information prove Dr. Russell is breaking any laws ? I've been told that it does not. Should the authorities be watching him, I would hope so. I would assume that if you were going to audit a certain group, you would look real hard at the number one on the list.
If Dr. Russell is your doctor, you might want to reconsider what you are getting for your money. The numbers above are Medicare only. If you are not one of those 261 Medicare patients, then you are somewhere between 262, and ????
Here is the link to the Wall Street Journal website mentioned above. Just out of curiosity, put your doctor in and see how he ranks next to Dr. Larry Joe Russell.
http://projects.wsj.com/medicarebilling
Also, for the record, I have still not received any response from Aldona Vos, Pat McCrory or anyone else that received my letter. The letter was sent out on April 24, 2014.
Sunday, May 18, 2014
Saturday, May 10, 2014
Aldona Vos, and the Letter. Unreasonable, you be the judge!
It has been over two weeks since my letter to Dr. Aldona Vos, Secretary of the NCDHHS. I have still not received a reply. The same letter was sent to Governor Pat McCrory, Kathleen Sebelius and members of Congress. I have not received a reply from anyone. As a citizen of the United States and a Taxpayer, I should at least be entitled to a response.
This is routine when dealing with politicians, the first contact you will get a letter thanking you for your concern. Then the letter will tell you about all the fascinating things the politician has done, and how great they are. Then they will close with, " If I can be of any further assistance, please feel free to contact me ". They fail to even specify what you have written about. I received similar letters from almost everyone that I have reached out to, including the President.
Rather than writing what I asked for in the letter I am going to post it below. Are the requests I make unreasonable, you be the judge.
April 20, 2014
Dr. Aldona Vos
Secretary NCDHHS
2001 Mail Service Center
Raleigh, NC 27699-2001
Dear Secretary Vos:
I am writing to ask for your assistance in obtaining information from the NCDHSR. I am trying to get clarification concerning an investigation conducted as a result of a complaint I filed. Twice I have written to Beverly Speroff, Division Chief of the NCDHSR, and been denied.
Complaints were filed by my brother and I concerning the care our mother received at Hendersonville Health and Rehabilitation. The NCDHSR investigation was conducted on January 18 and 19 of 2011. Results of the investigation found no deficiencies. We had obtained a copy of mom’s medical records and found several issues that should have been addressed. After receiving the results, we met with Gail Maloney, who was then the Western Regional Director of the NCDHSR. Ms. Maloney was presented with a list of concerns we had with the records. The number of inaccuracies contained in the records was overwhelming.
One of the main issues was a nurse’s note concerning a fall; the note was a late entry and was written a month after the fall occurred. We obtained a written notarized statement from the patient that was in the other bed at the time. The roommate’s statement was quite different from one given in the “late entry” nurse’s note. Mom had undergone a craniotomy in September of 2011. She had been admitted to Hendersonville Health October 19, 2011 for physical and occupational rehabilitation. According to the records, she had reached her goals and was ready to be discharged on November 3, 2011. That morning she was found not breathing and without a pulse; she died a little before six am.
At the suggestion of Ms. Maloney, I filed a foia request of the results of the investigation. I did not receive the results from the foia until June 10, 2013. The documents from the investigation and the so called administrative review are full of inaccuracies and false information. The packet contains three different letters written by the doctor that conducted the review. Not one of the letters contains an accurate account of what is contained in the investigation documents. The lead investigator’s summary contains several conflicting statements; one concerning the fall mom sustained.
All I am asking for is clarification of what is contained in the investigation documents. If there are other pages proving what is stated, they are not in the report. As a United States citizen and a tax paying resident of the State of North Carolina, I should be entitled to the information I am requesting. I am not asking for a citation to be written against Hendersonville Health and Rehabilitation but my goal is to call attention to a possible flaw in the investigation process. This is extremely important because these investigations result in the licensing and certification of nursing homes. The results are also posted on Medicare.gov to be used as a tool by citizens trying to choose a nursing home.
Since the beginning of my involvement with the NCDHSR, I have been treated in an adversarial manner. I would question if this is not in some way a violation of Title 18, U.S.C., Section 242. If the report contains false information, I believe that it is a violation of Title 42 U.S. Code § 1320a–7b.
I would ask that Ms. Speroff reconsider my request, however according to her this matter is closed. As the Secretary of the NCDHHS, I would hope you would be concerned if the NCDHSR is denying the public representation. I would also assume that other statutes would be violated if the actions, or lack of action on the part of the NCDHSR, result in the loss of human life.
Thank you for your consideration.
Sincerely,
cc:
Beverley Speroff
Kathleen Sebelius
Governor Pat McCrory
Alfreda Walker CMS
Norma Elder NCI Advancemed
Joann Quarles QIO
This is routine when dealing with politicians, the first contact you will get a letter thanking you for your concern. Then the letter will tell you about all the fascinating things the politician has done, and how great they are. Then they will close with, " If I can be of any further assistance, please feel free to contact me ". They fail to even specify what you have written about. I received similar letters from almost everyone that I have reached out to, including the President.
