BY DANIEL GAITAN | email@example.com
Denise Brunson only lasted a year and a half at Passages Hospice as a certified nursing assistant.
During her short time there, however, she witnessed what the FBI calls “an extensive scheme” to obtain higher Medicare payments by fraudulently providing hospice services to seniors who did not qualify for the care.
Brunson said she and other co-workers were “bullied” by higher-ups and told not to ask any questions. “In the middle of you speaking with them about your concerns, BAM you’re fired,” Brunson told Life Matters Media. “I always had something to say.”
Partial owner Seth Gillman, 46, who founded the Lisle, Illinois-based for-profit company in 2005, was first charged in 2014 with health care fraud and conspiracy to defraud the government.
Fraud charges were later brought against Gwen Hilsabeck, who served as co-administrator; Carmen Velez, who served as director of clinical services and director of nurses for the Chicago region; and Angela Armenta, who served as director of certified nursing assistants for the Chicago region.
They were all released on bond and pleaded not guilty. Their trial is set for Feb. 16, 2016, an official with the Department of Justice told LMM.
From 2008 to 2009, Brunson said she was responsible for driving to various nursing homes across northeastern Illinois and providing hospice care services to patients. Brunson said Passages would “butter” nursing homes with baseball tickets, bonuses, “whatever you want” to make them more willing to accept Passages’ services. Passages did not operate its own inpatient facility, instead deploying clinicians to nursing homes and private residences throughout the Midwest.
Between 2008 and 2012, the FBI maintains that Gillman, Hilsabeck and Passages allegedly paid bonuses to nursing directors and certified nursing assistant directors to increase the number of patients receiving general inpatient hospice care. In 2012, Medicare’s daily reimbursement for general inpatient care was $671.84; the daily payment for routine care or home care was much lower, $151.23. Some patients may not have needed anything.
Hospice care is usually reserved for patients with a life-expectancy of six months or less.
“A lot of my patients really didn’t need to be on hospice,” Brunson said. “A lot of the patients that I had didn’t need to be on continuous care, and they would just shove me in there.”
It was common, Brunson said, to spend nights treating healthy patients and then be called to work the day shift in the morning.
“They never cared about giving us any time to sleep.” Following a night shift, Brunson said she was unexpectedly fired by Armenta for complaining about back pain. Turnover was “extremely high.”
Brunson’s claims were echoed by another former employee who asked not to be named as she continues to work in a similar industry.
“I left the company a few months before the indictment, after I couldn’t ignore my gut,” she said. “I was in the dark about the fraud, but I knew deep down I couldn’t be a part of that company anymore. I was appalled to find out how many people were involved in the deceit.”
Brunson said she only met Gillman once, during a “schmooze and groove” party between his many vacations. She hopes Gillman and Armenta are held responsible for their alleged actions.
“They had people working for them undercover somehow that would come into the facilities to spy on you,” she said. “People would come in, literally, and follow me around, ask me questions to see what I knew and what I didn’t know. It was ridiculous.”