Contributed to TLB by: Health Impact News and Medical Kidnap
Many of you already know that Laredo Regular and his mother have been fighting for the life of Julius Corley — US Air Force War Veteran, and grandfather and father respectively. Original story:
Laredo and his mother had been banned from seeing Julius by the hospital, yet maintained constant correspondence, inquiring upon his condition and their need for information regarding his health and care conditions, as several people they had sent to visually check his health since the ban was put in place had reported months prior that Julius had pneumonia, was losing weight, and was not being properly cared for by staff as his nails were long and curved.
Recently, Laredo reported that Montefiore Wakefield Hospital in the Bronx, New York, had summoned him and his mother to court regarding the placement of a feeding tube into Julius Corley’s stomach. The family contends that this procedure has never been necessary and that the hospital was illegally holding Julius as they maintained medical and legal determination rights. According to Laredo,
On Wednesday Sep 9, the court proceeding was held at Montefiore Wakefield Hospital in the conference room on the first floor. The hospital brought a case against my grandfather Julius Corley seeking judicial authorization to place a feeding tube (percutaneous endoscopic gastrostomy) <PEG> tube in his stomach. They claimed that Julius Corley had repeatedly refused the procedure however being that he has dementia he was not capable of making that decision. They also alleged that the Health Proxy was not able to be found and that he really needed this. The judge that presided over this matter was Honorable Lizbeth Gonzalez.
Hospital Refuses to Allow Second Opinion, Ignores Mr. Corley’s Wishes
Since the onset, Laredo and his mother have been trying to have Julius released in order to take him for a complete evaluation at another hospital, as they were not being given any substantial reports about Julius’ condition. Laredo attests that hospital staff would make claims that, when questioned, held no reasonable validity as to the information that was used to draw the misdiagnosed conclusions.
The Regulars related to the hospital that Julius had dementia and Bruxism, which is a side effect of the medication used to treat his dementia, but the hospital began saying that he had Parkinson’s Disease. The Regulars related that their family member had diabetes and glaucoma which took his vision, but the hospital nurse who had been treating him said he couldn’t talk and that she was unaware that he was legally blind.
However, it is clear that Julius can talk, because he told the hospital staff that he did not want a feeding tube placed in his stomach. The family also tells us that when they sent friends to the hospital to check on Julius, they reported that Julius was telling them that he was hungry, and they could see that he was losing weight.
Laredo made a video tape of his grandfather eating and drinking before he was banned from the hospital, and after the hospital alleged that he needed a feeding tube. Mr. Corley was transferred to the hospital after Laredo filed a complaint against the nursing home where Corley was residing. Laredo believes the transfer was made in retaliation for his complaint.
Is Julius Corley a Victim of Rampant Medicaid Fraud?
According to an investigative study conducted by New York State, “Combating Medicaid Fraud in New York State” in 2009, the amount of fraud from both recipients and medical facilities has risen:
One of the largest challenges New York State faces in its fight against Medicaid fraud is the sheer size of the Medicaid program. With a budget projected to exceed $52.5 billion in SFY 2010-11 and more than one fifth of the State’s population enrolled in the program, there are many opportunities for deception and dishonesty. … Individuals intent on defrauding the Medicaid system have developed numerous, inventive ways to steal taxpayers’ money. (p. 15)
Laredo believes that his grandfather is the victim of such a scheme to defraud the taxpayers and Medicaid:
While I was present at the proceedings, my mother and I told the judge that we wanted to take Julius Corley for a full evaluation and to obtain a second opinion on his overall conditions. The judge said it was too late for that and that she didn’t want Julius Corley to go to another hospital and have to wait in the emergency room. 3 doctors testified in the case in regarding my grandfather’s case which included Hilary I. Hertan, Vijay V. Khatiwala. However the individuals that supposedly administered the speech and swallow was NOT present during the testimony.
Hospital Confuses Medical Records/Diagnoses
The Regular family is not denying that Julius needs medical care; they are arguing the type of care that is needed, the newly undocumented Parkinson’s claims, and the dysphagia claims given by the hospital doctors who seem unaware of any first hand accounts of the testing and who admitted to be working on hearsay from their staff – staff who could not even determine that the patient was blind, could speak, and had dementia for which he was already being treated – and not Parkinson’s (all of this was in Julius’ transferred medical files).