Rather than writing what I asked for in the letter I am going to post it below. Are the requests I make unreasonable, you be the judge.
April 20, 2014
Dr. Aldona Vos
Secretary NCDHHS
2001 Mail Service Center
Raleigh, NC 27699-2001
Dear Secretary Vos:
I am writing to ask for your assistance in obtaining information from the NCDHSR. I am trying to get clarification concerning an investigation conducted as a result of a complaint I filed. Twice I have written to Beverly Speroff, Division Chief of the NCDHSR, and been denied.
Complaints were filed by my brother and I concerning the care our mother received at Hendersonville Health and Rehabilitation. The NCDHSR investigation was conducted on January 18 and 19 of 2011. Results of the investigation found no deficiencies. We had obtained a copy of mom’s medical records and found several issues that should have been addressed. After receiving the results, we met with Gail Maloney, who was then the Western Regional Director of the NCDHSR. Ms. Maloney was presented with a list of concerns we had with the records. The number of inaccuracies contained in the records was overwhelming.
One of the main issues was a nurse’s note concerning a fall; the note was a late entry and was written a month after the fall occurred. We obtained a written notarized statement from the patient that was in the other bed at the time. The roommate’s statement was quite different from one given in the “late entry” nurse’s note. Mom had undergone a craniotomy in September of 2011. She had been admitted to Hendersonville Health October 19, 2011 for physical and occupational rehabilitation. According to the records, she had reached her goals and was ready to be discharged on November 3, 2011. That morning she was found not breathing and without a pulse; she died a little before six am.
At the suggestion of Ms. Maloney, I filed a foia request of the results of the investigation. I did not receive the results from the foia until June 10, 2013. The documents from the investigation and the so called administrative review are full of inaccuracies and false information. The packet contains three different letters written by the doctor that conducted the review. Not one of the letters contains an accurate account of what is contained in the investigation documents. The lead investigator’s summary contains several conflicting statements; one concerning the fall mom sustained.
All I am asking for is clarification of what is contained in the investigation documents. If there are other pages proving what is stated, they are not in the report. As a United States citizen and a tax paying resident of the State of North Carolina, I should be entitled to the information I am requesting. I am not asking for a citation to be written against Hendersonville Health and Rehabilitation but my goal is to call attention to a possible flaw in the investigation process. This is extremely important because these investigations result in the licensing and certification of nursing homes. The results are also posted on Medicare.gov to be used as a tool by citizens trying to choose a nursing home.
Since the beginning of my involvement with the NCDHSR, I have been treated in an adversarial manner. I would question if this is not in some way a violation of Title 18, U.S.C., Section 242. If the report contains false information, I believe that it is a violation of Title 42 U.S. Code § 1320a–7b.
I would ask that Ms. Speroff reconsider my request, however according to her this matter is closed. As the Secretary of the NCDHHS, I would hope you would be concerned if the NCDHSR is denying the public representation. I would also assume that other statutes would be violated if the actions, or lack of action on the part of the NCDHSR, result in the loss of human life.
Thank you for your consideration.
Sincerely,
cc:
Beverley Speroff
Kathleen Sebelius
Governor Pat McCrory
Alfreda Walker CMS
Norma Elder NCI Advancemed
Joann Quarles QIO
Wednesday, May 7, 2014
How many patients can a doctor see in one day? Can you say malpractice!
This is just one of many answers to the question. How many patients can a doctor see in one day. Just to show how outrageous Dr. Larry Joe Russell's referral numbers are! Note the third paragraph!
How many patients can a doctor safely see a day?
Luis Collar, MD Physician
| December 31, 2013
Today’s question is a simple one. How many patients can a physician see in one day and still be thorough? Don’t get me wrong; I’m all for efficiency. But we need to recognize when efforts at efficiency become “medical sloppiness” or, frankly, malpractice.
With health care policy and insurance reimbursement what they are today, it’s not uncommon to encounter physicians seeing forty, fifty, and even sixty or more patients a day in the outpatient setting. The truth is, though, no matter how experienced the doctor, no matter how technologically streamlined the practice, one physician can’t maintain medical accuracy at that frenetic a pace. Many physicians like to think they can because they manage to see every patient on their schedule and do their thing. But, in most instances, good medicine simply can’t be practiced in five to seven minutes.
Sure, there are cases where that is all that’s required. A young, healthy patient, a simple physical, or a stable patient that just needs a medication refill can usually be handled that quickly. But I often see physicians trying to care for medically complex, older patients on multiple medications in the same fashion. The rationalization is usually that, with enough experience, one can take care of these patients just as quickly. But the issue, then, becomes precisely what constitutes “handling” a patient.
A patient with a complex medical history always requires more time. Trying to argue otherwise is simply intellectually dishonest. You can’t take a history, no matter how focused, reconcile all current medications looking for undesired interactions or required modifications, review labs, monitor patient progress, look for better therapeutic approaches, address new issues, encourage communication, conduct a thorough physical exam, and spend time on health counseling / preventive care in five to seven minutes. It just can’t be done that quickly with these patients.
