The Freedom of Information Act (FOIA) is a law that gives you the right to access information from the federal government. It is often described as the law that keeps citizens in the know about their government.
My first experience with the FOIA was when I requested the results of the investigation of my complaint with DHSR. The Complaint was against Dr. Larry Joe Russell and Hendersonville Health and Rehabilitation. A SanStone Property.
I filled out the form on line and the next day received conformation that they had received my request. Three days later I received the same conformation letter in the mail. It took over one year to actually receive the information I requested that first time!
By the time I received the information, there was nothing I could do about all of the mistakes in the report. When I contacted the NCDHSR to request clarification, they said it had been too long since the complaint was filed. So basically I have no rights because it took them so long to answer my request. The system is set up to prevent the use of any NCDHSR results in a law suit or any other legal action. Basically they make you wait till there is absolutely nothing you can do. If we had the information when we started, we could have gotten quite a bit further with law enforcement. By the time we received the report, nobody wanted to hear it.
I have requested clarification from Todd Davis, the Western Regional Director of the NCDHSR, my request was denied, due to the time since the investigation. I then went the next step and contacted Beverly Speroff, the section chief of the NCDHSR. Again I was refused and informed that the time was the problem, and after subsequent investigations they could not issue a citation.
I wrote Ms. Speroff again and explained that I was not looking for a citation to be written. Again I simply wanted some clarification on parts of their report. The next communication was short and sweet. They refused all requests and informed me if I wanted to make another complaint I could call the hotline.
My brother and I also filed FOIA requests for other information from the CMS (Center for Medicare and Medicaid Services). It has been over a year and we are still being sent back and forth from one FOIA specialist to another. Robin Brooks, Michael S. Marquis, Garfield Daley, Danean Jones, TedDoolittle , Breita Gillard, Sherry Landtroop, Reg 04, Donna Mott, back to Danean Jones and now Edna Brady.
Ms. Brady responded to my email two weeks ago, she said she would call or email me by Friday July 11th. I never received any communication from Ms. Brady. I emailed her again as a reminder, and she responded that she would be in touch by Friday the 18th. It was no surprise that she failed to respond, again. I sent her another email today, and have not yet received any response.
How long does it take to get information from the FOIA? I guess it all depends on who is incriminated by the information you request. What are they trying to keep us from finding out? What right do they have to deny us the information we requested? Is FOIA keeping me "in the know about my government"? I'm more confused now than I was when this whole thing started, is the FOIA based on the discretion of the "information specialist".
Actually as I re read this, I think I may be starting to understand how the system works afterall. It doesn't. Plain and simple this group of people and agencies have no idea who has what. They cant even say they will release any information, or even if there is any thing to be released.
I have asked Ms. Brady twice to expedite the request due to the time since the actual request was made. As of now I have been lead to believe there is some information, but not sure they will release it. I guess this shows that Freedom Of Information is not always a promise, or that they actually have any information at all.
Its a good thing we have this Law like the FOIA, or we would never be able to understand how the government works!
Tuesday, July 22, 2014
Wednesday, July 9, 2014
Is the NCDHSR letting Hendersonville Health and Rehabilitation and Dr. Larry Joe Russell Get away with murder?
Is it possible that the NCDHSR is allowing DR. Larry Joe Russell and Hendersonville Health and Rehabilitation to get away with murder? Sounds like I finally lost my mind right? Before you judge my sanity, lets look at the facts.
First you have a patient that is admitted for vocational and physical rehabilitation. The admission form states the diagnosis as rectal pain, constipation and encephalopathy ( disease damage or malfunction of the brain , not necessarily permanent).
The encephalopathy was a result of a craniotomy performed by Dr. Harold Picus. The surgery was to remove a tumor from the pituitary gland. According to Dr. Picus the surgery was successful and a complete recovery was expected.
After spending time at Care Partners in Asheville Mom returned home. She was home for about a week and then readmitted to Mission Hospital for hemorrhoids and stomach pain. After a little over a week she was discharged and sent to Hendersonville Health and Rehabilitation to regain her strength and continue her recovery.
During her stay at Hendersonville Health and Rehabilitation she was actively participating in the therapy, and getting stronger every day. There were several issues with the care she was receiving at Hendersonville Health and Rehabilitation. At the time most of them seemed minor, and Mom was getting stronger. There was a family member with her most of the day .
