By Dan Christensen, FloridaBulldog.org
The law firm that’s overseeing taxpayer-supported Broward Health’s compliance with conditions imposed by the U.S. last year when it paid $70 million to resolve alleged lawbreaking has concluded the troubled hospital district is in a state of “cultural civil war.”
Baker Donelson was hired in December to serve as the “Independent Review Organization” (IRO) under the terms of a five-year Corporate Integrity Agreement between the North Broward Hospital District (NBHD) – Broward Health’s legal name – and the U.S. Department of Health and Human Services.
The IRO’s 137-page annual report, obtained by Florida Bulldog using Florida’s Public Records Law, lays out what it says are Broward Health’s “numerous systems deficiencies” while also defending itself from anonymous, yet widely distributed accusations that it was not truly independent and was hired thanks to insider connections.
The report, often citing unnamed sources, is highly critical of Broward Health’s recently departed Chief Compliance Officer Donna Lewis for refusing to produce, among other things, requested information about employee complaints. Also singled out for criticism: Broward Health’s Interim CEO Pauline Grant and Chief Information Officer Doris Peek, who, along with Lewis, are accused of planting “negative articles regarding the IRO in the local media.”
Grant and Peek both denied the accusation on Sunday. “I never planted any negative articles,” said Grant. Lewis could not be reached for comment.
The report and its exhibits can be downloaded here.
“There has been a pervasive pattern of personal destruction in which former and some current members of the senior management team use public meetings, the media, self-serving reports disguised as work product, and frivolous ‘anonymous’ complaints through the disclosure program as a means to falsely attack the character of, pressure, or aid in the termination of NBHD’s Board of Commissioners, senior management, and others,” the report says. “In other situations, it appears the methods are used to enhance the influence of senior management’s departmental fiefdoms.”
The report goes on to assert that management actions “appear to be routinely based upon self-interest, protection of position and department, not for the betterment of the system.” That “lack of professionalism” fails “not only the patients the system services, but the taxpayers who help fund it.”
Anticipating the report’s release, Broward Health’s board voted last week to authorize management to request up to 60 days to respond to the IRO report which will be sent to a federal monitor and could lead to further government action against Broward Health.
A new CEO coming soon
Who will author the response is unclear. The board recently has interviewed several candidates to become Broward Health’s permanent President/CEO. A meeting to make that selection is set for Oct. 31.
Broward Health, with four hospitals, three outpatient facilities and nearly 9,000 employees all north of Griffin Road, is the ninth-largest public health system in the country. It is a special taxing district overseen by a board of commissioners appointed by the governor.
The report says Broward Health suffers from “operational mismanagement” to include “considerable understaffing” in key areas such as physician services and the compliance and ethics office. Likewise, the report notes, two seats on the governing board of commissioners remain vacant. (On Friday, Gov. Rick Scott appointed Parkland’s Bev Capasso, a former chief executive officer of Jackson Memorial Hospital, to one of those seats.)
The report traces Broward Health’s “cultural war” to the hospital district’s “pervasive physician-centric tradition, in which senior management and staff instinctively defer to physicians, particularly regarding compensation.”
Allegedly illegal pay deals between Broward Health and its physicians was the focus of the False Claims Act lawsuit brought by whistleblower Dr. Michael Reilly that led to the $70 million settlement in September 2015. Allegedly violated in the scheme: the Stark Law, which generally prohibits physicians from referring patients to hospitals with whom they have a financial relationship, and the Anti-Kickback Statute, which prohibits paying physicians for healthcare referrals.
Without naming names, the report says some physicians are involved in “repetitive upcoding,” or assigning improper billing codes for medical procedures to increase their Medicare and Medicaid reimbursements. Baker Donelson says it has “encouraged” Broward Health to hire “expert coders” to handle coding for it doctors “to help remove even the appearance of a conflict of interest in coding.”
The report is similarly critical of Broward Health’s “ineffective response to the implementation” of compliance monitoring and auditing procedures, notably the lack of what’s known as a “Focus Arrangements” database that can track government-reimbursed physician referrals and sales.
‘Lack of commitment to compliance’
Baker Donelson’s report, prepared under the direction of attorney J. Scott Newton, accuses Broward Health of a “lack of commitment to compliance” both before and after the embarrassing federal investigation and costly settlement. It says problems began after Lewis was hired as chief compliance officer in April 2011.
