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Part One: The Whistleblower and the Healthcare Corporation
By Andrew Hanson
It is the carefully stated policy of healthcare institutions that employees must document every glitch in any system, care practice, or device that might adversely affect patient treatment. If a report is not investigated by authorized personnel within the institution; if the report is suppressed by top administrators; if the employee is threatened and/or fired in an attempt to keep the report from being made public, then someone may become a “whistleblower.”
Whistleblowers, by definition, are seen as enemies by the institutions they work for. Institutions often use the threat of litigation to silence whistleblowers. Their reasons for doing this involve money, corporate reputation, and, sometimes, unlawful behavior.
Adventist Today has discovered a story about an Adventist healthcare system and a whistleblower. The healthcare system she worked for was in a hurry to replace an old, inefficient record keeping system with a “unified suite of digital solutions proven to streamline administration, reduce costs and enhance patient safety” in which “an online digital chart displays up-to-date patient information in real time, complete with decision-support tools for physicians and nurses. Simple prompts allow swift and accurate ordering, documentation, and billing.” (Quoting the company provided the new system.) This is a change that many health care organizations are making today, encouraged by national policies.
Of course, this record-keeping change required an initial investment of millions of dollars in hardware, integrated software programs, and technical assistance directed by a company that specialized in hospital record-keeping. Employee training programs were also required for a healthcare system that administers 41 medical facilities and employs more than 50,000 workers.
When such changes are made, problems are inevitably encountered in the implementation and care is required to prevent the loss or confusion of medical records and employee contacts. Consequently, it became the job of specially trained IT workers to monitor this process and prevent information loss.
The whistleblower in this case is Patricia Moleski, one of those IT workers. The medical institution involved is Adventist Health System. It is generally identified as the largest Protestant healthcare provider in America with headquarters in Orlando, Florida.
Moleski’s story, as it has come to Adventist Today, is told in the video interview below. Adventist Today continues to pursue this story and will publish future reports as more is learned.
http://www.youtube.com/watch?v=F91hN9nR1KA
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It's amazing that no one has yet commented on this video. Yes, it is like a full-length "60 Minutes" expose but after listening to the entire story, how can the truth be denied?
Patricia Moleski, from Risk Management of AHS saw thousands of medical "events" (unfortunate or mismanaged episodes) deleted from records; events that could have been inimical to the hospital in major ways. This is in absolute violation of federal HIPPA law and if any patient requested her own medical records, any possible mishandled episode would be deleted from those records. This also was the way the employee's accident or injury on the job was handled: DELETED. Again, an employee would be denied the reports if she desired further compensatory action taken.
A number of events were revealed. A newborn was given the usual Vitamin K injection and then when transferred to another place in the hospital was given another Vitamin K injection because the first one had not been recorded. The baby died from blood in the brain. This was deleted from the records, and the parents were told it was sad that the newborn died, period.
This is FRAUD, defrauding both the U.S. government and the state of Florida.
This occurred in all the SDA hospitals in Florida. One hospital in Deland, with approximately 400 patient beds had 10,000 such events deleted in a few short years!
Attorney General Eric Holder, Senator Grassley and the FBI were all notified.
After notifying the FBI, Patricia's house was shot at; her car was set on fire, and her computer was tapped. She was fired for being a whistle blower and no one knows whether the case is being studied, "dumped," or ignored.
But, with the eventual cost-cutting that must be practiced in healthcare, this cannot be ignored; the penalties could be enormous. Physicians are now advocating against the many unnecessary procedures and diagnostic tests that are driving up healthcare costs so there will be additional scrutiny on medical records.
BTW: Google SDA health administrator's salaries and bonuses.
When did AToday discover this story? The lawsuit was filed in 2010. When did it come to the attention of Atoday? Under what conditions? Why was it not reported several years ago?
There is concern that because of the hospital's position in the entire state of Florida, that many have already rcused themselves. Why would an attorney take such a lawsuit when there are so many in high places involved?
The real question: did AToday just now discover this case? Why was it not reported two years ago?