The problem was Mom was not getting the assistance with toileting or eating. The time it took for them to respond to the call light, forced her to try to go to the bathroom by herself. If one of us was there we would always help, but if we weren't she would try on her own. The response time to the call lights was anywhere from five to thirty minutes .That's a long time to wait if you have to go to the bathroom.
From the roommates description of a fall that occurred days before her death, she was attempting to get to the bathroom. There was another instance that was brought up by a nurse when Mom was found outside her room using her food tray as a walker, looking for the bathroom . Although neither of the two events was correctly documented in her records.
The day of her discharge, Mom was found without a pulse and not breathing. The details of that morning are still a mystery. The owners and administration of Hendersonville Health and Rehabilitation, refuse to provide any details other than the medical records. The records are inaccurate and contain false information. If there is nothing to hide, why are they going to such extremes to hide things.
I'm no doctor, and have no medical training other than what I got in Boy Scouts. I have however done a considerable amount of research, and have come up with a theory. I believe that when Mom fell, she hit her head on the terrazzo floor or her food tray. Being only two months after a craniotomy, this could have been tragic. According to medical journals and articles I have read it takes up to a year for the skull to heal after the surgery.
I believe she suffered a subdural hematoma (bleeding on the brain) that eventually caused her death. According to the records there are facts that indicate she was exhibiting symptoms of the above. There were no tests done after the fall, other than a blood pressure test, oxygen saturation, and pulse. A simple check of her pupils could have indicated further treatment , that was not done. The nurses note describing the fall was dated a month after Mom's death. It was created in an effort to stop the NC State Medical examiners office from doing an autopsy. The nurse Lara Mooney LPN states that she witnessed the fall. According to her statement, Mom actually slid out of bed and did not hit her head. It seems a little hard to believe that a month after a fall, she would remember such details! Not to mention Mom's records say she was to have a personal alarm, and bed and chair alarms at all times.
I have a death certificate of another patient at Hendersonville Health and Rehabilitation , signed by Dr. Larry Joe Russell . I believe the cause of death listed on the original death certificate was failure to thrive. According to the coroner Dr. Huntley, the actual cause of death was a "subdural hematoma as a result of a fall". I was given the name of that patient, by someone who has a relative in Hendersonville Health and Rehabilitation. According to witnesses, the patient was dropped on her head by a nurse, who tried to lift her alone, which is against regulations.
The NCDHSR is conducting bogus investigations which are allowing people to die. In 2011 and 2012, there were nine complaints filed against Hendersonville Health and Rehabilitation. Of those only one was found to be substantiated. In that case the patient was given the wrong medication, and ended up in the hospital. It would have been hard for the NCDHSR to find that one unsubstantiated.
During their yearly inspections they managed to find a total of forty six pages of deficiencies.
Is the NCDHSR letting nursing homes get away with murder? They certainly don't go out of their way to find deficiencies. I've been trying to get them to look at the report for over two years. I cant even get them to answer my letters.
The definition of murders : the killing of another human being under conditions specifically covered by law. Maybe like dropping an elderly lady on her head and not getting her the proper medical treatment. Murder or not you be the judge, because the NCDHSR will never bring them to a real judge.
First you have a patient that is admitted for vocational and physical rehabilitation. The admission form states the diagnosis as rectal pain, constipation and encephalopathy ( disease damage or malfunction of the brain , not necessarily permanent).
The encephalopathy was a result of a craniotomy performed by Dr. Harold Picus. The surgery was to remove a tumor from the pituitary gland. According to Dr. Picus the surgery was successful and a complete recovery was expected.
After spending time at Care Partners in Asheville Mom returned home. She was home for about a week and then readmitted to Mission Hospital for hemorrhoids and stomach pain. After a little over a week she was discharged and sent to Hendersonville Health and Rehabilitation to regain her strength and continue her recovery.
During her stay at Hendersonville Health and Rehabilitation she was actively participating in the therapy, and getting stronger every day. There were several issues with the care she was receiving at Hendersonville Health and Rehabilitation. At the time most of them seemed minor, and Mom was getting stronger. There was a family member with her most of the day .