One month later, a federal subpoena announced the start of the government’s fraud probe. It sought a multitude of records about physician contracts and other matters, yet appears to have had no “impact whatsoever on the operation or effectiveness of the compliance program,” according to the report.
The report’s litany of deficiencies, however, neglects to note that Broward Health’s compliance troubles pre-date Lewis’ arrival. For example, for more than a decade both management and the board ignored a lobbyist registration policy adopted in 2004. The district finally implemented a policy requiring lobbyists to register last month as a result of a Florida Bulldog story in May.
Baker Donelson’s report praises the “outstanding work” of Broward Health’s controversial General Counsel Lynn Barrett and her Legal Department in making important changes to the district’s poorly crafted compliance program by re-writing its Code of Conduct and ethics policies. The problem: the implementation of those measures was “seriously deficient in many critically high risk areas,” the report says.
The report, however, makes no mention of various controversies that have swirled around Barrett. They include allegations Barrett improperly attempted to block the public from meetings, steered millions of dollars in legal work to law firms with strong ties to Gov. Scott, and failed to cooperate with the FBI during an ongoing federal grand jury investigation into allegedly corrupt purchasing practices at Broward Health.
The report also details Baker Donelson’s annoyance at an article published in Medicare Compliance Review that “impugned the IRO’s qualifications.” The report suggests Interim CEO Grant, Compliance Chief Lewis and Chief Information Officer Peek planted the story.
A newsletter’s upsetting story
The story apparently at issue was published in June by a newsletter with a different name, Report on Medicare Compliance. Among other things, the story quoted Donna Lewis as criticizing the board’s efforts to identify the author of the anonymous email that raised questions about Baker Donelson’s independence and other matters. She told the newsletter that anonymous allegations are “routine” compliance matters and that the board’s high-profile hunt for the author had “eroded” trust.
“I have never seen a compliance complaint take up so much time from a governing body,” she said.
At a subsequent meeting by Baker Donelson with top Broward Health management, “it was emphatically noted to Grant that what appeared to be senior management-placed negative articles regarding the IRO in the local media would not deter our work. We advised Grant that we did not believe any articles or public comments were made without her authorization.”
The report adds that anonymous employees had told the law firm that Grant, Lewis and Peek “were overheard in Peek’s office discussing” what later became the article.
“Contacting the media, particularly because of the Florida Sunshine law, appears to be used as a common weapon in the cultural war at NBHD as a means of asserting false allegations and/or pressure on those who would refuse to change the culture of corruption,” the report says.
“Here, while it is certainly beyond the scope of our review, the IRO questions whether tax dollars were used to publish the ‘Medicare Compliance Review’ article and if so, if that constitutes an improper misuse of public funds. We will leave that determination for state officials, should they undertake a review.”
FRANK DADDARIO / October 24, 2016 9:51 am
“Without naming names, the report says some physicians are involved in “repetitive upcoding,” or assigning improper billing codes for medical procedures to increase their Medicare and Medicaid reimbursements.”
wait….isn’t this the same charge GOV SCOTT had to defend at HCA ?
Stop the Press! / October 24, 2016 3:50 pm
Let me get this straight!!!!!!
Pauline Grant who terminated the employment of Donna Lewis and dealt with all issues to assure the organization is compliant is now the problem?
News Flash, it must be true that the INDEPENDENT (HA HA) REVIEW ORGANIZATION has a bias. Why didn’t the IRO look at contracts that are NON COMPLIANT and stuck in the legal department? Who DID the IRO interview? Why aren’t names mentioned? Could it be that some self-serving people were interviewed and have a bias toward their own self-worth performance?
There is a civil war, Pauline is the North Star for all that is good in Broward Health! There is not one dishonest bone in her body!
Don’t worry there will soon be a good ole’ boy white man running the system, I’m sure all will be INDEPENDENTLY verified as compliant then! Ha Ha.
SELL THE SYSTEM, PRIVATIZE IT! GET POLITICS OUT OF THE SYSTEM. PUT THE MONEY FROM THE SALE IN A TRUST TO HELP THE POOR.
