Last tap on the Stake for the Hospital?

[150thBucktailCo.I]

Ex-employees sue hospital

Former officials claiming Tyrone facility submitted bogus bills to government, paid kickbacks to doctors.

By Walt Frank, wfrank@altoonamirror.com



Two former employees allege in a federal lawsuit that Tyrone Hospital submitted fraudulent billings to government agencies and paid kickbacks to doctors to refer patients to the facility.

In a lawsuit filed in U.S. District Court in Johnstown, former Chief Executive Officer Thomas Bartlett and former Human Resources Director Kimberly Gummo claim their employment was terminated after blowing the whistle on the hospital and others.

Bartlett and Gummo seek damages for the alleged retaliation.

The lawsuit names Tyrone Hospital Inc.; Quorum Health Resources LLC; Tyrone Medical Associates Inc.; Daniel Ashcroft; Tri-County Imaging Associates Inc.; Dr. Bernard DiGiacobbe; Maria Friday, executrix for the estate of Dr. Daniel Friday; Dr. Barry Bender; Dr. Carlos A. Wiegering; Dr. Ramesh Agarwal; Dr. Ramesh Chopra; and Dr. Raj Kansel as defendants.

Barlett served as hospital CEO from 2000 until he was terminated Dec. 5, 2003, by QHR, which provides management services.

Gummo was human relations director from September 2002 until July 2004, said their attorney, Andrew M. Stone of Pittsburgh.

“They filed this as whistle-blowers on behalf of the United States seeking to recover the money they claim was obtained fraudulently,” Stone said.

“There were several things that they came across while under employment and did something about it.”

According to court documents, the claims were based on fraudulent patient claims and hospital cost reports submitted to the United States in order to obtain millions of dollars in payments for various health care services. The suit alleges this started at least in January 1994 and continues through the present.

These false claims and false statements were part of an unlawful scheme to obtain business by paying kickbacks and illegal remuneration to physicians and others and entering into prohibited financial relationships with physicians to have them refer patients to defendants’ facilities, court documents state.

Top management of Tyrone Hospital participated in offering and paying kickbacks to physicians and continued to do so despite repeated warnings by the hospital’s internal audit personnel, court documents state.

The physicians receiving the payments referred large volumes of patients including Medicare and Medicaid patients and beneficiaries of other government health care programs to Tyrone Hospital, DiGiacobbe and Tri-County in violation of federal law.

The defendants in turn submitted claims to Medicare, Medicaid and other government health care programs and obtained millions of dollars worth of payments, court documents state.

Bartlett and Gummo learned of the arrangements and provided the information to the federal government starting about October 2003, court documents state.

Attorneys representing several of the defendants have filed a motion to dismiss the lawsuit.

In June, hospital officials said they were discontinuing their relationship with QHR for management services effective this Saturday.

The move to discontinue the hospital’s relationship with QHR was a ‘‘direction the board of directors think will better serve the community now and in the future,’’ said Judith Norris, board president.

Mirror staff writer Walt Frank is at 946-7466.

[banksy]

Good luck getting something from Bender....... what a sorry excuse for a human.

[caf941]

I grew up in Tyrone, was born at the above hospital, had all my medical care provided by Tyrone physicians and was a candystriper for three years. I had always looked up to and respected this medical facility.
Unfortunately when you acquire corrupt administration, board members who are out for themselves and have their own agendas, this is not going to save the facility from financial ruin. Most importantly, it is all about money,looking good for the community and social status.
Tyrone Hospital is not the only rural, small community hospital in PA. Others have made it with less. I have seen first hand how creativity, common sense and ethics can be a guiding force. Out of curiosity, did Quorum hire the kickback administrator? Did they receive monies? Quorum supplied the present CEO. If they are going to get the boot, then he should as well.
Maybe what the hospital really needed was a consultant to come in and troubleshoot. There are people out there who do this for a living and do a very good job. Instead, we received a temp CFO in 2004 who was more concerned with dating Tyrone residents (even though married) than saving our hospital. If one can lie about important things like marital status, what else are they hiding?
Somewhere, I believe it is written down that hospital employees should not date/pursue hospital patients. When I tried to look up the reg in the employee handbook, the Human Resources manager was clueless. He came from Quorum as well. I believe the words I want to use are "fratenization and adultry."
I was told confidential employee information, hospital financial statuses, his hatred for the hosital and how he felt it should just go under or "burn down." Go figure. This is what we really needed.
When I approached the board president and CEO, they both knew what I told them was true. Their solution was to "sweep it under the rug." I knew confidential information about employees, hospital finances, and the personal life of their temp CFO.
For myself, the worst part was that they did not care about how I was doing as a patient, emotionally and personally. Their concern was image. Sadly, I even approached the former administrator about the above situation. He told me he would look into it and get back to me. That was two years ago.
Now, after learning about possible kickbacks, I can see why he did not want to get involved.
As a result of this, I chose the Health Policy Administration major at Penn State. If a patient or hospital is exploited like Tyrone, I might just be able to effectively intervene before emotional and financial devastation occur.

