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Patient Recruitment


Today, in Baton Rouge, someone was sentenced to prison for recruiting patients.  While goofing off on the internet, I came across this story by Investigative Reporter Terri Langston published in the Houston Chronicle.   Click on the image to read the full text which involves over 100M dollars in fraud and again, patient recruitment.

Now, color me clueless, but I really do not understand the difference between recruitment and marketing in the context that normal people use the terms in daily life.  If you look up ‘patient recruitment’ you find tons of articles on how to recruit patients……….  for clinical trials.

The dictionary defines recruit as, ‘to seek to enroll’ as students.  This does not seem worthy of jail time either.  Solicitation doesn’t seem all that horrible either.  When I write a post and tell you to please call if you need help, wouldn’t that be soliciting your business?

So who better to consult than a health care lawyer.

Christopher Johnston has the distinction of knowing more people who have been or will go to jail than anyone else I know. (It is relevant that I have a very good friend on the SWAT team.) This is because he is one of the best lawyers for keeping healthcare providers out of jail or reducing their sentences. He also has to work with what he gets from clients and sometimes, well…… a couple of years is better than twenty.  Chris’s success rate for clients who call him before they are in trouble is stellar.

He has a list of commandments to follow should you want to stay clear of any accusations of inappropriate marketing. Read them and share with your marketers.  Chris is not a cheap lawyer and I am giving away his advice for free. Take it and run with it.  Or don’t.  Just remember that in this period of intense scrutiny, a reduction in your sentence may be the best anyone can do for you after you get caught.

  1. Do not bribe, harass, coerce, or intimidate any patient into selecting or changing agencies.   (Julianne’s note:  In reading Animal Husbandry Weekly, I gather it is okay to sell cattle per head.  In reading the HEAT Task Force News page, I gather it is NOT okay to sell or buy referrals per head.)
  2. Do not allow any of your employees to bribe, harass, coerce or intimidate any patient into selecting or changing and agency.  (Julianne’s note: What do you think a marketer will tell the investigators when they are caught?  Do you think they will say their employer knew nothing about it or will they throw you under the bus?)
  3. Do  not falsely advertise about any services, awards or credentials or anything that may mislead the public.  (Julianne’s note:  A nurse without a license is not a nurse for the purposes of home health. If you advertise nursing care, please send licensed nurses only.)
  4. You may certainly respond to inquiries about home health but DO NOT initiate the conversation.  (Julianne’s admission of guilt: I might have to go to jail if I heard of someone who really needed home health but I would NOT – and do not – recommend specific agencies.)
  5. Do recommend that the patient contact his or her physician but do not recommend a physician to the patient.  Under NO circumstances should you ever bring a patient to the physician or the physician to the patient’s home. (Julianne’s note: If you do not believe this happens, talk to your folks at MD offices.  The waiting rooms are filled with aides bringing patients to MD offices.)
  6. Do not go into people’s homes or call them on the phone to tell them about the availability of home health.  (Julianne’s note: We did not need a lawyer to tell us this, I hope and yet, I know of instances where it has happened.)
  7. Do not conduct marketing inservices in people’s homes.  Stick to the physician’s office.
  8. Never, ever offer anything of value to anyone in an effort to select your agency or refer to your agency. (Julianne’s note: See the way Chris used both of the words, ‘never andever’ in his advice.  I know from experience this  means he is deadly serious about giving people cool stuff in return for being your patient or referring to your agency.)

Specifically excluded from these guidelines is community education.  If you think about it, when providing support groups and speakers for community functions, you are generally not interacting with people who would meet the home health requirements for homebound status so there are no ‘patients’ involved.

The truth of the matter is that every time an agency gets closed down or someone goes to jail, it reduces my pool of potential clients.  And remember, it is all about me.

And it is about you.  My experience is that nurses who violate these guidelines typically are unaware that they exist.  I am not completely innocent here. I have paid for drugs on occasion and also food.  (Attention:  if you are a federal agent or work for a contractor who has the authority to arrest fraudulent nurses, I haven’t been in the field since the 90’s.  Surely there is a statute of limitations.  If not, can I write my blog from prison?)

We can’t do this anymore.  We absolutely must put safeguards in place to protect us from having to tell a client we are so sorry they have no meds or food but can’t anything about it.  Because nurses are not wired to do that and we will end up in trouble if we don’t act preemptively.  This means hooking up with your local food banks and indigent pharmacies and getting to know how they work before you need them.  And when  you have a few dollars to give away, donate them to the pharmacy or food bank.

And if you don’t have a formal compliance plan, contact me.  If you have unwittingly participated in any of the above, contact Chris.  We can help you.  There I go again – soliciting business.  It actually works.  Sorry you can’t participate.

4 Comments Post a comment
  1. Delaine Henry COS-C, HCS-D #

    You mean having a non clinical administrator visiting a patient and presenting as an MSW is a crime? Who knew! The things people do still amaze me. Thanks once again for excellent advice!.

    February 14, 2012

    • Chris did not speak directly to non-clinicians posing as MSW’s and because I am not a lawyer, I am hesitant to go out on a limb and offer legal advice. However, I am confident in saying that it will put you on the CMS naughty list. Oh, what the hell…….. OF COURSE IT IS A CRIME!!!!!!!

      February 14, 2012
  2. Lisa #

    Just through my happy a** in jail…when I walk into a pts home and find nothing but rotten milk and a can of beans…And we live in a rural community that has little resources…of course I get an emergency order for an MSW…it still takes days sometimes weeks to get these people help…I will NEVER walk out of a home with a hungry human (or animal for that matter..and yes I have bought cat food dog food and bathed them as well!!) in it with out at least buying some emergency food to hold them over for a few days…(all in the office and field will chip in to help)
    Please God let me retire soon!!!!!! This world is NUTS!!!! 😉

    February 14, 2012

    • Yes, dear. The world is nuts. Have you not been reading my blog? I draw the line at bathing cats but I have never read where it was illegal to do so so long as the bath is incidental to a skill recognized by Medicare. You may want to check with your agency’s insurance company. Mr. B, my cat, couldn’t help himself one day and jumped in the tub with me. I thought I would need a transfusion before it was all over. It doesn’t take a lot of blood to turn the bath water red, by the way. Just so you know…

      I think that the laws were made to prevent people from being sleazy and the law in general is very rigid. In healthcare, one of the more interesting changes this year is that intent no longer has to proven. That is why it is important for us to know these things. Would I leave a patient hungry? Of course not. On the other hand, when I was in the field, I knew exactly what I was doing and what the law stated. That allowed me to be a cautious as possible. Again, I am not a lawyer and I don’t know what Chris or anyone else would say, but if the feds go after you for that, then I will blog about it every day with the heading, ‘FREE LISA’. I believe that your unwillingness to let someone go hungry is a good thing and I do not believe that is what the feds are actively prosecuting.

      There are cases where patients have been offered cash dollars to ‘join an agency’ or worse – simply hand over their Medicare numbers so someone can bill. That fifty bucks, in my opinion, does not fall into the same category as the fifty bucks you used to get meds and food for a patient who is without. BUT, if it happens often or if you become known as the agency that people need to call so they can get food and meds at no cost, you probably won’t withstand scrutiny.

      I am certainly not going to tell anyone to break the law. I, personally, wouldn’t lose any sleep if I ran into one of these patients once a year or so and took care of their immediate needs. I would lose sleep if every other admit had a cat in need of a bath.

      February 14, 2012

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