The problem was Mom was not getting the assistance with toileting or eating. The time it took for them to respond to the call light, forced her to try to go to the bathroom by herself. If one of us was there we would always help, but if we weren't she would try on her own. The response time to the call lights was anywhere from five to thirty minutes .That's a long time to wait if you have to go to the bathroom.
From the roommates description of a fall that occurred days before her death, she was attempting to get to the bathroom. There was another instance that was brought up by a nurse when Mom was found outside her room using her food tray as a walker, looking for the bathroom . Although neither of the two events was correctly documented in her records.
The day of her discharge, Mom was found without a pulse and not breathing. The details of that morning are still a mystery. The owners and administration of Hendersonville Health and Rehabilitation, refuse to provide any details other than the medical records. The records are inaccurate and contain false information. If there is nothing to hide, why are they going to such extremes to hide things.
I'm no doctor, and have no medical training other than what I got in Boy Scouts. I have however done a considerable amount of research, and have come up with a theory. I believe that when Mom fell, she hit her head on the terrazzo floor or her food tray. Being only two months after a craniotomy, this could have been tragic. According to medical journals and articles I have read it takes up to a year for the skull to heal after the surgery.
I believe she suffered a subdural hematoma (bleeding on the brain) that eventually caused her death. According to the records there are facts that indicate she was exhibiting symptoms of the above. There were no tests done after the fall, other than a blood pressure test, oxygen saturation, and pulse. A simple check of her pupils could have indicated further treatment , that was not done. The nurses note describing the fall was dated a month after Mom's death. It was created in an effort to stop the NC State Medical examiners office from doing an autopsy. The nurse Lara Mooney LPN states that she witnessed the fall. According to her statement, Mom actually slid out of bed and did not hit her head. It seems a little hard to believe that a month after a fall, she would remember such details! Not to mention Mom's records say she was to have a personal alarm, and bed and chair alarms at all times.
I have a death certificate of another patient at Hendersonville Health and Rehabilitation , signed by Dr. Larry Joe Russell . I believe the cause of death listed on the original death certificate was failure to thrive. According to the coroner Dr. Huntley, the actual cause of death was a "subdural hematoma as a result of a fall". I was given the name of that patient, by someone who has a relative in Hendersonville Health and Rehabilitation. According to witnesses, the patient was dropped on her head by a nurse, who tried to lift her alone, which is against regulations.
The NCDHSR is conducting bogus investigations which are allowing people to die. In 2011 and 2012, there were nine complaints filed against Hendersonville Health and Rehabilitation. Of those only one was found to be substantiated. In that case the patient was given the wrong medication, and ended up in the hospital. It would have been hard for the NCDHSR to find that one unsubstantiated.
During their yearly inspections they managed to find a total of forty six pages of deficiencies.
Is the NCDHSR letting nursing homes get away with murder? They certainly don't go out of their way to find deficiencies. I've been trying to get them to look at the report for over two years. I cant even get them to answer my letters.
The definition of murders : the killing of another human being under conditions specifically covered by law. Maybe like dropping an elderly lady on her head and not getting her the proper medical treatment. Murder or not you be the judge, because the NCDHSR will never bring them to a real judge.
Sunday, June 15, 2014
It's our money they are stealing!
It has been two weeks since my last post. As of today, I still have not received a response to the letter I mailed on April 24, 2014. The letter was sent to Aldona Wos Secretary of the NCDHHS, Governor Pat McCrory, CMS, and several law enforcement agencies. The letter asks for an explanation of why the investigation of Hendersonvlle Health and Rehabilitation contained false statements and inaccuracies. Todd Davis, Kim Britt and Paul Yockey did the supposed "investigation".
In the summary there are several statements that contain conflicting information. There are also quite a few times that statements are made that have no supporting facts. The investigation is a joke, and the head of the NCDHHS doesn't seem to be concerned. These investigations allow the nursing homes to remain licensed, even when lives are being lost due to the violations of regulations they are paid to enforce.
If you have read my posts, you are probably familiar with the things I mention above.
I have repeatedly contacted employees of the NCDHHS, CMS, Governor McCrory and members of the Senate and Congress. For two and a half years, I have been pushing them to do their jobs. The responses I have received imply that it is not my right to doubt them. This just proves that if you question anything that is putting money into their pockets, you are the bad guy.