I’ve worked in offices where this level of “efficiency” is touted as the future, the result of effectively leveraging new technology. But the truth is, as much as it pains me to say it, it’s just bad medicine. And the argument that a particular practice doesn’t have that many complicated patients is, in most cases, yet another fallacy.
Complicated patients are not to be confused with medically interesting patients. Many of the most common chronic illnesses that find their way into physicians’ offices are, in fact, not interesting or exciting for seasoned medical professionals. After all, diabetes isn’t exactly extraskeletal myxoid chondrosarcoma or any of the “sexy” hemorrhagic fevers, but that doesn’t mean it isn’t an exquisitely complex illness requiring a thorough clinical approach.
So the average primary care physician may not have many “medically interesting” patients, but they probably do have many complex patients. I would argue that if any practice has a significant amount of patients over the age of fifty, then seeing more than about twenty-five to thirty patients a day is irresponsible. Seeing three to four patients an hour yields a number somewhere in that range. And while some patients can be “handled” more quickly than others, once you go above that number in one day you’re entering dangerous territory.
If you look at the available data and the current incidence of obesity, heart disease, hypertension, diabetes, and depression to name a few, then any practice serving patients over the age of fifty must, by definition, have a good number of complex patients. Although common, none of these illnesses are “simple.” Quick refills, not listening, not asking probing questions, shoddy physical exams, not looking for all possible signs and symptoms of disease progression, poor or no counseling, and not actively staying ahead of a disease are all poor practice. More importantly, those practices lead to poorer patient outcomes and increased health care costs in the long run. That is particularly true with this patient population.
The challenge, of course, is that our current system still rewards speed and procedures much more richly than patient interaction and thorough analysis. Although not a new concept, as reimbursement continues to decrease necessarily (Medicare’s pockets aren’t as deep as they used to be) and more patients gain access to the system, addressing the question of “medical speed” will become increasingly important.
Admittedly, the thoughts presented here are only based on anectdotal evidence collected over several years of working with numerous physicians, in multiple settings, and at several different hospitals. However, I do believe there is a trend here. The more “evolved” our health care system becomes, the more pressure is placed on physicians to leverage technology and see more patients, the more bad professional habits are being developed. Technology can help increase efficiency, but it can’t yet replace ample time with an interested, compassionate, well-trained physician. Not every patient requires thirty or forty minutes, but if we’re going to be honest, forty or more patients a day is simply ridiculous.
I would challenge all physicians to honestly evaluate how long they spend with complicated patients. More importantly, I’d be interested in knowing how they define a complex patient. And I would question any definition that doesn’t include even the most common chronic illnesses. No matter how “boring” these may be, their intrinsic complexity and impact on public health certainly justify more than a few minutes of diagnostic effort, even with routine follow-up visits.
I would also encourage all patients to expect more from their doctors than a couple of questions and some quick advice in five to seven minutes. If you’re there for a simple cold, then maybe that approach is appropriate. But if you have a chronic illness and are concerned by some new symptoms or recent changes in your overall health, you should expect much more from an office visit.
And finally, I would encourage all policy makers to recognize the valuable role physicians play in our society. We need policies that encourage them to do their jobs properly instead of punishing them for it. Ultimately, though, it’s up to physicians to choose. I hope they are true to their training and show humility in the face of complex, albeit common, diseases. It’s a shame to simply toss all that “medical school stuff” out the window simply because the system is currently what it is.
How many patients can a doctor safely see a day?
Luis Collar, MD Physician
| December 31, 2013
Today’s question is a simple one. How many patients can a physician see in one day and still be thorough? Don’t get me wrong; I’m all for efficiency. But we need to recognize when efforts at efficiency become “medical sloppiness” or, frankly, malpractice.
With health care policy and insurance reimbursement what they are today, it’s not uncommon to encounter physicians seeing forty, fifty, and even sixty or more patients a day in the outpatient setting. The truth is, though, no matter how experienced the doctor, no matter how technologically streamlined the practice, one physician can’t maintain medical accuracy at that frenetic a pace. Many physicians like to think they can because they manage to see every patient on their schedule and do their thing. But, in most instances, good medicine simply can’t be practiced in five to seven minutes.
Sure, there are cases where that is all that’s required. A young, healthy patient, a simple physical, or a stable patient that just needs a medication refill can usually be handled that quickly. But I often see physicians trying to care for medically complex, older patients on multiple medications in the same fashion. The rationalization is usually that, with enough experience, one can take care of these patients just as quickly. But the issue, then, becomes precisely what constitutes “handling” a patient.
A patient with a complex medical history always requires more time. Trying to argue otherwise is simply intellectually dishonest. You can’t take a history, no matter how focused, reconcile all current medications looking for undesired interactions or required modifications, review labs, monitor patient progress, look for better therapeutic approaches, address new issues, encourage communication, conduct a thorough physical exam, and spend time on health counseling / preventive care in five to seven minutes. It just can’t be done that quickly with these patients.