Qui Tam / October 24, 2016 6:39 pm
You are most naive, Stop The Press. It always takes two to tangle. There are very few innocents. There are far too many players, Ms. is one, as are the others and all the way to the very top. TY Bulldog for noting the IRO with its own connections.
IRO / October 24, 2016 8:43 pm
Wow. BH paid millions to Baker Donelson to come up with this piece of crap report. There are so many errors in the processes they describe – they def were a total waste of taxpayer money. And to compliment the Legal Lynn who is by far one of the biggest problems at BH. She needs to go as does all of the rest of Snr management. Pauline is the only good one plus she is honest. The rest of the mgmt. team are either corrupt or too afraid to lose their job to do the right thing. Either way, they have to go!
Help us somebody PLEASE / October 24, 2016 8:55 pm
Will someone please get rid of the entire C-Suite and put them in the basket of deplorables. We are tired of working like slaves, underpaid, risking patient care and our jobs for what? A bunch of spoiled brats. This place is sick and if you think for one moment that Peek, Grant, Lewis and Wong..who engineered the one year severance package for Lewis are not involved in this, you are sadly mistaken.
These people disgust me. They are dispicable.
Jeremy / October 25, 2016 12:24 am
Code of ethics and compliance was not done by the incompetent Ms Barrett. Their legal department is where documents go to die. Her appointment was pure politics. Perhaps more research should be done as to where she worked before and why she is no longer there. The code of ethics and corporate compliance was done by the compliance and ethics department. And I do agree that Ms grant is indeed and honest and ethical person.
FRANK DADDARIO / October 25, 2016 2:36 pm
IF the BROWARD COUNTY operates a public transit operation that is a mess, oversees the county LEOs at the Broward Sherrifs Office that is known for pervasive corruption, oversees the county court system that has a half-dozen or so County Judges getting booted out and another dozen under investigation, has maybe a hundred million dollars in question for the airport expansion costst and tens of millions in question for the new county courthouse and its garage, a voting systems that has BAD BALLOTs, predatory towing operators paying off county commissioners to run illegal scams getting the cooperation of the city’s parking violations bureau and the YELLOW CAB company price gouging $40 to go ten (10) miles FRIDAY after Hurricane Matthew and also paying county commissioners to go against UBER………..what makes anyone think the county run HOSPITAL operation is kosher ?……….what a show this is……………..and don’t think the rednecks that run the county are going to actually HIRE someone they cannot control which is why the county previously hired a BCT chief from DETROIT of all places to run the county bus operations into the ground so the thefts and abuses can go unchecked
The People Rest / October 25, 2016 9:44 pm
Okay so we have an IRO report that is mostly gossip and fiction.
So the “People” rest, get ready for the defense. The IRO will be a LRO- Liable Responsible Organization for publishing gossip with conclusions as if it is fact.
25yrs service / October 26, 2016 5:26 am
really,…..and all this is a surprise
mama mia / October 26, 2016 9:32 pm
Miss Pauline Grant is exceptional, ever since she came to North she set a high standard of care, however on her time away at the “crazy camp” Robert Bugg has really raised the bar he stands for everything good at BHN, he has good support and respect. As for as for Betty and Dan the man, you can keep them many have no time for them at all, and have little if anything good to say. They make BHN a hostile environment to work in,They are horrible I know I report to one of them, Soon a new President? I will be interested to see if Pauline comes back, and how long the new president lasts,
Don’t get me wrong there are many good people here great work is done, care is exceptional, but it is time for change Just remember KARMA Betty and Dan just remember KARMA
Jay Jones / October 27, 2016 12:13 am
Grant has to go. She cant even fix her bs clinic system for the “good of the people”. But thank god they get all the taxpayer/government money for the clinics that dont work. Whered all that money all go? Grant has to go.
Help us somebody PLEASE / October 27, 2016 6:34 pm
@The people rest. Who do you think you are, Brad and Angelina. Suing for liable? The IRO report is not a tabloid, it is a report required by the government and paid for by your employer. If it touched a nerve, then quit or sue your employer.
Also as a member of the rank and file, we do not believe for one second that Lynn Barrett is responsible for everything. This place was a mess long before she got here. How stupid do you think we are? The real story will be told and the couture loving puppet master will be seen as the emperor with no clothes. How fitting.