The Laconia nursing home stated that they transferred Julius for “loss of appetite.” Montefiore Wakefield Hospital held Julius and tested him for a week and never confirmed any diagnosis that caused Julius to be initially placed at Laconia, but instead made up a list of their own without looking at his medical records, which became evident by the nurse’s reaction while she was being told of his medical history by the family.
If there was a misdiagnosis of dementia, the hospital did not rule it out, nor did they confirm their diagnosis of Parkinson’s. However, the hospital doctors had a sudden epiphany during the hearing when they admitted to the judge that Julius had dementia, and were now using dementia as the reasoning behind their claims that Julius must have the PEG inserted into his stomach. According to the family:
The hospital claimed that Julius Corley lost substantial weight and now has pneumonia while under their care.
The attending physician admitted that according to Julius Corley’s medical file, the standard speech & swallow test known as the “modified Barium swallow” MBS was NEVER administered on Julius Corley to determine if he could actually swallow or not. He also admitted that he was NEVER present during any of these speech & swallow tests and that he was just relying on the statements of the individuals that administered the test. The attending doctor stated that he “assumed” that my granddad had “Dysphagia.”
The judge inquired if they were treating the bruxism (involuntary teeth grinding) that my grandfather was suffering from and he said “no.”
Their claims were equally as elusive as the information given to Laredo and his mom:
“dementia was most likely causing him to be in denial of his health issues.”
The psychiatrist claimed that individuals with Dementia “sometimes forget how to eat.” How many times have you heard the phrase ‘most likely to’ since senior year of high school? This is a guess, not a diagnosis, nor a prognosis, since he was there to determine an immediate need. How does this happen? When Laredo and his mom have been saying the same thing since the onset of this horrendous event, they report that the hospital and doctors have been continuously changing their stories.
The Laconia Nursing Home and Montefiore are within the same pharmaceutical dispensary and support care network. Surely they have the ability to contact and confer on such cases? According to the “Combating Medicaid Fraud in New York State” report:
The New York Times discovered that Executives who head nursing homes and clinics profit from the Medicaid program. Investigators obtained records from the State Health Department showing that 70 executives made more than $500,000 in 2002 and 25 earned more than $1 million annually. For example in the Bronx, Laconia Nursing Home’s operator earned $3 million in salary and profit, 90% derived from Medicaid. (p. 17)
The investigative study also listed some of the most common forms of Medicaid fraud:
- False Claim Schemes – Can be perpetrated by recipients and providers and include the following;
- Billing for services not provided
- Misrepresentation of what was provided
- Providing unnecessary services
- Charging Medicaid patients more than uninsured patients
- Unbundling of claims
- Double billing
- Fraudulent claim coding (upcoding, miscoding)
- False patient review instruments (PRIs) –“A Patient Review Instrument (PRI) is a medical evaluation tool that identifies whether or not an individual is eligible for skilled nursing care placement. As part of the PRI, the “Screen” is required. The PRI and Screen is used to determine the level of care and appropriateness of placement.”
- Excessive or Inappropriate Testing – Some physicians order unnecessary tests in order to draw additional Medicaid dollars;
The Family Has Many Unanswered Questions
Has Julius Corley been a pawn in a Medicaid fraud claim? Why was Julius allowed to waste away to 135 lbs while in Montefiore Hospital when he could and would eat for his family, and when allowed to see his loved ones and those who cared about him, and could and would speak on his own behalf? Why, although the hospital claims that “sometimes dementia patients are in denial,” was Mr. Corley able to speak well enough and was lucid enough for the hospital to honor his request to not have a feeding tube inserted—for over three and a half months?
According to Laredo Regular:
During the psychiatrist’s testimony, he claimed that my grandfather rejected the need for a PEG, stating that he could eat and swallow without any problems. The psychiatrists claimed that Julius Corley’s dementia was most likely causing him to be in denial of his health issues. The psychiatrist claimed that individuals with dementia sometimes forget how to eat.