I’ve worked in offices where this level of “efficiency” is touted as the future, the result of effectively leveraging new technology. But the truth is, as much as it pains me to say it, it’s just bad medicine. And the argument that a particular practice doesn’t have that many complicated patients is, in most cases, yet another fallacy.
Complicated patients are not to be confused with medically interesting patients. Many of the most common chronic illnesses that find their way into physicians’ offices are, in fact, not interesting or exciting for seasoned medical professionals. After all, diabetes isn’t exactly extraskeletal myxoid chondrosarcoma or any of the “sexy” hemorrhagic fevers, but that doesn’t mean it isn’t an exquisitely complex illness requiring a thorough clinical approach.
So the average primary care physician may not have many “medically interesting” patients, but they probably do have many complex patients. I would argue that if any practice has a significant amount of patients over the age of fifty, then seeing more than about twenty-five to thirty patients a day is irresponsible. Seeing three to four patients an hour yields a number somewhere in that range. And while some patients can be “handled” more quickly than others, once you go above that number in one day you’re entering dangerous territory.
If you look at the available data and the current incidence of obesity, heart disease, hypertension, diabetes, and depression to name a few, then any practice serving patients over the age of fifty must, by definition, have a good number of complex patients. Although common, none of these illnesses are “simple.” Quick refills, not listening, not asking probing questions, shoddy physical exams, not looking for all possible signs and symptoms of disease progression, poor or no counseling, and not actively staying ahead of a disease are all poor practice. More importantly, those practices lead to poorer patient outcomes and increased health care costs in the long run. That is particularly true with this patient population.
The challenge, of course, is that our current system still rewards speed and procedures much more richly than patient interaction and thorough analysis. Although not a new concept, as reimbursement continues to decrease necessarily (Medicare’s pockets aren’t as deep as they used to be) and more patients gain access to the system, addressing the question of “medical speed” will become increasingly important.
Admittedly, the thoughts presented here are only based on anectdotal evidence collected over several years of working with numerous physicians, in multiple settings, and at several different hospitals. However, I do believe there is a trend here. The more “evolved” our health care system becomes, the more pressure is placed on physicians to leverage technology and see more patients, the more bad professional habits are being developed. Technology can help increase efficiency, but it can’t yet replace ample time with an interested, compassionate, well-trained physician. Not every patient requires thirty or forty minutes, but if we’re going to be honest, forty or more patients a day is simply ridiculous.
I would challenge all physicians to honestly evaluate how long they spend with complicated patients. More importantly, I’d be interested in knowing how they define a complex patient. And I would question any definition that doesn’t include even the most common chronic illnesses. No matter how “boring” these may be, their intrinsic complexity and impact on public health certainly justify more than a few minutes of diagnostic effort, even with routine follow-up visits.
I would also encourage all patients to expect more from their doctors than a couple of questions and some quick advice in five to seven minutes. If you’re there for a simple cold, then maybe that approach is appropriate. But if you have a chronic illness and are concerned by some new symptoms or recent changes in your overall health, you should expect much more from an office visit.
And finally, I would encourage all policy makers to recognize the valuable role physicians play in our society. We need policies that encourage them to do their jobs properly instead of punishing them for it. Ultimately, though, it’s up to physicians to choose. I hope they are true to their training and show humility in the face of complex, albeit common, diseases. It’s a shame to simply toss all that “medical school stuff” out the window simply because the system is currently what it is.
Saturday, May 3, 2014
Dr. Larry Joe Russell and friends. Stealing from Medicare ???
For the record, I have still not received a response to my letter to Dr. Aldona Vos, Secretary of the NCDHHS. Copies of the same letter were sent to Governor Pat McCrory, Kathleen Sebelius, CMS, Beverley Speroff and other officials. I have not received a response from any of the letters I sent.
In the last post I shared a couple of links to a website that posts referral data on doctors. According to the website, the referrals are taken from Medicare billing records. That would indicate that the data does not contain any information concerning private insurance, or Medicaid. It also states that only the top ten referring physicians are listed. That said I am going to post some information given on the website.
This was copied and pasted directly from the website, which I believe is published by the CMS.
"In order to protect patient privacy, the referral data records the number of times two providers billed Medicare for the same patient within a sliding 30-day period, where at least 11 patients were involved in transactions."
Dr. Larry Joe Russell received a total of 429,739 incoming referrals in a three year span. That means an average of 143,246 a year, or 11,937 a week. That's a lot of patients for one small town doctor. But it gets better Dr. Russell also had 315,328 outgoing referrals, 105,109 a year or 2,021 a week. Together that totals 745,067 over a three year period, or, 248,355 a year or 4776 a week. Dr. Russell charges $125.00 for an office visit, that means if the data is correct, Dr. Russell billed Medicare around $93,133,375.00 over the three year period. Red Flag, Red Flag!!! Is nobody monitoring these numbers.
I will post the top five incoming and the top five outgoing sources, in the interest of public awareness. I will post the information from the three years in the data base.
I will begin with the top five outgoing referrals, from Dr. Larry Joe Russell.