[Mainegirl]

Sounds like someone has a clue! Good luck Christine.

[monecheri]

maybe residents from tyrone with kids on meds need to look in to all the billing the school does to medicade for guidence counsling ect . thats a huge bill for doing what counslers are supose to be doing. but if a kids on meds its big billing unessesarly . they do what the hospital did everyday

if you dont belive me ask a mom with a kid on ridlin to get a print out of services insuance have paid for its astronomical .
and most parents dont even know its being done till they get the print out
that isnt givin unless its requested it goes to the school . and parents never know that the kid on pills is being charged
and the good kids they like to call them who see the counslers arent

[jokerman]

I think that one thing the Hospital could pursue would be to open and run a Methadone Clinic. Or at least lease the space to an already established organization such as Discovery House. Nobody can question the need for one in Blair County, and if it's in a Medical Facility, there won't be the "not in my back yard" opposition that seems to appear no matter where a clinic is proposed.
I think it would be a win-win situation for both the hospital and community.

[monecheri]

i think thats a wonderful idea too!!!!!!!!! maybe they could take the now
empty birthing part and make an in patient wing along side the methadone clinic . that would bring revenue to tyrone be using the empty space and really help the comunity . most addicts dont go for help because there scared of the withdraws but a place where doctors might be able to help ease the withdraws where they could be monitored might incouage more addicts to attempt to try getting help

if welfare insurance can pay for all theese oxycotins vicodines percaset and hard core opiates to start the habbit for a 2.00 co-pay why not use it for low cost granted treatment and methadone clinics

methadone is exspensive and most addicts can afford 30.00 a day to keep well as they call it a lot easier then 100. for methadone to reduce the withdrawls...

[billm]

Yeah, that would be fantastic -- put your methadone clinic in close proximity to the school -- PERFECT!
How many of your children attend the tyrone school?

I have a friend who was nearly killed when 3 people coming from being doped up from the methadone clinic smashed into his van at almost 100 miles per hour!

There are many bigger issues to the methadone clinic than putting a bandaid on the injury -- and also asking for insurance to pay for it!
How about instead of a tyrone sidewalk which costs half a million bucks to pay for, we put that money into the YMCA or other opportunities for people to find better things to do with their time than drugs? Especially the youth of the community.
So you don't give the youth anything to do, but put a methadone clinic right next to their school -- GREAT IDEA?

I am all for free opinion - but if you don't live in or help out the local tyrone community - your suggestions aren't as heartfelt.

[djbigdawg1]

There are many bigger issues to the methadone clinic than putting a bandaid on the injury -- and also asking for insurance to pay for it!
How about instead of a tyrone sidewalk which costs half a million bucks to pay for, we put that money into the YMCA or other opportunities for people to find better things to do with their time than drugs? Especially the youth of the community.
So you don't give the youth anything to do, but put a methadone clinic right next to their school -- GREAT IDEA?

I am all for free opinion - but if you don't live in or help out the local tyrone community - your suggestions aren't as heartfelt.

Do you really think the people of Tyrone had ANY say in the rebuilding of the sidewalks in Tyrone? Many questioned the ideas of X-Mayor McCheese and her hamburglars of council. Instead of getting finances to help with YMCA building upkeep, they decide to build a park (that noone under the age of 50 can enjoy without harrassment), fix up the sidewalks and put in new lightposts (or targets 4 trucks entering into town is any better description). This was all done after she was elected with the promise to bring in new and more businesses. The only thing i see in town is empty storefronts, clock in the park that doesnt keep good time and no more shade trees.

billm, i am from Tyrone and LIVE in Tyrone. I have seen and heard whats going on in town. I even told the mayor-to-be to his face NOT to become Mayor McCheese's puppet. If we cannot even Attend council meetings to voice our opinion and be turned away without being berated like some have been, what else can we do except wait for the next election.

[jayestewart]

Did I just read that city council meetings are closed to the public?

[150thBucktailCo.I]

What IS the deal with the sidewalk in front of the YMCA? Will they ever reopen that sidewalk, or will they just let the building rot for the next 30 years in hopes that it will collapse and solve the problem?

[jokerman]

Well, billm, I see I have to clarify some things for you.
First off, I have lived and worked in Tyrone for 28 years. I've put 3 kids through the Tyrone School District from kindergarten through graduation. I like living here and plan to stay. Unfortunately, there has been quite a decline in the quality of living in "this place we call home" since the arrival of heroin and crack. Not so long ago, I could leave my car unlocked and we could go to bed at night with the front door unlocked. Those days are long gone. Why? Because the local drug addicts will rob and steal to support their habit because they certainly wouldn't be able to work and earn enough money even if they wanted to.

