Tuesday, February 27, 2007

Elder Abuse & Fraud in Atrium & Elsewhere

Recent news reports highlight that -- even though rarely reported in the media -- nursing home fraud and neglect of care-dependent residents do occur within institutions in Pennsylvania. When law enforcement officials discover serious violations, perpetrators sometimes are pursued criminally. The process, however, is long-term and time-consuming.

In western Pennsylvania, a widely-reported prosecution by the United States Attorney's Office in Federal District Court recently ended with the sentencing of a former nursing home operator, Martha Bell, 60, to a five-year term. The fraud occurred between 1999 and 2003, while Bell acted as administrator of the Ronald Reagan Atrium I Nursing & Rehabilitation Center, in suburban Robinson Township.

The prosecution alleged that Atrium I provided sub-standard care to its residents, while its administrator ordered falsification of records and expended $88,000 in charges on nursing home credit cards, including 1,400 meals at restaurants. The prosecutors further asserted that the altered records and fraudulent charges bilked the Medicare & Medicaid government programs out of $8 million.

Neglect of the residents at the home began sometime after 1996, according to witnesses, but increased in 2001. See: "Witness: Atrium Nursing Home Poorly Staffed", published January 31, 2007, in the Pittsburgh Post-Gazette. According to witnesses, the Home's Administrator then told workers to alter records, covering up the shortcomings. See: "Bell told workers to 'fix' records", published July 20, 2005, in that newspaper.

At the federal trial, which concluded in August 2005, Bell was convicted on one count of health care fraud and eight counts of making false statements. See: "Former Nursing Home Administrator Found Guilty", dated August 23, 2005, by KDKA-TV in Pittsburgh.

Prosecutors then sought a harsh sentence, as indicated in a news report
, "Atrium nursing home founder given 5 years in jail for fraud", by Jason Cato, published in the Pittsburgh Tribune-Review, on October 28, 2006.

Assistant U.S. Attorney Leo Dillon said this case did not involve a typical white-collar crime, where only money was lost.

"People were hurt. People were seriously hurt," Dillon said. One patient suffered a broken hip after being assaulted by a staff member, he said. Others were not fed, bathed or given medication.

Mabel Taylor, 88, was found dead in October 2001 after she apparently wandered undetected into a courtyard and died from cardiac arrest. The temperature that night was in the 40s, and the coroner's office ruled exposure was a probable factor.
The U. S. Department of Justice and the Federal Bureau of Investigation together issued a press release, dated October 27, 2006, announcing the result in the case. See: "Former Nursing Home Administrator Sentenced to Five Years in Prison for Fraud Scheme".

The worst of the abuses at the Atrium I facility involved the death of resident Mabel Taylor, 88, in October, 2001, due to exposure when she wandered away unsupervised in cold weather. Allegheny County prosecutors alleged that Bell conspired to cover-up the death -- by ordering employees to bring her body back inside to make it appear as though she died in her sleep.

However, the incident resulted in investigations beginning in September 2002, and then the filing of separate criminal charges, based on Pennsylvania's "Neglect of Care-Dependent Person" law. It is found in Title 18 (Crimes & Offenses), in
Section 2713.

A prosecutor in Allegheny County commented on the seriousness of such state crimes, in an article published on January 7, 2007, "Jury selection begins in nursing home death".
District Attorney Stephen A. Zappala Jr. said the case has prompted him to focus more on abuse of the elderly. He hopes to have a special squad focusing on health care fraud and elderly abuse consisting of assistant district attorneys, accountants and help from county police detectives.

"This particular case gave a snapshot of the bureaucracy involving senior agencies," Zappala said. "It's clear Allegheny County should be doing more in this area."

Taylor's daughter, Jane Baczewski, 60, of Hopewell, Beaver County, said she's glad the trial is starting.

"But in the public interest, I think it's good so much time has passed because it's making people aware and keeping the pressure on administrators of other homes and the state to inspect them," Baczewski said.

Bell was schedule to report to authorities last week to begin her federal sentence, even while the other (state) proceeding continued. But, that was forestalled for five days due to her medical complaints. See: "Hospital stay delays prison for nursing home boss", published February 24, 2007, by Paula Reed Ward, of the Pittsburgh Post-Gazette.

That case may be nearly over, but another just began.