2009 2010 2011 Total
Henderson County Hospital ( Pardee ) 11,628 10,150 9894 31,672
Denise Hunt FNP 3437 3166 3791 10,394
Dr Kevan Hansel, BlueSky MD 3254 2656 1593 7,503
Linda Brooks FNP 1036 1718 2575 5,329
Deborah Whitmire Pitillo FNP 2236 0 1878 4,114
For the record, Dr Russell was instrumental in the negotiations of the purchase of Hendersonville Health and Rehabilitation from Pardee Hospital. Also Linda Brooks FNP is one of the owners of Hendersonville Physicians and Associates, the ones who purchased Hendersonville Health and Rehabilitation. Denise Hunt FNP and Deborah Whitmire Pitillo are both under Dr. Russells supervision, according to the NC Medical Board. Dr Kevan Hansel worked in Dr Russels office but is now with BlueSky, who also owns a percentage of Hendersonville Physicians and Associates. Seems like a cozy little group, living off of Medicare Dollars!
Now here are the top five incoming referrals to Dr. Larry Joe Russell.
2009 2010 2012 Total
Henderson County Hospital ( Pardee ) 15,885 14,043 14,073 44,001
Dr. Kevan Hansel, BlueSky MD 4,609 3,396 1,980 9,985
Denise Hunt FNP 2,900 2,411 3,004 8,315
Henderson County EMS 2,586 2,649 2,663 7,898
Hendersonville Health and Rehabilitation 2,440 2,172 2,253 6,865
Looks like friends scratching each others backs, also looks a lot like several violations of the Stark Law and the law prohibiting physicians self referrals. It appears that somehow this little group of friends are exempt from State and Federal laws. Is nobody in law enforcement looking at this. It is all public information, posted by the very agencies that are supposed to enforce the laws.
All of the information posted here was also forwarded to the FBI, OIG, CMS, NCDHHS, DHHS, and members of Congress. Not one reply so far. Who's running the State of North Carolina ? Is it politicians, or the healthcare PAC's and wealthy nursing home owners? What's the difference at this point, the results are the same. People suffering and dying due to the low staff levels, and the high number of patients supposedly seen by the doctors.
Here is the link again to Dr. Larry Joe Russells referral information.
http://w.npidashboard.com/npi/1891772513
In the last post I shared a couple of links to a website that posts referral data on doctors. According to the website, the referrals are taken from Medicare billing records. That would indicate that the data does not contain any information concerning private insurance, or Medicaid. It also states that only the top ten referring physicians are listed. That said I am going to post some information given on the website.
This was copied and pasted directly from the website, which I believe is published by the CMS.
"In order to protect patient privacy, the referral data records the number of times two providers billed Medicare for the same patient within a sliding 30-day period, where at least 11 patients were involved in transactions."
Dr. Larry Joe Russell received a total of 429,739 incoming referrals in a three year span. That means an average of 143,246 a year, or 11,937 a week. That's a lot of patients for one small town doctor. But it gets better Dr. Russell also had 315,328 outgoing referrals, 105,109 a year or 2,021 a week. Together that totals 745,067 over a three year period, or, 248,355 a year or 4776 a week. Dr. Russell charges $125.00 for an office visit, that means if the data is correct, Dr. Russell billed Medicare around $93,133,375.00 over the three year period. Red Flag, Red Flag!!! Is nobody monitoring these numbers.
I will post the top five incoming and the top five outgoing sources, in the interest of public awareness. I will post the information from the three years in the data base.
I will begin with the top five outgoing referrals, from Dr. Larry Joe Russell.
2009 2010 2011 Total
Henderson County Hospital ( Pardee ) 11,628 10,150 9894 31,672
Denise Hunt FNP 3437 3166 3791 10,394
Dr Kevan Hansel, BlueSky MD 3254 2656 1593 7,503
Linda Brooks FNP 1036 1718 2575 5,329
Deborah Whitmire Pitillo FNP 2236 0 1878 4,114
For the record, Dr Russell was instrumental in the negotiations of the purchase of Hendersonville Health and Rehabilitation from Pardee Hospital. Also Linda Brooks FNP is one of the owners of Hendersonville Physicians and Associates, the ones who purchased Hendersonville Health and Rehabilitation. Denise Hunt FNP and Deborah Whitmire Pitillo are both under Dr. Russells supervision, according to the NC Medical Board. Dr Kevan Hansel worked in Dr Russels office but is now with BlueSky, who also owns a percentage of Hendersonville Physicians and Associates. Seems like a cozy little group, living off of Medicare Dollars!
Now here are the top five incoming referrals to Dr. Larry Joe Russell.
2009 2010 2012 Total
Henderson County Hospital ( Pardee ) 15,885 14,043 14,073 44,001
Dr. Kevan Hansel, BlueSky MD 4,609 3,396 1,980 9,985
Denise Hunt FNP 2,900 2,411 3,004 8,315
Henderson County EMS 2,586 2,649 2,663 7,898
Hendersonville Health and Rehabilitation 2,440 2,172 2,253 6,865
Looks like friends scratching each others backs, also looks a lot like several violations of the Stark Law and the law prohibiting physicians self referrals. It appears that somehow this little group of friends are exempt from State and Federal laws. Is nobody in law enforcement looking at this. It is all public information, posted by the very agencies that are supposed to enforce the laws.
