Criminal cases cast shadows on hospice
Medicare fraud, credit card theft alleged
Two serious cases alleging criminal behavior by individuals associated with hospice programs in Illinois and Florida landed in local newspapers just as hospice professionals were gathering in Atlanta in mid-October for the National Hospice Organization’s (NHO) annual meeting. Given increased national attention to health care fraud, abuse, and waste issues, as well as the greater focus on compliance for hospices, in particular (see related story, p. 133), these high-profile cases could bring unwelcome scrutiny to an industry previously known mainly for its compassion.
The former operator of a Chicago-area hospice has been accused of defrauding Medicare and others of $28 million. Joseph Kirschenbaum, 38, formerly of Skokie, IL, and now a resident of Hollywood, FL, was charged in federal court Oct. 14 on 73 counts of defrauding Medicare and others while administrator of Samaritan Care Inc., a hospice program in suburban Lansing and Calumet City, IL.
Charges are detailed in an Oct. 15 story in the Chicago Tribune, titled "Hospice tied to swindle of Medicare," which reports his indictment for allegedly "carrying out one of the largest health care frauds in Chicago history while posing as the volunteer administrator of a bogus not-for-profit hospice." A press release issued the same day by NHO states that the national association "wholeheartedly supports the United States Attorney for the Northern District of Illinois’ investigations into the actions of Joseph Ari Kirschenbaum."
Kirschenbaum’s attorney, Gordon Nash, told the Tribune that his client intends to vigorously fight the charges and said that every patient admitted to Samaritan Care had been certified by the hospice’s medical director and the attending physician. Nash tells Hospice Management Advisor that Kirschenbaum would be entering a plea of not guilty in federal court on Oct. 28, but he is not permitted to comment more specifically on the charges.
According to the Tribune, Kirschenbaum, who was laid off in 1991 from a Chicago investment firm, started Samaritan Care hospice later that same year and lined up exclusive referral contracts with 18 area nursing homes. Then in 1994 he sold the hospice and his half interest in another hospice in Michigan for $17 million to Integrated Health Services of Owings Mill, MD, a national subacute and postacute care provider with a hospice product line.
The government is seeking forfeiture of that sale amount and of $8.6 million in alleged fraudulent Medicare payments. According to the Tribune, the indictment details charges that Kirschenbaum falsified medical certifications, social work assessments, and board of directors meeting minutes but was able to make these records appear as if Samaritan was in compliance with Medicare rules.
More fraud reported
According to its press release, "NHO is appalled by these alleged activities and is concerned that the reputation of hospice care will suffer because of these unprecedented activities. . . . There is no place in the hospice community for organizations and individuals characterized by these allegations, and we look forward to continuing to work with the administration and Congress to make certain that such activities do not happen in the future."
Meanwhile, in Fort Myers, FL, a nurse’s aide was arrested and charged with stealing and using credit cards belonging to two patients in a residential hospice facility operated by Hope Hospice and Palliative Care. The hospice cooperated with authorities after learning from a family member that credit card purchases had been made after the patient was admitted to the facility. In fact, says Hope Hospice CEO Samira Beckwith, ACSW, LCSW, the hospice had to prod local police to investigate the case more vigorously.
"It made staff uncomfortable. It couldn’t be one of us. It couldn’t be anyone who works in hospice," Beckwith says. "We couldn’t stand having a thief in our midst." The hospice issued a press release and contacted the local news media when the arrest was made. "I think press coverage has been positive, asking, How could somebody do this at a hospice?’" she says.
Beckwith emphasizes the importance of background and reference checks on any new hospice employee, by whatever legal means are available in their state. "If you suspect a problem, confront it. Make sure you deal with it, so you don’t just pass it along to another organization," by quietly discharging an individual who engages in criminal behavior, Beckwith adds. "Then talk to the community about it what you’ve done and why it’s appropriate. Also make sure your staff are prepared to respond to what they hear from the public or from patients. We worked through our management team to prepare all of our staff on the issue."
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