So many unanswered questions; so few answers.
The SDA Church and its healthcare arm aren't getting any smaller or less complex, nor is the tab for this level of reportage falling in price.... Thanks again to all who make this coverage possible...
Ed Schwisow, AT Executive Secretary, Development
Fatal Accounts: The Audacity of an Adventist Auditor's Quest for Transparency, by David Dennis.
I had a chance to speak to David Dennis several years ago when I also felt the wrath of the Adventist hierarchy. His insight and knowledge was immense, but most of all his understanding of what the higher ups are capable of doing.
When I finally connected with Patricia, she was able to verify everything I always knew.
My medical records had been tampered with, pertinent records destroyed. I was deemed mentally ill and my reputation smeared, eight restraining orders filed against me.
So many of us, just doing the honest thing, doing the right thing and in the end we are treated like criminals.
In then end, it is faith that gets you through.
My gratitude also goes out to various others in this battle, who have chosen to do the right thing
Dr. Lyle Griffith, Dr. Ironside, Dr. Edric Willis,
Dr. Brent Smith (RIP)
To all at Adventist Today, thank you for believing in the ones who try to stand up for what is right and who continue to do the right thing.{C}
Barb,
Thanks for adding your experience to Pat's. I have read those books you mention and everyone who doubts these stories should check out those personal accounts of the church's "mighty arm" to destroy one's reputation in the interest of maintaining the pure picture of the church and its institutions.
It is quite amazing that this has elicited so little interest. Why are dedicated SDAs turning a blind eye and ignoring these true stories? Having worked in medical records for years, and my daughter a NP of 25 years, we were appalled at this conduct that was essentially ignored--by the hospital administration; the church; the FBI, attorney general and Sen. Grassley.
We can hold to a very slim hope that this is truly being investigated to present a thorough charge, but most of us, aware of the tremendous financial power held by Florida Hospital throughout the state, that powerful individuls can manage to
see that it never gets to the courts. Florida is currently under scrutiny over its voter suppression and the 2000 election fiasco and the billion-dollar Medicare fraud committed by a group of Florida physicians and medical suppliers.
I sent this information to Spectrum's blog as the more publicity the more possible action. It was considered to be "old news" and that if it had been worth investigating, it would have been done years ago--meaning--publicity is not possible.
Andrew Hanson should be commended for furnishing this information. Getting action is only accomplished by information.
http://www.atoday.org/article/1213/news/june-headlines/part-one-the-whistleblower-and-the-healthcare-corporation
If you read the entire letter - people can better understand the "full" situation here.
Black helicopters. 9-11. Moon landings. Masons. Illumnati.
Enough said...
Posted wrong link - though content in similar "camp"...
Worth reading letter above from Barbara and Patricia to the President of the United States.
Open Letter To President Obama & Attorney General Holder On National Systemic Corruption and Terrorism Against Injured Workers and Whistleblowers At Adventist Health System
Barbara Clark RN, NP
c/o 8200 Stockdale Highway M10 #230
Bakersfield, CA 93301
October 9, 2010
Hon. Barrack Hussein Obama
c/o The Old Executive Office Building
1600 Pennsylvania Avenue, N.W.
Washington, D.C. 20500
Eric Holder, Jr.
Attorney General
U.S. Department of Justice
950 Pennsylvania Avenue, N.W.
Washington, D.C. 20001
Subj: Gross violations of Federal Racketeering laws and systemic Medicare Fraud by Adventist Health Systems Nationwide.
Dear President Obama and Attorney General Eric Holder Jr.,
We are writing this letter to you to make sure you are aware of a systemic national criminal conspiracy to shift liability for workers compensation claims to the Federal government and the cover-up in ten states of liability for deaths and other injuries of the patients of the Adventist Healthcare System. We are also victims of terrorism by this corporation to silence our speaking out and limit their liability and legal responsibility.
This cover-up also uses the vulnerability of the electronification of medical records and workers compensation records with no hard copy back-up and the ability to easily manipulate these records by unscrupulous hospitals, doctors and the insurance industry.