All of the information posted here was also forwarded to the FBI, OIG, CMS, NCDHHS, DHHS, and members of Congress. Not one reply so far. Who's running the State of North Carolina ? Is it politicians, or the healthcare PAC's and wealthy nursing home owners? What's the difference at this point, the results are the same. People suffering and dying due to the low staff levels, and the high number of patients supposedly seen by the doctors.
Here is the link again to Dr. Larry Joe Russells referral information.
http://w.npidashboard.com/npi/1891772513
Saturday, April 26, 2014
More about the NCDHHS!
Last post I wrote about my contact with Beverley Speroff and her response to my request for information. This week I received a reply from the office of Kathleen Sebelius, in response to the same letter that was sent to Ms. Speroff . The response was pretty much the same, I was referred back to the local DHHS office. My next step was to write to Aldona Vos the Secretary of the NCDHHS, requesting the same information. As of yet I have not received a reply from Secretary Vos.
The reason for the letters is, the report of the investigation conducted by the NCDHSR. I have a copy of the documents from their investigation that are full of inaccurate information. I am only asking them to produce some sort of documentation concerning facts that are crucial to their investigation. I would assume that if they actually had done an investigation, there would be documentation of the facts. When you read the report, it appears that the things in question were simply the opinion of the investigator. That investigator, Todd Davis, is now the Western Regional Director of the NCDHSR nursing home licensure division. I guess like most government positions, incompetence is rewarded with a promotion!
I will continue to check the mail for a letter from Secretary Vos's office, but I am not holding my breath. It is obvious that the money the nursing home owners throw around is a huge obstacle. For the record, a copy of the letter sent to Secretary Vos was also sent to Governor Pat McCrory. If the media is correct, there seems to be a cozy relationship between Governor McCrory , Secretary Vos and her husband as well. My thinking is that the North Carolina group is seriously connected to a larger group in Washington. All of them simply looking for the biggest campaign contributions and special perks.
My brother found some pretty interesting facts, concerning referrals in the healthcare business. I know there are laws against physician self referral, yet CMS publishes a list of providers and referrals. The list indicates that DR. Larry Joe Russell averaged 2756 referrals a week for three years, and referred out 2243 a week, most of them to his office. Is that not what would be considered self referrals? I guess that the CMS is too busy doing whatever else they do to read their own reports!
Below is the link to DR. Russells referrals, take a look at the list of people sharing the same address.
http://w.npidashboard.com/relationship/1891772513
http://w.npidashboard.com/npi/1891772513
Self referrals ? Not Dr. Larry Joe.
The reason for the letters is, the report of the investigation conducted by the NCDHSR. I have a copy of the documents from their investigation that are full of inaccurate information. I am only asking them to produce some sort of documentation concerning facts that are crucial to their investigation. I would assume that if they actually had done an investigation, there would be documentation of the facts. When you read the report, it appears that the things in question were simply the opinion of the investigator. That investigator, Todd Davis, is now the Western Regional Director of the NCDHSR nursing home licensure division. I guess like most government positions, incompetence is rewarded with a promotion!
I will continue to check the mail for a letter from Secretary Vos's office, but I am not holding my breath. It is obvious that the money the nursing home owners throw around is a huge obstacle. For the record, a copy of the letter sent to Secretary Vos was also sent to Governor Pat McCrory. If the media is correct, there seems to be a cozy relationship between Governor McCrory , Secretary Vos and her husband as well. My thinking is that the North Carolina group is seriously connected to a larger group in Washington. All of them simply looking for the biggest campaign contributions and special perks.
My brother found some pretty interesting facts, concerning referrals in the healthcare business. I know there are laws against physician self referral, yet CMS publishes a list of providers and referrals. The list indicates that DR. Larry Joe Russell averaged 2756 referrals a week for three years, and referred out 2243 a week, most of them to his office. Is that not what would be considered self referrals? I guess that the CMS is too busy doing whatever else they do to read their own reports!
Below is the link to DR. Russells referrals, take a look at the list of people sharing the same address.
http://w.npidashboard.com/relationship/1891772513
http://w.npidashboard.com/npi/1891772513
Self referrals ? Not Dr. Larry Joe.
Friday, April 18, 2014
Who is Beverly Speroff and the Nursing Home Licensure and Certification Division of NCDHHS protecting ?
I have been attempting to get a representative from the NCDHHS to explain their investigation results from the inspection of Hendersonville Health and Rehabilitation, resulting from my complaint. I started by calling the Western Regional office of NCDHSR in Black Mountain. This is the office that did the "administrative review " of the complaint findings. I spoke to the director Todd Davis, and asked if someone would explain the findings to me. Mr. Davis immediately took an offensive position, and denied my request simply because the survey was done in 2012.