I was recently speaking to a Congressman and he even admitted that these people will ignore you and run you in circles till you go away. That's not going to happen in this case. I will continue to pursue the truth and strive to have the laws changed to stop these people from stealing Medicare dollars. They are stealing money from you and I, and apparently that's acceptable to most people.
I have an acquaintance, that told me their mother was at Hendersonville Health and Rehabilitation and they were double billing Medicare. The mother would call them and they would suggest that they would look into the bills. They were never corrected, and nothing was done about it. Another person called me and told me that DR. Russell was treating her for sleep apnea, and supplying her with a cpap machine. When she changed doctors, they told her she did not have sleep apnea.
There are more stories and I have names and contact information. That's our money folks, they are stealing our money! I work hard to pay my bills and I personally find it hard to swallow. There are plenty of sick people who need treatment, why does Dr. Russell have to falsely diagnose patients. Cant he simply treat patients and provide the appropriate care, or is it that easy to steal from Medicare and private insurance companies.
I have seen many stories on the news about how they caught someone fraudulently obtaining benefits from Medicare or the NCDHHS. Believe me that's small potatoes compared to the money that the operators like SanStone and Dr. Larry Joe Russell are stealing. The difference is that the agencies that are supposed to enforce and investigate are controlled by the politicians who owe their positions to these thieves.
The problem is the way businesses contribute to political campaigns. Obviously this is not just an issue with nursing homes, it affects all industries. It is the reason we are eating food contaminated with hazardous chemicals, damaging our ecosystem by allowing fracking, the list goes on and on. The nursing home owners are serious contributors to republicans and democrats alike. The party affiliation is not important, as long as they "earn" there campaign funds after the election.
We are taught from an early age that democracy guarantees that our vote counts. Have you seen the children come home from school with the little "I voted" stickers. They come home and they are so proud of the fact that they "voted". As a parent it is difficult for me not to explain to them that politicians are not always honest? Should I explain to my son that corporate money is what is controlling the politicians, or do I let him believe his vote will actually make a difference?
We can only hope that there are some politicians that care about more than just money. However in order to get elected, they are relying on corporate campaign contributions. If they get elected and want to stay in office, they have to be careful who's toes they step on. America is being governed by the influence of corporations. I'm sure this is not a surprise to anyone, but why do we allow them to get away with it. How do you stop the cycle if they are the ones making the laws?
In the summary there are several statements that contain conflicting information. There are also quite a few times that statements are made that have no supporting facts. The investigation is a joke, and the head of the NCDHHS doesn't seem to be concerned. These investigations allow the nursing homes to remain licensed, even when lives are being lost due to the violations of regulations they are paid to enforce.
If you have read my posts, you are probably familiar with the things I mention above.
I have repeatedly contacted employees of the NCDHHS, CMS, Governor McCrory and members of the Senate and Congress. For two and a half years, I have been pushing them to do their jobs. The responses I have received imply that it is not my right to doubt them. This just proves that if you question anything that is putting money into their pockets, you are the bad guy.
I was recently speaking to a Congressman and he even admitted that these people will ignore you and run you in circles till you go away. That's not going to happen in this case. I will continue to pursue the truth and strive to have the laws changed to stop these people from stealing Medicare dollars. They are stealing money from you and I, and apparently that's acceptable to most people.
I have an acquaintance, that told me their mother was at Hendersonville Health and Rehabilitation and they were double billing Medicare. The mother would call them and they would suggest that they would look into the bills. They were never corrected, and nothing was done about it. Another person called me and told me that DR. Russell was treating her for sleep apnea, and supplying her with a cpap machine. When she changed doctors, they told her she did not have sleep apnea.
There are more stories and I have names and contact information. That's our money folks, they are stealing our money! I work hard to pay my bills and I personally find it hard to swallow. There are plenty of sick people who need treatment, why does Dr. Russell have to falsely diagnose patients. Cant he simply treat patients and provide the appropriate care, or is it that easy to steal from Medicare and private insurance companies.
I have seen many stories on the news about how they caught someone fraudulently obtaining benefits from Medicare or the NCDHHS. Believe me that's small potatoes compared to the money that the operators like SanStone and Dr. Larry Joe Russell are stealing. The difference is that the agencies that are supposed to enforce and investigate are controlled by the politicians who owe their positions to these thieves.