The People Rest / October 27, 2016 6:52 pm
You Screwed up ‘Help us somebody PLEASE’ I never said Lynn Barrett is responsible for everything in this post, perhaps you and your spies are getting things mixed up. I know you’re tracking IP addresses, it’s fine, I stand by everything I said. The truth always wins.
Qui Tam / October 27, 2016 7:22 pm
Only two words necessary: CLUSTER F*#k
Newbie / October 28, 2016 5:22 am
I am new to BH as an outsider I see people really stressed, but providing exceptional care stroke cardiac trauma pediatrics surgery medicine wound care
I can not imagine what the c suite is going through, walking a mile in their shoes may be very interesting for us all
Former Employee / October 28, 2016 7:14 am
After reading the IROs report I can tell you that while they are correct on many issues, they are off the mark on many others. One would like to think bias due to their very close association with Lynn Barrett were not a factor but one must question this. They are slanted when it comes to the board, who are the biggest players in this mess never mind senior execs and physicians, who have pilfered for decades while hiding underneath the petticoats of politicians that are malodorous at best. I hope the system collapses before property taxes are paid as that money will assuredly be misappropriated into the wrong pockets.
Qui Tam / October 30, 2016 4:27 pm
Heard a rumor who the CEO is going to be. Yup, just rumor an internal candidate already picked by Rick Scott, oops I meant the Board. If true, it will mirror a rerun of the Twilight Zone! Interesting timing, also are the absurdly, oops I unusually high earnings HCA just announced. While other health systems going broke Rick Scott’s buddies at HCA thriving. Guess HCA has a wad of extra cash and good reason to purchase Broward Health, oops I mean other failing health systems.
'The View' / October 31, 2016 6:51 am
This site is like watching the ‘The View” full of rumors, gossip and innuendo.
The truth is financially and Broward Health is doing well all things considered and physicians and patients have remained loyal.
The only problem at Broward Health is the puppet Board and General Counsel.
Broward Health is not failing, it is flourishing despite bad Governance.
Awkward Moment / November 2, 2016 6:27 pm
The IRO has presented a well written but grossly biased report. Our government is so corrupt, and Broward Health is but a tiny piece though a transparent looking glass through which one can see the bigger picture. Pathetic. The whole bunch. The way leadership, the board, that attorney, the governor all behave and get away with it is DISGUSTING.
Curious Employee / November 3, 2016 7:17 pm
I heard the search for a CEO has been put to a hault. Does anyone have information on this?
Awkward Moment / November 4, 2016 6:22 pm
Look internally….if true, your next CEO is a replay. If so, he may be the one to finally bring it down.
The Real Betrayal / November 5, 2016 6:46 am
Did commissioner Canada leave the Board before her term was up?
Get real / November 6, 2016 5:06 am
@real. Who cares? When will this just be over with?
Most employees, even those far removed from the storm are tired of the stagnant,strangled, paralyzation that has gripped BH for the past ten months. There are more interim executives playing the part way too long. We need some REAL leadership in these roles STAT!
Do whatever but let’s move on.
Qui Tam / November 15, 2016 7:17 am
Well, I care. I care a lot. I care that the taxes I pay to support quality healthcare to this community is instead squandered by a board and c-suite with ulterior motives that include lining the pockets of themselves, politicians, and those who support politicians for their own agendas. I care that leadership is so compromised at corporate and at each facility that it disrupts appropriate leadership, management, hiring and continuing education of the staff who provide patient care. I care that BH has permitted lobbyists free access, against their own somehow lost or buried policy. I care because staffing is compromised, meaning all that they do is compromised, not their fault. I care that a certain governor can puppeteer and get away with it. I care about the millions upon millions of dollars being misappropriated and disappearing. I care that even an attorney walked after just four weeks as Compliance officer as their law degree obviously on the line if they stayed. I care that there is no one over internal audit, not that they weren’t compromised by the board and c-suite. I care! It won’t go away until BH folds and is sold off, gratis the governor and his friends at BH, both on the board and in the c-suite. I’m sure on their way out the door they will each get their million dollar parachute. I care!