If Mr. Corley was in this dire condition when he entered the hospital, what took the staff so long to act? Did they have to wait until Julius actually appeared to have need of the feeding tube to tell the judge he was losing weight and had pneumonia? Julius started losing weight and caught pneumonia after being in the hospital’s care for a month, so why did they wait so long? Why didn’t Montefiore respect the family’s request to have him examined by another facility if Montefiore could not accurately determine the problem?
The judge inquired if they were treating the bruxism (involuntary teeth grinding) that my grandfather was suffering from and he said no.
During the psychiatrist’s testimony, he claimed that my grandfather rejected the need for a PEG, stating that he could eat and swallow without any problems. The psychiatrists claimed that Julius Corley’s dementia was most likely causing him to be in denial of his health issues. The psychiatrist claimed that individuals with Dementia sometimes forget how to eat.
When it was time for me to question the validity of some of the statements in regard to my grandfather, especially his ability to swallow or not, none of the doctors could give a solid response. All of them claimed that it was not their position or that they relied on someone else’s report on his ability to swallow. I asked the doctor: if my granddad had a swallowing issue, wouldn’t he have a reaction such as choking, coughing, gurgling, etc. I asked him this more than once and he said yes.
During the testimony, I offered to show Judge Lizbeth Gonzalez video of my grandfather drinking 3 cups of water while he was being held at Montefiore to prove the Dysphagia diagnosis was clearly false and she refused to view the video. She said it was about my grandfather’s current condition and not what he was able to do in June (even though these diagnoses were made in May). She also refused to view documentation (emails, call logs, fax submissions) of me communicating with the hospital during the times the hospital claimed they were not able to reach me.
She ruled in favor of the hospital inserting the PEG and stated that Julius Corley could not leave Montefiore until it was placed.
She didn’t question the doctors as to the reason why Julius Corley was losing weight under their care. She didn’t ask to hear the testimony of the individuals who administered the speech and swallow test. She also didn’t ask the hospital staff why they were not seeking to treat the Bruxism when they admitted they were doing nothing to address it.”
What you can do? The family believes that someone in that hospital has a conscience, that someone there still believes that they are helping people have better lives. This is not a good life for Julius, nor anyone else who is suffering there. Speak up. Speak out!
Recently, a New York State False Claims Act for Health Care was enacted, modeled after the Federal False Claims Act. The Act authorizes an individual with evidence of fraud to file a case in court and sue on behalf of the state or local government and obtain a share of the recovery.
Under the “Labor Law section 740 and Civil Service Law section 75-b,” the whistleblower receives many of the same protections as afforded in other states. These protections include that public and private employers cannot take retaliatory action towards whistle blowers. In addition aggrieved employees can sue for reinstatement, back-pay and benefits and may be entitled to court costs and attorney fees. (S. 2108-C, Chapter 58, Laws of 2007). (p. 18)
Laredo Regular writes of his beloved grandfather:
Here are some photos of my granddad’s condition. One shows how thin he has become. There is a photo showing blood caked under my granddad’s nails. A picture attached shows how long his finger nails were … The hospital states that my granddad is 5 ft 9 and currently weighs around 135 lbs.
According to the family, the judge stated that it was now “too late” to have Julius transferred and reevaluated and that he could not be “removed” from the hospital until “after” the procedure was completed.
If you can and want to help Laredo and his grandfather Julius, please contact him at email@example.com, so that you can help this veteran, this man, this grandfather who simply wants to be in a safe place where he can live out the remainder of his days without being tortured or experimented upon. Laredo and his mother have full medical and custodial rights.
New York State Governor Andrew Cuomo at 1-518-474-8390, or reach him here. He can also be found on Facebook and Twitter.
Bronx Borough President Ruben Diaz Jr. at (718) 590-3557(718) 590-3557, or reach him here. He can also be found on Facebook and Twitter.
Sherrif Joseph Fucito/Bronx County Division at (718) 993-3880(718) 993-3880. Here.
Montefiore Wakefield Hospital’s President’s Office at (718) 920 – 2001(718) 920 – 2001. Here.