Three executives of the now-defunct Sacred Heart Hospital have been found guilty of a massive fraud scheme that led to serious patient harm and deaths. The executives were convicted of bribing doctors to send Medicare and Medicaid patients to the substandard, filthy hospital.
In July 2013 our medical malpractice attorneys posted on this blog that the West hospital abruptly closed following an FBI raid. Six employees were arrested at that time on charges ranging from purposefully overmedicating patients to a scheme to defraud federal health systems. Ed Novak, the hospital’s owner and mastermind behind the scheme, is now facing prison time. Two hospital executives, the former finance chief and chief operating officer, also face prison time.
The men have been convicted of bribing doctors to send patients on federal assistance to Sacred Heart, where they received grossly inadequate care at the cost of taxpayers. These patients would be driven by ambulance across Chicago, past higher quality hospitals to get to Sacred Heart.
The bribes to doctors were disguised as staffing fees, rental payments and teaching costs. In secretly recorded conversations played during trial, Novak is heard telling his staff to “cover our asses” before federal and state investigators came in.
Patient Deaths from Unnecessary Surgeries
Among the most disturbing allegations against Novak and his hospital staff includes orders to perform tracheotomies on patients that were not medically needed. Novak would urge doctors to dose patients with dangerous medications so they were unable to breathe on their own, then use this as justification to perform the tracheotomy. A tracheotomy is a surgical procedure that creates a hole through the front of the neck into the windpipe.
Some patients died from the unnecessary procedure. Novak urged doctors to do this so he could bill Medicare and Medicaid for the surgery and collect high reimbursements.
Federal prosecutors were not able to use these specific allegations during trial, but they may be able to refer to them at Novak’s sentencing hearing, which is scheduled for July 2015. He has been convicted of 27 counts of fraud and is facing five years in prison.
Government Releases Hospital Compare Fact Sheet
The Centers for Medicare and Medicaid Services has a website for public use called Hospital Compare, which provides information on quality of care. This information is collected by a standardized 32-question survey and other data collection techniques that measure patient’s own perspectives of their hospital care.
The website includes hospital ratings and comparisons to other facilities and to national or state averages. Hospitals are rated on a five-star system, with 12 different categories for each hospital. This is similar to the rating system used on the government’s Nursing Home Compare and Physician Compare sites.
This star rating system – though far from complete – gives the public a quick summary of each hospital’s quality based on patients’ experiences. It is updated each quarter, and includes categories such as: cleanliness of hospital environment, responsiveness of staff, communication with doctors and nurses, pain management, and communication about medicines.
“Satisfaction” Does not Equal Quality Care
The Atlantic recently published an interesting take on this new healthcare rating system, titled The Problem with Satisfied Patients, which outlines the problems with this new government ratings program. Not only is the government publishing results on these surveys online, but it is also basing 30% of hospital Medicare reimbursements on these survey scores.
Experts believe this will cause hospitals to steer focus away from patient health and toward patient “satisfaction.” Patients can be dissatisfied because the hospital does not carry Splenda, or because their sandwich did not have enough meat on it, translating to poorer scores for nursing care. Nurses often have to sacrifice patient satisfaction for the greater good: their life.
A national study found that patients who said they were the most satisfied on surveys were actually more likely to be hospitalized and more likely to die within four years than patients who said they were less satisfied. It’s an issue of giving patients what they need instead of what they want.