How much bribe money might someone be willing to pay for a confidential schedule of upcoming “unannounced” state oversight inspections at nursing homes?
Three thousand dollars per schedule was the going price in one case in Florida, according to an affidavit filed recently by a special agent for the U.S. Department of Health and Human Services, Office of the Inspector General (OIG).
Read MoreOne Certified Nurse’s Aide (CNA) pointed out that if nursing homes knew the inspectors were coming, the inspectors didn’t get to see what normal life was like for residents and employees of those nursing homes. Instead, inspectors were presented with a sanitized version of conditions.
When I was a kid in McKeesport, Pennsylvania, in the 1960s, people hanging out in my pool hall knew when the county detectives’ racket squad was about to raid my town’s bookmaking joints and the prostitution district. The bookies and pimps certainly knew too. The raids were a joke, and after the raids the racketeers went back to business as usual. I asked rhetorically in my book whether someone similarly was tipping off some nursing homes about looming inspections.
At the time my book was published, I had no hard evidence that any nursing home was paying bribes to a state oversight official.
However, I recently discovered that the U.S. Department of Justice has filed an affidavit in federal court in Florida alleging that a Florida state employee had been taking cash bribes for years in exchange for confidential information that she provided to middlemen for nursing home operators. The information included “patient complaints and the unannounced inspection schedules” from her agency. The nursing homes would use the information to prepare for the inspections and “fabricate and falsify medical paperwork and temporarily remedy deficiencies.”
The agency was the Florida Agency for Health Care Administration (AHCA), which administers Florida’s Medicaid program and does the state’s nursing home inspections. On October 6, 2017 the defendant was arraigned on a charge of “Receipt of a bribe by agent of an organization receiving federal funds.”
According to the affidavit, the AHCA employee, Bertha Blanco, admitted taking bribes, and middlemen admitted passing bribe money to her.
A middleman said he was getting $200 for each patient complaint and $3,000 for each AHCA inspection schedule, and was passing some of the money on to Blanco, according to the affidavit.
This does not mean that anything like this was happening in Pennsylvania or New Mexico, or anywhere else. Certainly most nursing home operators and state inspection agency personnel are honest. They deserve the benefit of the doubt. And it is unfortunate that the conduct of one government employee casts a shadow on others. The office of the Pennsylvania secretary of health told me:
“The department is required to survey (inspect) each facility with a 12- to 16-month window in order to meet state and federal requirements. The department very conscientiously ensures that survey schedules are not disclosed to facilities and makes every effort to vary the timing of surveys to minimize the ‘predictability’ of the next one. The department is not aware of information about survey schedules or timing being disclosed to facilities.”
Nevertheless, the Florida nursing home bribery case and the testimony of confidential witnesses in other states are reason to suspect something might be seriously wrong if nursing homes know when inspectors are coming. I view the Florida bribery case in the context of my unsatisfactory personal experience with the Pennsylvania Department of Health after I asked it to investigate my mother’s nursing home, and the national statistics showing that complaints about nursing homes have gone up while enforcement actions have gone down substantially.
Federal authorities and attorneys general such as those in Florida, Pennsylvania, and New Mexico, deserve to be commended for trying to hold bad nursing homes or corrupt officials accountable. I hope they all follow through when they are told by confidential witnesses, such as CNAs, that nursing homes knew when inspectors were coming. Investigators should find out who told the CNAs the inspectors were coming, and who told the person who told the CNAs. And who told that person.
A copy of the OIG agent’s affidavit in the Blanco case is available under the heading “Litigation-Related Documents” at www.wbeerman.com