The
88-year-old woman at Claywest House nursing home near St. Louis was
totally reliant on staff for her care. There was nothing she could do
about the ants crawling all over her. Or the waste she helplessly waited
in during the weeks leading up to her death.
She’d
been in good standing, her bills covered, at least in part, by the
federal Medicare program. The problem at Claywest and at two other area
nursing homes was poor staffing. And as investigators would later learn,
the shortage wasn’t an oversight. It was built into the system—a
decision that led to horrific conditions at the nursing homes between
1998 and 2001 and federal charges that the homes and their upper
management were padding their balance sheets on the backs of helpless
residents in their care.
“They
were all trying to make a buck,” said Alan Peak, a supervisory special
agent in the white collar crimes unit of our St. Louis field office,
where the case was investigated in conjunction with local Health and
Human Services inspectors. The probe revealed criminal conditions at the
nursing homes—residents suffering from bed sores, malnutrition,
beatings, neglect—all the result of their management company’s
directives to cut costs. Meanwhile, managers rewarded themselves
handsomely for their efficiency.
“Service
was so bad and so neglectful that patients were essentially being
charged for worthless services,” said Special Agent Wade Beach, who
worked the case. “They were running skeleton crews who couldn’t get
around to all the patients.”
While
systematically cutting back on service at the nursing homes, management
continued to collect money from Medicare and Medicaid for services they
knew were inadequate, or in some cases not performed at all. The
management company and its CEO, as well as the nursing homes, pled
guilty to fraud conspiracy charges. The CEO was sentenced to 18 months in prison, and the nursing homes were each fined $180,000. [2]
What organizational ethics issues were illustrated by this case?
This patient had suffered a complete loss of autonomy being reliant upon the staff for her care. The terrible thing about this case for me is I have seen this more times than I can remember. It is a soul crushing thing to see these people just wasting away and nobody cares. They
are pushed aside by their families, ignored by the people being paid to
take care of them and they are forgotten by society. The
other ethical issue is one of trust and square dealing, the facility
being deliberately under staffed and the poor quality of the staff. Not to mention the fact that they are taking money for a service and not adequately providing it. Finally, padding their balance sheets, it just does not get any worse than that.
The False Claims Act imposes liability on persons and companies who defraud government programs. This
law allows people who are not affiliated with the government to file
actions on behalf of the government and they can receive 15-25% of any
recovered damages. The government has recovered nearly $22 billion under the False Claims Act between 1987 and 2008. [1]
Impact on the bottom line
The impact is that the publicity of a case like this has the potential to financially destroy the institution. The families of the customers will surely pull their family members out of the nursing home, at least the ones who care. The newly earned bad reputation will reduce the number of incoming patients. Many of the employees may also look for employment elsewhere. The nursing home may have to change their name and re-open under new management. The bottom line is there will be a severe loss of revenue.
How would this information impact the culture of the organization? How will the outcome of this case impact the community?
A case like this would have a very negative impact on the culture of the organization. It would cast the entire health care industry in a negative light. Now other institutions in the area will fall under stiff scrutiny. An
incident like this would also have the result of raising community
awareness to the facts of health care fraud and nursing home patient
abuse. It could also have the effect of making the family members paranoid.
If
I were recently employed as an HCA at this organization, how would
I respond? What type of ethical practice could I institute at this
organization?
If I were employed as an administrator at this organization, I would want to shake things up. My
first move would be to get rid of substandard employees, that is,
employees with a poor work history and employees with bad attitudes and
only keep the best of the best. I would institute mandatory training for employees to make sure they are following proper procedures. I
would also want to bring in some quality assurance people to review
procedures and to investigate every aspect of the institution. I would set higher standards for facility sanitation, employee appearances and employee performance. Also I would want to recruit and hire quality employees and pay them a fair wage. I would push to have the name of the facility changed and start a new public relations media champagne. In
short, I would set and enforce higher standards of cleanliness, quality
patient care, employee training, and ethics awareness. In this way everyone would know what is expected of them as well as what is acceptable and what is not.
2. http://www.fbi.gov/news/stories/2007/april/fraud042007 Federal Bureau of Investigation, “Nursing Home Horror”, April 20th, 2007.
No comments:
Post a Comment