The problem is the way businesses contribute to political campaigns. Obviously this is not just an issue with nursing homes, it affects all industries. It is the reason we are eating food contaminated with hazardous chemicals, damaging our ecosystem by allowing fracking, the list goes on and on. The nursing home owners are serious contributors to republicans and democrats alike. The party affiliation is not important, as long as they "earn" there campaign funds after the election.
We are taught from an early age that democracy guarantees that our vote counts. Have you seen the children come home from school with the little "I voted" stickers. They come home and they are so proud of the fact that they "voted". As a parent it is difficult for me not to explain to them that politicians are not always honest? Should I explain to my son that corporate money is what is controlling the politicians, or do I let him believe his vote will actually make a difference?
We can only hope that there are some politicians that care about more than just money. However in order to get elected, they are relying on corporate campaign contributions. If they get elected and want to stay in office, they have to be careful who's toes they step on. America is being governed by the influence of corporations. I'm sure this is not a surprise to anyone, but why do we allow them to get away with it. How do you stop the cycle if they are the ones making the laws?
Sunday, June 1, 2014
Shame on you, Todd Davis, Kim Britt, Paul Yockey, Aldona Wos and Pat McCrory
For the record, I sent a letter to Secretary Aldona Wos of the NCDHHS on April 24, 2014. The letter was pretty simple, it was about the lack of effectiveness of the local DHSR. I offer to share information that would prove that the nursing home inspection process is flawed. I also sent the same letter to Pat McCrory, and others that should be concerned. Still have not received any response. Not even the typical " we appreciate your concern but ... " letter.
What is up with the NCDHHS, are they above making mistakes,or simply not to be held accountable for the ones they do make. One would hope that if there was a private citizen with concerns, they would be taken seriously. Basically from what I've seen , if you disagree with the NCDHHS, that's your problem. Even the State director ( DR. Wos ) doesn't care enough to consider that there may be a problem.
Is there no one watching over this agency at the local level? I thought that by going to the State Secretary of the NCDHHS something would happen. I was definitely wrong about that. What about Governor Pat McCrory, as a citizen of North Carolina am I not entitled to a response? How much do you have to contribute to ones campaign to get an answer to a letter?
Politicians are supposed to be working for the good of the people. If that is the case, how can they ignore their concerns ? I have documentation that shows how little effort is put into the nursing home inspection process. Either someone made a mistake, or simply lied to protect the nursing home operators.
Todd Davis, Kim Britt and Paul Yockey, are the ones who conducted the investigation. I say you should all be ashamed of yourselves. How can you walk by the terrible things happening at Hendersonville Health and Rehabilitation and ignore them. What if your mother or father were residents there. Would you be able to sleep at night, knowing what you know?
I don't see how anyone with a conscience could possibly ignore what happens in these places. I could not imagine how much you would have to be paid to let this happen. There must be a considerable amount of "benefits" to look the other way. What makes it even worse, is that my tax dollars are being used to pay you.
Talk to the nurses at Hendersonville Health and Rehabilitation and they will tell you they are understaffed. Talk to the residents, they will tell you they had to wait three or four days for a shower. Talk to the cna's and they will tell you there is no way they can do everything they are supposed to in one shift. Talk to the administrators, they will tell you how " It's their passion that makes the Difference ". Talk to the NCDHSR, they will tell you there were " no deficiencies found ". Again I say shame on you, Todd Davis, Kim Britt and Paul Yockey.
I say to the NCDHSR, Governor McCrory and Aldona Wos, do your jobs. Protect and serve the citizens of North Carolina, not the wealthy businessmen who own the nursing homes. Go into Hendersonville Health and Rehabilitation and stay for a week. Sleep in one of the urine soaked beds. Wait for them to give you a shower. Eat the same cold food as the rest of the residents. After a week come out and say you couldn't find any deficiencies!
What is up with the NCDHHS, are they above making mistakes,or simply not to be held accountable for the ones they do make. One would hope that if there was a private citizen with concerns, they would be taken seriously. Basically from what I've seen , if you disagree with the NCDHHS, that's your problem. Even the State director ( DR. Wos ) doesn't care enough to consider that there may be a problem.