The next step was to contact the State level director of NCDHSR , Ms. Beverly Speroff. I requested the same meeting from Ms. Speroff, explaining that it might help them in future investigations. Of course I was denied again because there have been investigations since my complaint. Ms. Speroff informed me they can not go back and cite a facility if there have been subsequent investigations. I wrote Ms. Speroff again, explaining that I did not expect them to write any citations. The reason for my request was simply to understand their findings from my complaint. After two weeks I received a response to my request. " We informed you in a letter dated February 6, 2014 that this request will not be honored because the investigation was completed in the spring of 2012. This matter is closed."
Does this mean the amount of time passed changes the fact that they failed to do a thorough job? Is the NCDHSR doing a perfect job with their investigations ? Am I not entitled to an explanation of the conflicting information in their report ?
If I have information that could improve the effectiveness of future investigations, why don't they want to know? Could it be that the same Todd Davis, was the lead investigator of my complaint ? I can understand why someone would not want their incompetency's exposed. The fact that those incompetency's affect the licensing of nursing homes, should be more important than ones pride. I am being nice in calling them incompetency's. I believe that the findings of the NCDHSR investigations are just plain false. There are no other explanations for their findings, not even plain old stupidity.
Is the NCDHSR incompetent, or are they another example of what money can buy in our political system? From everything I have seen and heard, my bet is good old fashioned corruption. The following paragraph is from Wikepedias definition of corruption.
Some forms of corruption – now called “institutional corruption” – are distinguished from bribery and other kinds of obvious personal gain. Campaign contributions are a prime example. Even when they are legal, and do not constitute a quid pro quo, they have a tendency to bias the process in favor of special interests and undermine public confidence in the political institution. They corrupt the institution without individual members being corrupt themselves. A similar problem of corruption arises in any institution that depends on financial support from people who have interests that may conflict with the primary purpose of the institution.
When you look at the ownership of many nursing homes, you will find plenty of politicians. They go from County officials, all the way to Congressmen and Senators. There are also plenty of owners who belong to the same country clubs as the politicians. There is plenty of opportunity for corruption at any level. The fact that not one government agencey will follow through on a complaint against these people is a good indication of what is written above. Nursing home owners are major contributors to politicians, all the way up to the President. The nursing home PAC's have plenty of money to throw around, to obtain favors in the political arena.
The next step was to contact the State level director of NCDHSR , Ms. Beverly Speroff. I requested the same meeting from Ms. Speroff, explaining that it might help them in future investigations. Of course I was denied again because there have been investigations since my complaint. Ms. Speroff informed me they can not go back and cite a facility if there have been subsequent investigations. I wrote Ms. Speroff again, explaining that I did not expect them to write any citations. The reason for my request was simply to understand their findings from my complaint. After two weeks I received a response to my request. " We informed you in a letter dated February 6, 2014 that this request will not be honored because the investigation was completed in the spring of 2012. This matter is closed."
Does this mean the amount of time passed changes the fact that they failed to do a thorough job? Is the NCDHSR doing a perfect job with their investigations ? Am I not entitled to an explanation of the conflicting information in their report ?
If I have information that could improve the effectiveness of future investigations, why don't they want to know? Could it be that the same Todd Davis, was the lead investigator of my complaint ? I can understand why someone would not want their incompetency's exposed. The fact that those incompetency's affect the licensing of nursing homes, should be more important than ones pride. I am being nice in calling them incompetency's. I believe that the findings of the NCDHSR investigations are just plain false. There are no other explanations for their findings, not even plain old stupidity.
Is the NCDHSR incompetent, or are they another example of what money can buy in our political system? From everything I have seen and heard, my bet is good old fashioned corruption. The following paragraph is from Wikepedias definition of corruption.
Some forms of corruption – now called “institutional corruption” – are distinguished from bribery and other kinds of obvious personal gain. Campaign contributions are a prime example. Even when they are legal, and do not constitute a quid pro quo, they have a tendency to bias the process in favor of special interests and undermine public confidence in the political institution. They corrupt the institution without individual members being corrupt themselves. A similar problem of corruption arises in any institution that depends on financial support from people who have interests that may conflict with the primary purpose of the institution.
When you look at the ownership of many nursing homes, you will find plenty of politicians. They go from County officials, all the way to Congressmen and Senators. There are also plenty of owners who belong to the same country clubs as the politicians. There is plenty of opportunity for corruption at any level. The fact that not one government agencey will follow through on a complaint against these people is a good indication of what is written above. Nursing home owners are major contributors to politicians, all the way up to the President. The nursing home PAC's have plenty of money to throw around, to obtain favors in the political arena.
Saturday, April 5, 2014
SanStone, twenty minutes to answer the call lights. Little shop of horrors !
Needless to say this has been an eye opening week for me. Some of what I've seen just proves to me that the care at Hendersonville Health and Rehabilitation is as bad as I always thought it was.
I've seen the call lights on down the hallway, and not a nurse in sight. I witnessed a patient in a wheel chair, with one arm bandaged up and useless, drag a walker the entire length of the hall.This was done with two nurses standing there watching as they talked. I've seen them move patients with and without the help of the lift, depending whether they can get someone to assist with the lift.
