Hospice of the Comforter, which is based in Altamonte Springs and is one of the largest hospice organizations in central Florida, is facing allegations that could leave the nonprofit with millions of dollars in fines and damages. According to the Orlando Sentinel, the federal government filed a lawsuit in early January alleging the hospice center committed Medicare fraud by billing for patients who were not terminally ill and encouraging “creative” record-keeping to cover up the truth.
Patients are typically moved to hospice care when they have less than six months to live. However, investigations by the U.S. Attorneys Office revealed several cases where patients stayed for extended periods of time, such as when the center billed hospice care over four and a half years for an Alzheimer’s patient who was never considered terminally ill.
In another case, a nurse noted that a patient’s current condition would not qualify them for hospice care, and shortly after the diagnosis was suddenly changed to rectal cancer. According to the suit, however, there was no evidence that the patient had cancer at any point during her 287-day stay in hospice.
Allegations arose in 2011, and the suit alleges that Robert Wilson, CEO and co-founder of the hospice, instructed employees to admit patients without determining whether they were terminally ill, as Medicare requires. A former hospice executive, Douglas Stone, filed his own federal case after trying to get hospice management to “do the right thing,” which resulted in his termination. Stone agreed in August to let the Department of Justice pursue the matter instead.
Records show top administrators got big bonus checks based on how many patients they had on the books. Wilson earned a base salary of $122,000 plus patient bonuses of nearly $207,000 for the year. With the addition of a clergy-housing allowance, Wilson received more than $362,000. He also had a list of patients who were not to be discharged regardless of what the review committee found, as they were friends of his.
Although the total amount of actual damages will not be determined until trial, the law allows the court to fine hospice as much as triple whatever that amount is. Wilson is no longer CEO at the Hospice Center of Comforter, but he remains president of the nonprofit and chairman of its board of directors. Stone notes that the hospice had ample opportunity to do the right thing, follow the law and return overpayments, but instead “allowed retaliation against a number of individuals making good faith efforts to report potential fraud.”