Is there no one watching over this agency at the local level? I thought that by going to the State Secretary of the NCDHHS something would happen. I was definitely wrong about that. What about Governor Pat McCrory, as a citizen of North Carolina am I not entitled to a response? How much do you have to contribute to ones campaign to get an answer to a letter?
Politicians are supposed to be working for the good of the people. If that is the case, how can they ignore their concerns ? I have documentation that shows how little effort is put into the nursing home inspection process. Either someone made a mistake, or simply lied to protect the nursing home operators.
Todd Davis, Kim Britt and Paul Yockey, are the ones who conducted the investigation. I say you should all be ashamed of yourselves. How can you walk by the terrible things happening at Hendersonville Health and Rehabilitation and ignore them. What if your mother or father were residents there. Would you be able to sleep at night, knowing what you know?
I don't see how anyone with a conscience could possibly ignore what happens in these places. I could not imagine how much you would have to be paid to let this happen. There must be a considerable amount of "benefits" to look the other way. What makes it even worse, is that my tax dollars are being used to pay you.
Talk to the nurses at Hendersonville Health and Rehabilitation and they will tell you they are understaffed. Talk to the residents, they will tell you they had to wait three or four days for a shower. Talk to the cna's and they will tell you there is no way they can do everything they are supposed to in one shift. Talk to the administrators, they will tell you how " It's their passion that makes the Difference ". Talk to the NCDHSR, they will tell you there were " no deficiencies found ". Again I say shame on you, Todd Davis, Kim Britt and Paul Yockey.
I say to the NCDHSR, Governor McCrory and Aldona Wos, do your jobs. Protect and serve the citizens of North Carolina, not the wealthy businessmen who own the nursing homes. Go into Hendersonville Health and Rehabilitation and stay for a week. Sleep in one of the urine soaked beds. Wait for them to give you a shower. Eat the same cold food as the rest of the residents. After a week come out and say you couldn't find any deficiencies!
Sunday, May 25, 2014
It all started with SanStone Health and Rehabilitation and Hendersonville Health and Rehabilitation
For the record I have still not received any response to my letter to Secretary Aldona Vos, or Governor Pat McCrory. The letter was mailed on April 24, 2014.
My last few posts were focused on Dr. Larry Joe Russell and his Medicare billing practices. The reason for that is the newly released numbers, posted by the CMS (Centers for Medicare and Medicaid Services). According to CMS the reason they are posting these numbers is so people can find and report Medicare fraud. Seems like a great idea, if they actually intend to take any complaints serious.
My first encounter with CMS was almost two years ago. I was referred to them by then Congressman Heath Shuler's office. The initial reply from CMS starts with how they appreciate concerned citizens who report Medicare fraud. Then it goes on to tell how seriously they take these allegations. When you look at the amount of taxpayer dollars spent on Medicare, they should be taken serious. That letter was from Alfreda Walker out of the Atlanta office of CMS. The letter goes on to say that I will be contacted directly by someone from their office. It also says that I will be contacted by someone from a State agency, concerning Medicaid. Four months went by an I never heard from anyone.
I contacted the Congressman's office and apparently somebody dropped the ball. Turns out it never left Ms. Walkers office. My phone call made something happen, but I'm not sure what. The next communication I received was from NCI Advancemed. The letter I got stated that they had completed their investigation and appropriate action had been taken. I called the number on the letter and spoke to Shannon Stinedurf, the one who had signed the letter. I asked her what action had been taken. Her reply was " there was no action taken, we didn't find anything wrong ". This prompted me to contact Ms. Walker again. She explained that NCI Advancemed was the contractor that handled Medicare fraud investigations. I asked her how they had conducted an investigation without ever contacting me for my information. Ms Walker failed to explain how this was possible. Then she told me that the "quality of care issue was being handled by the Carolina Centers for Medical Excellence, another contractor. She gave me a number to contact them, but it wasn't the right number. After a couple of emails to the CMS, I finally got a number that worked.
I then Called the CCME , and spoke to a representative that listened to my story. The representative seemed to think that there were several issues of concern in what I told her. She said she would pass things on to someone who would conduct a review. It only took a week or so, and I received the letter saying they did not find anything wrong. I tried to contact the first person I had spoken to, and could not get her on the phone. Things were getting more and more confusing.