Separately, in
Chester County, it was reported on February 14, 2007, that the former nursing director of an assisted-living facility was accused of neglecting a patient's head wound for so long that it filled with maggots, and of trying to conceal the poor care by altering records. See: "Neglect Charged at Pa. Nursing Home", posted on February 14, 2007, by Federal News Radio:
Authorities on Tuesday charged Donna Marie Cameron, 39, of Aston, with criminal neglect, perjury and tampering with records at St. James Retirement and Rehabilitation Center in Chester, a Philadelphia suburb.

State regulators shut down the facility last year, citing unsanitary conditions and alleged mistreatment of patients.

According to prosecutors, Cameron neglected a deep head wound suffered by a 72-year-old patient in June. In September, the woman was taken to a hospital emergency room where nurses found more than 50 maggots in the wound.

The woman recovered and now lives in another assisted-living home.

Cameron tried to hide the neglect by altering medical charts to falsely state that workers had treated the wound with antibiotic ointment and changed dressings, authorities said.

See also: Press Release, "Attorney General Corbett announces arrest of three Delaware County women in Elder Abuse case", dated February 13, 2007. In the AG's press release, charges were outlined:

Cameron is charged with one count each for neglect of a care dependent person, false swearing, and perjury, and two counts each for tampering with or fabricating physical evidence, tampering with public records, tampering with records, and unsworn falsification.

Curtis is charged with one count each of false swearing, perjury, and tampering with records; three counts each of tampering with or fabricating physical evidence and tamperingwith public records; and two counts of unsworn falsification.

Tribbey is charged with one count each of false swearing, perjury, tampering with or fabricating physical evidence, tampering with records, and unsworn falsification.

In Pennsylvania, reports of suspected health care fraud, as described here, can be made to Medicaid Fraud Control Section of the Attorney General's Office at one of its regional offices.

Reports of suspected elder abuse, as described here, can be made to the Elder Abuse Unit of the Attorney General's Office, which supports Pennsylvania's Elder Abuse Hotline (1-800-490-8505) and the Department of Aging's protective services.

* * *
Update: 02/27/07:

After posting, I noticed on the website of the Pennsylvania Bar Institute this month's free offering of an "Online CLE Course". The subject: "
Understanding the Basics of Fraud and Abuse in the Health Care Industry" (PBI No. 4634, with materials 68 Pages, 566 KB, PDF). You can view the Table of Contents here (107 KB, PDF).

Update: 03/01/07:

See: "Phila. Inquirer's 'Shame of the State' Investigation", posted March 1, 2007, on this blog.

Update: 03/09/07:

For a development in the Attrium I case, see:
"Atrium supervisor pleads guilty to coverup", by Cindi Lash, published in the Pittsburgh Post Gazette on March 9, 2007:

A former nursing supervisor at the defunct Ronald Reagan Atrium I Nursing, Research and Rehabilitation Center has pleaded guilty to several charges stemming from an attempt to cover up how a resident died in 2001.

Kathryn Galati, 61, of the North Side, this week pleaded guilty before Common Pleas Judge David R. Cashman to one count each of perjury, false swearing, conspiracy and tampering with evidence. Three other counts of perjury and false swearing and one count of tampering with evidence were dropped.

Ms. Galati will be sentenced June 5. She was the supervisor on duty on Oct. 26, 2001 when Atrium resident Mabel Taylor, 88, died after she was trapped overnight in an outdoor courtyard at the former nursing and personal care home in Robinson. * * *

Update: 06/09/08:

For an update on these matters, see "Conviction of former Robinson nursing home operator upheld", by Jason Cato, published by the
Pittsburgh Tribune-Review on June 6, 2008.
A federal appeals court today upheld the conviction of the former administrator of a defunct Robinson nursing home on one count of health-care fraud and eight counts of making false statements on health-care matters.

Martha Ann Bell, 62, formerly of West Mifflin, was found guilty in August 2005. U.S. District Judge Terrence F. McVerry sentenced Bell in October 2006 to five years in prison.

Bell operated the Ronald Reagan Atrium I Nursing and Rehabiliation Center on Campbell's Run Road. Nursing home employees doctored records in order to receive Medicaid and Medicare payments for treatment that was never rendered.

Bell is scheduled for release in 2011, according to the U.S. Bureau of Prisons.

Bell is being held at the Allegheny County Jail pending an upcoming theft trial in state court, where she will face charges that she stole more than $50,000 from an Atrium account for her personal use.

Bell's lawyer, Thomas N. Farrell, said he might ask the U.S. Supreme Court to review today's decision by the 3rd U.S. Circuit Court of Appeals in Philadelphia. * * *