In the case of Adventist Healthcare System, this has come to a head after an employee, Patricia Moleski, discovered that records regarding patient death and Worker Compensation employee records were illegally altered to limit or eliminate AHS’liability. She went undercover with the FBI to allow them to obtain further information about this criminal enterprise and was even wired.
Instead of protecting Patricia Moleski, the FBI is now refusing to take her calls and is missing in action MIA. We believe that you have the responsibility to pursue the investigation of the Adventist Healthcare System and to protect those whistle blowers who have put themselves in jeopardy in the cause of justice and human rights.
In addition, Moleski has reported and opened claims with OSHA, DOJ, Attorney General (Florida), GAP Government Accountability Project, POGO Project on Government Oversight, Department of Labor, The EEOC, The Government Healthcare Administration, Senators Grassley & McCain, The Senate Finance Committee. Moleski has been asked to testify before the Senate Finance Committee and agrees to do so.
As you are also well aware, the U.S. Food and Drug Administration (FDA)
launched the Sentinel Initiative, a database of databases that will access the private health information of all Americans via the use of electronic medical records. It is interesting to note that the chief architect of this system is a federal contractor in your home state;
RTI International
230 W Monroe, Suite 2100
Chicago, IL 60606
Considering the U.S. Department of Justice (DoJ) dismal record of criminal enforcement of the Health Insurance Portability and Accountability Act (HIPAA) and the horrible reviews of FDA cyber-security by the Government Accounting Office (GAO), the Sentinel Initiative appears to be another poorly designed database that will leak the personal details of a patient’s medical history to the
Cyber-hackers are not the major problem here, it is the Health care facilities such as the Adventist Health System that uses this technology to manipulate medical files, delete pertinent medical information and also manipulate health care, by altering records, bills and events in order to save money, including a way to bill the federal Medicare program and others for charges grossly inflated, duplicated and falsified. It allows such an organization to avoid paying workers’ compensation liabilities.
Attorney General Eric Holder seems to remain blind to the massive Medicare fraud in California and other states in the form of cost shifting private workers compensation liabilities to the federal Medicare program (see Adventist Health). In the case of Adventist Healthcare System, the Federal government as a result of criminal workers compensation fraud by the corporation (AHS) Clark’s surgeries was paid for by the US government. This systemic massive cost shifting is not only taking place with Barbara Clark but with tens of thousands of injured workers throughout the country.
Until the American public witnesses some degree of interest by the DoJ in federal racketeering Medicare fraud, no patient can expect the DoJ to pursue criminal sanctions against health care facilities and insurance companies that seize medical records from the FDA’s Sentinel Initiative. Especially Adventist Health that owns and operates over 75 percent of rural health in America.
When a Health care organization such as the Adventist Health Care System is able to delete and dismiss pertinent information that could possibly result in liability on their part, double and triple bill for medications and services for patients that may not even exist or have deceased by changing patient ID numbers, thus saving millions of dollars and spreading it amongst their CEO’s as yearly bonuses, while in the mean time the Federal Medicare program has to pick up the tab, one has to wonder why no agency is stepping in to stop this corruption.
This utterly woeful reckless disregard of patient medical record confidentiality and federal racketeering Medicare fraud is costing the government and the taxpayers millions of dollars each year.
There is an easy answer to that question and concern.
For over a decade, Barbara Clark has informed you and many other agencies about this national systemic fraud. In the end her concerns have fallen on deaf ears with agencies ranging from the Department of Industrial Relations (DIR California), FBI, Judges, only to name a few. Instead injunctions are being brought against us, restraining orders are put in place, so that we no longer are allowed to file letters of complaints to the Federal Government and then it is testified under oath by Adventist corporate officers that death threat letters were issued against them. Although no one has yet to be able to produce any such letters. We are told that “political decisions were made not to prosecute Fraud” after cases are forwarded to the District Attorney for prosecution.(Ed Jagels District Attorney, Bakersfield, CA)
Our homes have been shot at, we have been chased by investigators who attempt to run us off the road and our families are destroyed. Earlier last month Moleski had an arson attack on her vehicle. Frivolous injunctions are filed against us. Restraining orders are filed against us. Every trick is used to deny us our constitutional right to free speech and pursuit of justice.
