P is for Peril

"Last Monday, I went over to St. Terry's and talked with Penelope Delacorte. Your name came up so I thought maybe you could fill in some blanks. May I call you Tina?" I asked, interrupting myself.

She lifted one shoulder in a careless shrug, which I took as assent. "I know you and Ms. Delacorte left Pacific Meadows at about the same time. She said the choices here were pretty limited in the health care field. Have you found another job?" I hoped to give the impression of a long, friendly chat between Ms. Delacorte and me instead of the one we'd actually had.

"I'm still looking. I'm collecting unemployment checks until my benefits run out." Her eyes were a pale gray, her manner flat.

"How long did you work for them?"

"Fifteen years."

"Doing what?"

"Front office. I was hired as a file clerk and worked my way up. Nights, I put myself through school and finally got my degree."

"In what?"

"Hospital Administration and Finance, which sounds more impressive than it is. I've always been more attracted to the accounting end of the business than to management, so I was happy where I was . . . more or less."

"Could I ask you some questions about Pacific Meadows?"

"Sure. I don't work there anymore and I have nothing to hide."

"Who owned the building before Glazer and Broadus?"

"A company called Silver Age Enterprises. I never knew the owner's name. There might have been more than one. Before that, there was another company called the Endeavor Group."

I reached into my handbag and took out a little spiral-bound notebook with a pencil tucked in the coil. I made a note of the two names. "With Silver Age, was the place owned and operated by the same people or were those two functions kept separate?"

"They were separate. The Medicare and Medicaid programs were enacted in the '60s and neither had much provision for fraud prevention. The regulations about arm's-length ownership and operations probably didn't come until the late '70s, when Congress passed legislation establishing fraud control units ... for all the good that did. You have no idea how many different agencies go after these guys: the Office of Inspector General, the civil and criminal divisions of the U.S. Attorney's Office, the FBI, HHS, HCFA, and MFCU-the Medicare Fraud Control Units. Doesn't deter the fraudsters. Cheaters love rules and regulations. Every time you put up a barrier, they figure out a way around it. One of the many challenges of the entrepreneurial spirit," she added drily. "I saw Pacific Meadows change hands three times and the price came close to doubling with each of those transactions."

I made another note, thinking about ways to check out the dollar figures on those deals. "Did you work for Endeavor or Silver Age?"

"Actually, I think Silver Age was a subsidiary of Endeavor. The head of Endeavor was a woman named Peabody. She used to run all her personal expenses through our accounts payable. She'd renovate her house and write it off to Pacific Meadows as 'maintenance and repairs.' Or she'd put in new draperies at home and claim she'd had them installed in all the patients' rooms. Groceries, utility bills, travel and entertainment-she never missed a trick."

"Isn't that illegal?"

"Mostly. Some of it was probably legitimate, but a lot was fraudulent. I called a few items to the administrator's attention, but he told me, in effect, I'd better mind my own business. He said the company accountant routinely reviewed the books and everything was okay. I knew if I pressed the point, I'd have been out the door right then. It seemed easier to shut my mouth. When Silver Age came in, someone else handled the books for a while. Then he got fired and I took over again. There was probably some tinkering going on at that point, but I never figured out what it was."

"Why didn't you quit and find another job?"

"I loved the work."

"You could have loved the same work somewhere else, couldn't you?"

"True, but I got stubborn. I figured one day they'd crash and burn and I'd be there to watch, maybe throw additional fuel on the fire."

"Did anything change when Dr. Purcell arrived on the scene?"

"Not the first couple of months. Then I noticed an increase in the number of charge slips for things like ambulance service and physical therapy, portable X-ray equipment, wheelchairs. I started keeping notes and then I wrote a memo to Mr. Harrington, the head of the billing department at Genesis. That was a mistake as it turned out, but I didn't care. He never said as much, but I'm sure he didn't appreciate the effort because it put him on the spot."