Old Soul / December 1, 2016 5:37 pm
Heard Grant out Fusco in as CEO @broward. With Grant “taken out” of the way, the BOC, Fusco, & Dickie Scott should get their wish to steal all the property tax money coming in this year before crashing the system and forcing its sale to Dickie’s friends that he must have blind trust investment with. Of course, I’m just hypothesizing.
Qui Tam / December 1, 2016 5:56 pm
Ok then. Bottom line; while I’m hard pressed to believe Grant did not eat a few appetizers given her tenure at corrupt BH and rumored jaunts to India gratis a large Indian family of physicians on staff, I’m going to bet her actions pale in comparison to the joker, Fusco, the entire BOC sans Canada (who was a tad late on the uptake), and that joke of an attorney, Barrett. I smell Tricky Ricky and wonder if the Feds may be involved since they seem to permit this mess despite BH’s CIA. Uh, hullo OIG? Uh, hullo M Satz? Is anybody awake here or is everyone getting a slice of pie. After all, as CFO background Fusco bleeds the system dry and forced its sale, who gets over $1B in tax revenues pouring in??? Surely BH can’t spend it on care before they go bankrupt so Bulldog, FOLLOW THAT MONEY
Awkward Moment / December 1, 2016 6:31 pm
Per Sun Sentinel, “The Broward Health board abruptly fired CEO Pauline Grant on Thursday over kickback allegations, in the latest blow to the troubled public hospital system.The 4-1 vote, with board member Maureen Canada dissenting, took place during a meeting that had been announced only late the previous afternoon, with no indication on the agenda that allegations against Grant or her possible firing would be discussed.”
I agree, Qui Tam. They obviously found that little crumb they could hang her for. Out of their way, all bets are off. If the Feds and regional justices sit on their thumbs you have to ponder what is padding their palms. It just smells like a set up, and a pretty low ball hit coming from a bunch of scrupulous bottom feeders. A ton of cash is flowing in and every damn penny needs to followed. This is where the rubber meets the road for investigative journalism.
Awkward Moment / December 1, 2016 6:33 pm
PS. Blow the damn whistle Pauline.
Get real / December 1, 2016 9:09 pm
@Akward. And jeopardize that fat severance package? No whistle blowing there, maybe whistling all the way to the bank for her.
Why does everyone find this so hard to believe? She was no saint, that’s for sure.
Yes,she gave a lot but she took a lot too. She was and will continue to be very well compensated. There is more to come.
Awkward Moment / December 2, 2016 7:07 am
Golden parachute for silence I’m sure, and agree has had her moments as no exec at BH seemingly clean. But compared to Barret, Rick Scott’s puppet and wanna be, Kevin Fusco, a CFO with a history of undermining the BOC when DiPietro was there and attempting to reign in gross fiscal abuse, a BOC comprised of Rick Scott’s toy soldiers so far up his batootie a high colonic couldn’t retrieve them, and an exoskeleton of a governor who defines evil, she almost smells like a newly bloomed rose! This is a set up, most likely orchestrated by Scott, Barrett, Robison, Rodriguez, Ure and Van Hoose, to seal the governor’s deal. With over a billion in tax revenues coming into this BOC and Exec bank account, and knowing FY 2016 ends 6/40/17, and known attempts to sell BH to HCA and other profitable private health system friends of the Dick, I’d say over the next 6 months this could be when these bottom feeders really rape the bank with contracts like Zimmerman, Scott racks up a ton of dough for his Senator run in 2018, the tax payers and patients and non physician get screwed, and the system sells for 10 cents on the dollar. Now of course, I’m not saying any of this is true as I would not want to smear a GOOD person. I only speculate, except for the onsite visits to corporate by HCA suits and other friends of the gov as I have seen them roll in over the years to discuss the purchase.
Qui Tam / December 2, 2016 5:08 pm
As I said in Oct w/o naming names the former temporary and inadequate CEO, Kevin Fusco, is back in the saddle gratis the board. If I knew Kevin Fusco would be CEO again back in Oct then how long did Lynn Barrett and the board know? Did they ensure his return? Ponder that. Of course, as Awkward Moment said it’s just thought. No accusation.
Being evil has consequences / December 4, 2016 7:23 pm
Lynn and the Board are going to have their reputation and careers justifiably ruined for framing Ms. Grant. It will all come out.