Tyrone Hospital once had a drug rehabilitation program in the hospital, and ran it for some time. I think if a treatment center was on-site and properly run, the location near the school wouldn't be an issue.
Besides, in case you don't know, there are drugs, including heroin, INSIDE the school every day. When you drive down through town, do you see all the pale, skinny, sickly-looking, unkempt kids lurking around the alleys and side streets? Those aren't Boy Scouts, biilm...and they're school-age. The problem won't go away by itself.

Maybe they can go over to the hospital and get their treatment before school? Maybe they can form their own club? Nah...they've already done that. (sorry...couldn't resist)

I, too, know people who were severely injured and even killed involving accidents traveling back and forth from Methadone clinics. Imagine getting up at 3 AM every morning, driving 100 miles to and from a clinic to get treatment, then going to work all day. Repeat that routine every day and it wouldn't take long to fall asleep at the wheel or be distracted enough to have an accident. These people do that to get and stay clean.

The people you need to worry about are the ones NOT in treatment.

To say people are "doped up" at a methadone clinic only shows your ignorance of the treatment. Sure, there are some that abuse the system, but most are in the program to become productive people again.

So be sure to educate your kids on the dangers and consequences of drugs, no matter how young (or old) they are. It's up to us to change the situation here...don't depend on council, the mayor, or even the police to stop it. They can't...
Like I've said before, take away the demand and the supply will disappear.

[150thBucktailCo.I]

Tuesday, August 29, 2006 — Time: 10:43:40 AM EST

Tyrone Hospital examines merger, Chapter 11 filing

By Greg Bock, gbock@altoonamirror.com




TYRONE — Faced with losses of nearly $4 million, Tyrone Hospital’s board of directors is looking into merging with a larger hospital, possibly Altoona Regional Health System, or filing Chapter 11 bankruptcy.

“We can’t stand alone,” board Chairwoman Judith Norris said Monday night during the annual meeting of the hospital’s nonprofit corporation.

The revelation came after the hospital’s chief financial officer and chief executive officer had finished their yearly reports.

“Tyrone Hospital is in the middle of a battlefield between two major competitors,” hospital CEO Walter Van dy** said in reference to Geisinger Health System’s dominance in Centre County and Altoona Regional’s position to the south.

“There is no way we can compete with either of these providers.”

Van dy** said a decision on whether the hospital will file Chapter 11 will come within 30 days.

A meeting with Altoona Regional representatives is slated for today. Norris said Tyrone Hospital received an “open-ended invitation” to explore collaboration with Altoona from CEO Jim Barner in April.

Hospital officials stressed the board and staff have an overriding goal — keeping the hospital open to serve the community — and any future decisions are rooted in that commitment.

Any merger or collaboration would have to be “mutually beneficial,” Van dy** said.

Geisinger has shown scant interest at this point, Norris said.

During the two-hour meeting, attended by scores of hospital stakeholders and residents, administrators laid out the hospital’s financial situation and steps already taken to cut costs.

A $4.5 million judgment against the hospital and obstetrician Dr. Roy Pazmino contributed to the bulk of the hospital’s debt, although Blair County Judge Hiram Carpenter’s gag order curtailed any specific mention of the case by hospital officials Monday.

In that case, Trudy and Melvin Mayhue sued after a delayed Caesarean section led to their son developing cerebral palsy after he stopped breathing during birth.

The $4 million judgment a jury handed down in February has risen because of interest to nearly $4.5 million.

Although the hospital was deemed only 20 percent at fault, it remains responsible for $3.25 million of the judgment. The hospital’s insurance will pick up $1 million, leaving the hospital to come up with $2.25 million.

Even without the judgment, the hospital’s operating loss was $2.2 million for the fiscal year that ended June 30, CFO George Berger said. In fiscal year 2005, the hospital lost $1.5 million.

“We don’t have it,” Van dy** said of the money for the judgment, emphasizing that the bankruptcy would allow the hospital to restructure its debt while continuing to operate. “That’s why bankruptcy is a consideration.”

“But business would go on as usual,” Norris said.

Just how much business will go on at Tyrone Hospital is a question, though.

Officials reported a drop of 16 percent in patients using the hospital in the last year. Add to that an increasing number of the hospital’s patients on Medicare, rising costs and dwindling cash reserves, and Tyrone is in the same situation as many rural hospitals with less than 100 beds, Van dy** said.

Mirror Staff Writer Greg Bock is at 946-7446.

[Bill Latchford]

Did I just read that city council meetings are closed to the public?

Jayestewart - The way it is being written was a bit off base...There are 2 council meeting a month. On the first and second Monday's of the month are regularly scheduled meetings of The Tyrone Borough Council. These are indeed PUBLIC meetings. Just thought I would make that clear. There are, at times, meetings held by Council that are called executive sessions. These are permitted to allow Council to discuss items like Personnel, Litigation, and such.