Nurses Fight Back and Win

I’ve represented nurses for over 35 years.  I’ve listened as hundreds of nurses describe their struggles with administrators determined to cut corners to make money.  They tell of staffing problems that make it impossible for them to provide the care their patients desperately need.  When the nurse complains too loudly, she finds herself fired or reported to the Nursing Board on trumped up charges.  As North Carolina law provides little recourse for mistreated employees, nurses often leave the profession for better jobs.  But two nurses recently made headlines.  They fought back and made quite a lot of money doing it.

Vanessa Absher and Lynda Mitchell worked for several years as nurses at the Momence Meadows Nursing Center in Illinois.  Medicare and Medicaid covered the care for most of the patients at the 130 bed skilled nursing facility.  The nurses complained of dismal conditions at the home.  Often, patients did not receive medication, food, or water.  They lay for days in their own excrement.  They developed bed sores, scabies infections, and blood poisoning.  Management ordered staff to falsify patient records, medication charts, and staffing records to hide patient injuries and deaths.  When the nurses objected, the owner ordered them to “shut your mouth.”  Management finally fired one of the nurses.  The other one quit.  Neither gave up.

The nurses filed an action under the federal and state False Claims Acts.  They alleged that Momence had fraudulently billed the government for care that it did not provide to the patients.  They also claimed that Momence fired them for blowing the whistle on the draconian conditions at the home. 

As Momence would soon learn, the law imposes extreme penalties for filing fraudulent claims for government money.  Assume the defendant files a false Medicare claim for $25.00.  Initially, the penalty is three times the amount of the false claim.  Now, the defendant has to reimburse the government $75.00.  But, an additional penalty of up to $10,000 can be added for each false claim. 

Based on these laws, the jury returned a verdict of over $28 million against Momence.  Because whistleblowers are entitled to a share of the damages awarded, the nurses’ share could total more than $7 million, plus court costs and attorney fees.  This is in addition to the $400,000 that the jury awarded the nurses in connection with their own claims against the defendant.

It took almost nine years for the nurses to get a jury verdict in the Momence case.  Appeals can tie up the courts for several years to come.  And the nurses may have a bit of trouble collecting their money.  Courts earlier ruled that Momence’s insurance company was not liable for the damages.  Accordingly, the defendants’ assets are the sole source of funds for the verdict.  Fortunately, the defendants can’t discharge the debt in bankruptcy court.  And the government will help the nurses collect the damages.  Even the Mafia has paid up when the government demands its money.

North Carolina has its own False Claims Act.  It provides for treble damages and penalties of up to $11,000 for each false claim.  Whistleblowers can receive up to 30% of damages collected.  In addition, any whistleblower who suffers retaliation from his employer-defendant is entitled to reinstatement and twice the lost back pay.  Again, the employee is entitled to attorney fees and court costs.

The state and federal False Claims Acts give nurses and other health care workers powerful weapons to use in fighting back against employers who commit health care fraud – even in North Carolina.

When It's Your Turn To Wear A White Rose

       I was in high school when my best friend’s father died.  “You have to go see her,” folks told me.  But I was afraid that  I wouldn’t know what to say to her.  I might even say something wrong that would make matters worse.  But others insisted and I went.  I tried to comfort her, but I knew that no one could take away her pain.  It was also clear that she couldn’t really focus on anything I said.  It was just important that I was there.

      I distinctly remember the day my mother received the phone call telling her that her mother had died.  I had never seen Mother so distraught.  As child raised in the Christian faith, I couldn’t understand why she would be so upset about her mother finally getting to go to heaven.  Only when the following Thanksgiving and Christmas came and went without Grandma being there, did I finally “get it.”  Grandma might be in a better place, but where ever that was, it wasn’t with us.

      I also remember the first Mother’s Day after Grandmother died.  As we got ready for church that Sunday, mother gave each of us our traditional red rose buds to pin on our Sunday outfits.  Then, she pinned a white rose onto her dress.  She explained to me that when your mother is dead, you can no longer wear a red rose.  From that day forward, you must always wear a white rose on Mother’s Day.  I remember checking my red rose most of that Sunday to be sure it was still safely pinned to my jacket.

      For the past many years, Mother suffered terribly from the ravages of dementia.  She rarely knew who I was.  When I showed up with food, she thought I was a caterer.  The day I gave her a pedicure, she thought I was a beautician and instructed Dad to give me a good tip.  When I played “Danny Boy” on the harp for her, her face lit up with joy.  Of all the hymns and songs I had played for her that day, “Danny Boy” was the only one she  recognized.  Although she no longer knew me, I took comfort in the fact that she always knew my father.  She never forgot her soul mate.

      Then her heart gave out.  The phone rang and, checking the caller ID, I realized that “the Home” was calling.  As Mom’s condition had stabilized over the past few months, I figured that there must be an insurance problem or some other trivial concern to be addressed.  I was not prepared for the nurse to tell me that my mother had died. 

      A powerful neutron bomb went off in my soul.  I instinctively realized that “my ship was taking on water”, but for several weeks, I had no idea how much water was flooding the decks.  After all, she had been sick and in pain for a long time.  Surely it was a relief that she was no longer suffering.  These and other comments by well-meaning folks who tried to console me, were logical but totally irrelevant.

      The extent of the damage came home on Mother’s Day.  Family members called all through the day to be sure I was all right and I assured each one that everything was fine.  But it wasn’t.  As I tried to grasp hold of some sane thought that day, my mind kept going back to white roses.  It would be my first Mother’s Day without my mother.  It was my turn to wear a white rose. 

      I had not planned to go to church that Sunday.  I had nowhere to go wearing a white rose and, as far as I knew, there was nowhere on Sunday to buy a white rose.  But the idea of the white rose hounded me the entire day.  As we no longer have “blue laws” requiring shops to be closed on Sundays, Michael’s Arts and Crafts Store was open hoping to make a few secular dollars on this otherwise sacred day.

      So, late Sunday afternoon, at Michael’s, I purchased my white rose and took it home.  Unlike my mother’s rose, mine doesn’t smell very good.  But unlike my mother’s, mine will be around for as long as I want it.

      A friend once told me that when her mother died, she realized that the world was divided into two kinds of people:  those who had lost a parent and those who had not.  I know now what she meant. 

      After my mother’s death, my father complained to me about the things people were saying to him in an effort to make him feel better.  He didn’t want to hear that Mother was “in a better place.”  Or that she had “gone to be with the Lord.”  I asked him what he did want to hear. 

      “Just that they love me and that they’re sorry,” he replied. 

      I would have to agree.  Like my Dad, those were the two things I most wanted to hear.  So, the next time a friend “loses” a loved one and you are feeling awkward about what to say, you might try Dad’s advice.  Of course, if you are one of those folks who have “lost” someone you love, you already know that.

      Thanks for reading.