Both the CCME and NCI Advancemed were government contractors, and both conducted their " investigations " in record time. Neither of them contacted me for any information nor did they seem to be concerned with what I had told them. Being the persistent person that I am, the next step was to call NCI Advancemed and start the move up the chain of command. I finally ended up with Norma Elder, who informed me that they had never been contacted by CMS, Congressman Shulers office or me. They got their information from the NCDMA ( North Carolina Division of Medical Assistance ). The NCDMA got their information from a complaint I had made with the NC Medical Board.
All of these different agencies had done nothing till my call to Congressman Shuler's office. Then they all seemed to find nothing wrong at the same time. I am convinced that someone with serious influence is controlling how this turns out.
If this seems confusing to you, welcome to the club. I have never been politically active, nor have I ever been so disappointed in the United States government. It seems that our government has decided that they are so incompetent they have to use contractors. It would not be surprising to know that the same contractors are owned by politicians and their family members. Probably the same people who own nursing home groups.
My last few posts were focused on Dr. Larry Joe Russell and his Medicare billing practices. The reason for that is the newly released numbers, posted by the CMS (Centers for Medicare and Medicaid Services). According to CMS the reason they are posting these numbers is so people can find and report Medicare fraud. Seems like a great idea, if they actually intend to take any complaints serious.
My first encounter with CMS was almost two years ago. I was referred to them by then Congressman Heath Shuler's office. The initial reply from CMS starts with how they appreciate concerned citizens who report Medicare fraud. Then it goes on to tell how seriously they take these allegations. When you look at the amount of taxpayer dollars spent on Medicare, they should be taken serious. That letter was from Alfreda Walker out of the Atlanta office of CMS. The letter goes on to say that I will be contacted directly by someone from their office. It also says that I will be contacted by someone from a State agency, concerning Medicaid. Four months went by an I never heard from anyone.
I contacted the Congressman's office and apparently somebody dropped the ball. Turns out it never left Ms. Walkers office. My phone call made something happen, but I'm not sure what. The next communication I received was from NCI Advancemed. The letter I got stated that they had completed their investigation and appropriate action had been taken. I called the number on the letter and spoke to Shannon Stinedurf, the one who had signed the letter. I asked her what action had been taken. Her reply was " there was no action taken, we didn't find anything wrong ". This prompted me to contact Ms. Walker again. She explained that NCI Advancemed was the contractor that handled Medicare fraud investigations. I asked her how they had conducted an investigation without ever contacting me for my information. Ms Walker failed to explain how this was possible. Then she told me that the "quality of care issue was being handled by the Carolina Centers for Medical Excellence, another contractor. She gave me a number to contact them, but it wasn't the right number. After a couple of emails to the CMS, I finally got a number that worked.
I then Called the CCME , and spoke to a representative that listened to my story. The representative seemed to think that there were several issues of concern in what I told her. She said she would pass things on to someone who would conduct a review. It only took a week or so, and I received the letter saying they did not find anything wrong. I tried to contact the first person I had spoken to, and could not get her on the phone. Things were getting more and more confusing.
Both the CCME and NCI Advancemed were government contractors, and both conducted their " investigations " in record time. Neither of them contacted me for any information nor did they seem to be concerned with what I had told them. Being the persistent person that I am, the next step was to call NCI Advancemed and start the move up the chain of command. I finally ended up with Norma Elder, who informed me that they had never been contacted by CMS, Congressman Shulers office or me. They got their information from the NCDMA ( North Carolina Division of Medical Assistance ). The NCDMA got their information from a complaint I had made with the NC Medical Board.
All of these different agencies had done nothing till my call to Congressman Shuler's office. Then they all seemed to find nothing wrong at the same time. I am convinced that someone with serious influence is controlling how this turns out.
If this seems confusing to you, welcome to the club. I have never been politically active, nor have I ever been so disappointed in the United States government. It seems that our government has decided that they are so incompetent they have to use contractors. It would not be surprising to know that the same contractors are owned by politicians and their family members. Probably the same people who own nursing home groups.
Sunday, May 18, 2014
Is Dr. Larry Joe Russell stealing from Medicare? You be the judge
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.
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.
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
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