Detroit Medical Center (DMC) boasts that it is one of the largest teaching hospitals in the United States. Affiliated with Wayne State University and Michigan State University, medical students from around the world learn their craft at DMC. According to a recent investigation by the Centers for Medicare and Medicaid Services (CMS), interns at Detroit’s largest hospital are operating on patients with dirty, unsterile instruments. Things are so bad that the feds have begun “termination proceedings.” The hospital is set to lose its federal funding in just two months.
In a 14 page report just released this week, the feds blasted the facility for unsanitary conditions. Included in the report:
- Improper sterilization of surgical instruments – one in three sets of instruments inspected were not sterilized
- Lack of training on sterilization and infection control
- Hospitals workers putting dirty gloves back into a box of clean gloves
- Lack of sanitation audits
- Blood on floors / failure to sanitize operating rooms between surgeries
- Destruction of training records – what records that did remain showed instances where more than half of the staff missed required training on sterile cleaning procedures
The inspection by CMS was done without notice (a surprise) and was based on a whistleblower complaint. If handled properly, whistleblowers can receive large cash awards for their inside information of Medicaid and Medicare fraud. (More on that below.)
The Detroit News has been covering problems at DMC and with its corporate owner Tenet Healthcare for years. In a feature article this week, the paper interviewed a sterile processing expert who was aghast at the findings. He said, “If I had the ability I would not let a patient go in there until there’s a lot of re-education, retraining and personnel changes.” Another expert said that “This is insanely basic stuff – people don’t do things this foolish even at home.”
Unfortunately, only the state can shut down the hospital. CMS has the ability to shut off federal funding which would preclude the facility from accepting any Medicare or Medicaid recipients or federal employees as patients.
DMC traces its roots back to 1863 and the founding of Harper Hospital. The following year Harper began treating Civil War patients. It grew until 1985 when many of Detroit’s major hospitals merged into the present day Detroit Medical Center. In 2013, the for-profit Tenet Healthcare acquired the hospital system.
Problems with sanitation seem to begin at the same time Tenet Healthcare took over. The Detroit News reports that in June of 2014, ophthalmologists were “so fed up” with sterility issues that they threatened to take patients to other hospitals for surgery.
The system hired a person in October of 2014 to manage sterilization procedures. Several months later the paper reports that she contacted Tenet and considered herself a whistleblower. She told the parent company that she was not getting any support from hospital administrators to make changes.
Tenet Healthcare and Whistleblower Claims
Tenet Healthcare has an inglorious reputation for healthcare fraud. The company has paid hundreds of millions of dollars in fines and penalties tied to the federal False Claims Act, a Civil War era fraud recovery statute.
Just two months ago, Tenet Healthcare paid $514 million to settle civil and criminal fraud charges brought under the False Claims Act and federal Anti-Kickback Statute. (The whistleblower in that case will be receiving $84 million.)
That Tenet is a “frequent flyer” in the Medicare fraud world is indisputable. The bigger question is why? Our answer? Profits before patients.
The Tenet Healthcare website says the company is a “leading healthcare services company working across the system to improve service delivery and patient outcomes.” Things are so bad at DMC, however, that CMS says there is the potential for “unsatisfactory patient outcomes”. That is regulatory speak for infections, longer recovery periods and even death.
Tenet Healthcare is a for profit company. It exists to pay dividends and make money for its shareholders. There is nothing wrong with for profit institutions, most people in the United States work hard in the hopes of making more money. When a healthcare company becomes too focused on profits, however, patients suffer.
Under the federal False Claims Act, whistleblowers can receive up to 30% of what the government receives from wrongdoers. Because the False Claims Act is an anti-fraud law, to claim an award one must do more than show mere negligence or sloppiness. In the case of DMC and Tenet, investigators have been on the hospital’s case for months regarding unsanitary conditions. The hospital’s own employee charged with cleaning up the mess reported directly to Tenet in April of 2015 about conditions. At some point, what may have been a simple lapse in housekeeping became fraud.
Why do we say fraud? Because each time a hospital sends a bill to Medicare, it certifies that it is in compliance with all Medicare and Medicaid rules. Putting dirty surgical gloves back in the box or using non sterile surgical instruments is certainly not in compliance with rules. Once you certify that you are in compliance and know that you are lying, that is a fraud.
If you have inside information of Medicare or Medicaid fraud, contact us. By doing so, you join the growing number of healthcare professionals committed to quality patient care and against greed and corruption. Our team of whistleblower lawyers will help you stop the fraud, protect you from illegal retaliation and help secure the largest award possible.
We began this story by noting that the recent CMS surprise inspection was the result of a complaint. Most whistleblowers are content to call the 800 fraud hotline number provided by CMS. Doing so can earn you an award of up to $1000. To get the large percentage awards, you must file a sealed complaint in federal court. That is where we get involved.
If you are looking to receive an award and want to insure your complaint is investigated, the best way is to not call the hotline but instead file a False Claims Act complaint. While the complaint is being investigated, it remains under seal meaning secret. Sometimes we can further protect whistleblower identities through special filing techniques.
Want to learn more? Contact the healthcare whistleblower lawyers at MahanyLaw. All inquiries are protected by the attorney client privilege, even if you never hire us. In just the last few years we have helped our whistleblower clients collect over $100,000,000.00 in awards. The next big award could be yours.
For more information, contact attorney Brian Mahany at or by telephone at (414) 704-6731 (direct).
MahanyLaw – America’s False Claims Act / Qui Tam Lawyers
[For more information, visit our main Tenet Healthcare fraud page.]