Yesterday I had to go down one of the other halls to get to the "big rehab room", the smell of urine and feces was so strong I held my breath. When I arrived, there were five or six patients and maybe four therapists. One gentleman was complaining that someone had just wheeled him there and left. He told one of the employees he had been in there for an hour and a half. I would assume that if you move all the residents to rehab or the dining room, they are easier to watch and less staff is needed.
I began this journey with one goal, and that was to spend time with a fellow church member who is dying. I was able to look past a lot of what I had seen, until it directly affected my friend.
I have seen him go a whole week without a shower. One day he was not given a shower because the heat was out in the shower room. The other day I finally reached my limit. As my friend was wheeled in after therapy, they left him in his wheelchair. While we were talking, his bladder released and his clothes got wet. He asked me to push the call button for a nurse to clean him and help him to bed. I pushed the button, and after five minutes I went outside the room to see if the light was on and if anyone was around. The light was on so I walked to the nurses station and there was one nurse there. I told her what had happened and she told me to push the call button. I told her that I had already done that and she just told me that the nurse would help when she came by. I went back into the room and waited with him. Finally after 20 minutes of sitting in urine soaked pants, two nurses showed up, they changed him and assisted him to bed. This was the first time I had ever seen them use the lift on him. It usually sits at the end of the hall against the wall.
I cant even imagine what happens to ones pride and self worth when treated this way. The nurses are so busy that they seem to resent you asking for anything. I have met a few nurses and cna's that seemed to have some compassion left, but they are few and far between. All of my visits were in the daytime hours between two and three, I cant even imagine how much worse it must be at night.
My experience with nursing homes reminds me of the way they portray mental institutions in old black and white movies.
I went there with the hope that things were not as bad as I remembered during Mom's stay. Unfortunatley I was dissappointed to see they were as bad or worse than I remembered from 2011. The problem is obvious, they do not have enough staff to provide the services needed by the residents. The staff that is there is overworked, and it shows in their attitude towards the patients.
SanStone, our passion makes us different, thats what they advertise. The truth is that their passion is the same as almost all the other nursing home groups, lots of money!!
I wonder how Dr. Larry Joe Russell, Christopher Sprenger and Michael Deloach would feel if they had to sit in their own urine for twenty minutes. I wonder how long they would go without a shower because they had no heat in their bathrooms?
I've seen the call lights on down the hallway, and not a nurse in sight. I witnessed a patient in a wheel chair, with one arm bandaged up and useless, drag a walker the entire length of the hall.This was done with two nurses standing there watching as they talked. I've seen them move patients with and without the help of the lift, depending whether they can get someone to assist with the lift.
Yesterday I had to go down one of the other halls to get to the "big rehab room", the smell of urine and feces was so strong I held my breath. When I arrived, there were five or six patients and maybe four therapists. One gentleman was complaining that someone had just wheeled him there and left. He told one of the employees he had been in there for an hour and a half. I would assume that if you move all the residents to rehab or the dining room, they are easier to watch and less staff is needed.
I began this journey with one goal, and that was to spend time with a fellow church member who is dying. I was able to look past a lot of what I had seen, until it directly affected my friend.
I have seen him go a whole week without a shower. One day he was not given a shower because the heat was out in the shower room. The other day I finally reached my limit. As my friend was wheeled in after therapy, they left him in his wheelchair. While we were talking, his bladder released and his clothes got wet. He asked me to push the call button for a nurse to clean him and help him to bed. I pushed the button, and after five minutes I went outside the room to see if the light was on and if anyone was around. The light was on so I walked to the nurses station and there was one nurse there. I told her what had happened and she told me to push the call button. I told her that I had already done that and she just told me that the nurse would help when she came by. I went back into the room and waited with him. Finally after 20 minutes of sitting in urine soaked pants, two nurses showed up, they changed him and assisted him to bed. This was the first time I had ever seen them use the lift on him. It usually sits at the end of the hall against the wall.
I cant even imagine what happens to ones pride and self worth when treated this way. The nurses are so busy that they seem to resent you asking for anything. I have met a few nurses and cna's that seemed to have some compassion left, but they are few and far between. All of my visits were in the daytime hours between two and three, I cant even imagine how much worse it must be at night.
My experience with nursing homes reminds me of the way they portray mental institutions in old black and white movies.
I went there with the hope that things were not as bad as I remembered during Mom's stay. Unfortunatley I was dissappointed to see they were as bad or worse than I remembered from 2011. The problem is obvious, they do not have enough staff to provide the services needed by the residents. The staff that is there is overworked, and it shows in their attitude towards the patients.
SanStone, our passion makes us different, thats what they advertise. The truth is that their passion is the same as almost all the other nursing home groups, lots of money!!
I wonder how Dr. Larry Joe Russell, Christopher Sprenger and Michael Deloach would feel if they had to sit in their own urine for twenty minutes. I wonder how long they would go without a shower because they had no heat in their bathrooms?
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