Clark has done the same, which got her 8 “sham” restraining orders, she was no longer allowed to file complaints to the Federal Government and its agencies.
Your Office must take this seriously, since people are dying, being killed and abused, harassed and destroyed by this organization. If the above mentioned choose to ignore this plea for help, one can assume that once again the Adventist Health System has used plenty of money to bribe, intimidate and extort members of this Administration.
It is time that the President and Attorney General take action to protect injured workers, whistle blowers and the targeting of those who expose what we to believe to be a national criminal operation.
Kindest Regards
Barbara Clark.
Patricia Moleski
(Thx for the link Jason. Copy/paste of referenced open letter)
"The medical world is abuzz with the word that Electronic Medical Records will prove to the be the Gold Rush of the next few years and that the Obama Administration has provided over $40 billion in its Economic Stimulus Package [American Recovery and Reinvestment Act of 2009, also known as H.R. 1 or the Obama Administration Stimulus Funding Package] that will reimburse physicians, hospitals and nursing homes far more than their actual costs of purchasing, installing, deploying and maintaining a certified EHR System as an incentive to get more than 90% of all physicians and other health care providers in America interfaced with a Universal EHR System within the next few years" (http://uniehr.com/stimulus-details).
EHR seems like a no-brainer. In my personal life, I've gone paperless as much as possible, and do almost all of my banking online. In listening to Ms. Moleski's account of inaction by FBI, judges, other agencies and individuals tied to the health industry, I'm wondering if it's because it's so universal, that scoping the extent of the problem is difficult. Currently many government agencies are struggling to get their information systems secure, and they decide to intervene on behalf of a medical corporation that is part of the move towards EHR, it could open a whole can of worms. As a federal (CISSP certified) IT Security employee, I can see problems with a rapid deployment of EHR. In the government push for implementation and corporate grab for stimulus money (Does this apply to AHS, I wonder?), there needs to be oversight to guarantee that accepted "Best Practices" are followed, in having a well-designed architecture and business processes that help in keeping with federal regulations such as HIPAA.
One of these standard best practices is to have strong MANDATORY ACCESS CONTROLS that prevent unauthorized individuals from accessing, modifying or deleting records. Access control is implemented on an organizational level by enforcing "Separation of Duties" (another standard Best Practice in business) so that even the CEO is not authorized to modify patient records. Another technical control would be to have automated logging that records any time a deletion or modification takes place, who accessed the system, when, and what type of event took place. No doubt FBI is looking at this in the case of AHS to seek evidence of these deletions and modifications. There are many other controls that can help in securing a well-designed computer information system that will help in keeping out malicious insiders as well as hackers that should be in place, regardless of whether it's a health institition, corporation or government agency.
There may have been haste in implementing electronic record before the kinks were straightened out.
I was hospitalized in January of this year and all the records were computerized, and I asked for a complete copy of all my medical records, under HIPPA, and now have a copy at home in my personal files. After carefully reviewing the records I found several errors, which I requested correction and now they are all correct. Everyone who has medical records should ask for his personal records so not only will he know all the procedures and medicines that were prescribed, but in case of a move, these can be taken with him and given to who will be your next medical provider, saving lots of time and memory.
Whether these patients, or families requested their records, had they done so, these errors would have been revealed. Of course, deletions would not be shown, but questions should have been asked, especially when there is a death. As a pathologist's wife, I often have I heard that the only way to be certain how a patient died is the autopsy. These used to be performed for more frequently in hospitals, now there are very few. They reveal secrets that go down in the grave--and many are hospital/physician errors.
Chuck Yeager
The story through Part 5 can now be viewed at:
http://healthcarewhistleblower.blogspot.com