Get real / December 6, 2016 7:32 am
Be careful what you ask for. Having it ALL come out may be more ugly than you imagine. Self righteousness is a precarious perch to sit on. No one’s hands are clean. If so, why is the board and Barrett now being called racist by some remaining executives? Yes, by all means let it all come out and the evidence stand on its own merit.
Awkward Moment / December 7, 2016 6:53 am
Love most recent SS article re: county withholding monies and contract from BH. BUT, Chip LaMarca a good guy? Don’t I recall him allegedly lobbying BH last year for a 5 year $71 million ad contract for his then employer, Jordan Zimmerman?
Qui Tam / December 7, 2016 7:09 am
LaMarca is no innocent. In fact, I seem to recall a he said she said about him allegedly threatening El Sanadi, warning that he put him where he was and could “take him out.”
Here’s a refresher for anyone with a short memory:
“In summary, Bulldog reports that Zimmerman and LaMarca–who currently serves as the agency’s director of community relations in addition to his job in politics–urged the client org to expand and finalize a $70 million-plus no-bid contract with Zimmerman while staffers mourned the suicide of its CEO, who had negotiated the initial deal.”
Awkward Moment / December 7, 2016 5:00 pm
Van Hoose all of a sudden upset with board’s actions, moving Grant out of the way to perhaps fill an ulterior motive? The same Van Hoose who is a friend of Rick Scott defies the board’s and internal counsels actions though one might summize those are actions puppeteered by the exoskeleton in Tallahassee himself? Sunshine Law not to be played with. I guess when potential surfaces the wise little rabbits start to run while the arrogant stay behind to become sacrificial lambs instead.
Awkward Moment / December 13, 2016 5:50 pm
As subpoenas are being served at BH over allegations of Sunshine Law violation, and as LB and KF circulate documents for who knows whose signatures, Rocky Rodriguez, despite historic visits to BH by suits from HCA and other health systems to discuss the purchase of BH at the old and current administrative offices, yes Rodriguez denied to the Sun Sentinel that the BH was seeking to privatize. Then why oh why all this past and current sneaky activity, and why oh why did Robison, a health systems mergers and acquisitions attorney, replace DiPietro on the board and assigned by Rick Scott? Come on Rocky! You can’t possibly believe anyone is really that stupid!
Awkward Moment / January 4, 2017 8:02 am
Sheela VanHoose resigned from the BH BOC, blaming Lynn Barrett. Sheela asked Rick Scott to “save” BH in her resignation letter. I’m confused. Since when does Rick Snott not want to privatize BH? Did Sheela leave for stated reasons, or was she just too savvy to get embroiled in the Sunshine lawsuit as her compadres did? And exactly what does Sheela mean when she say “save?”
Qui Tam / January 4, 2017 7:31 pm
By resigning and publicly asking her former mentor and friend, Rick Scott, to save BH, VanHoose has seemingly attempted to wash both her and the governor’s hands clean of any wrong doing, and has seemingly slammed open the door for privatization. If so, while they bask in their success what will happen to all the hapless tin soldiers? I wonder if and how those little toy soldiers are sleeping at night. Then again, what role do Bondi and Scott play in Sunshine Law violations and didn’t pammy poo give president elect DT a nice pass?
Qui Tam / January 12, 2017 7:57 pm
Another underhanded shakedown today at BH. Check storage for those COI forms reportedly not obtained. Read Zachariah contracts. Have fun!
Edward Brave / January 18, 2017 8:56 am
I have heard rumors of a “vote” to merge the two health districts on Thursday seems o have been kept very quiet, is this a rumor?
Prince / February 23, 2017 2:27 pm
The person that should have been booted out of that place is Sandra Reed. She has no idea how to run a laboratory. She walks around flirting with 90% of upper management in order to get what she wants. The other 10% which are females she knows how to wheel them in. What a conniving person who used her ways to push out a couple of well-respected people. I can’t say much for the replacement of the main lab area because he was right along with her. Maybe somebody needs to take their time and interview some of the people in the lab to realize how unhappy they are. Nothing is getting done there. People that have been here for many years are unhappy. This lady does not have a medical technologist license why is she here? She is completely inexperienced! Interview her and ask her a couple of questions about chemistry flow cytometry or even microbiology I bet you she’ll have no clue.