Who’s Beverly Cooper?
Why should you even care who Beverly Cooper is? A friend, Kelly, sent a link to a recent HEAT team arrests. Because I have worked so much with fraud over the past couple of years, almost nothing surprises me anymore. Here’s the exception.
Beverly Cooper admitted to Federal Authorities that as a registered nurse:
‘she and others conspired to defraud Medicare through home health care companies operating in the Detroit area, including Reliance Home Care LLC, First Choice Home Health Care Services Inc. and Accessible Home Care Inc. According to court documents, Cooper fabricated nursing visit notes and other documents to give Medicare the impression that she had provided home health care services, when, in fact, home health care was not needed and/or was not being provided’.
Wow! We are not talking about a rogue nurse. This woman systematically with cooperation from her employers signed legal documentation for the sole intention of defrauding the government. The total billed fraudulently was over 5M.
This is the stuff that makes headlines and sets examples of what happens to people who commit fraud. It is dramatic and so far away removed from our daily practices that we just look at it in awe.
What we miss is that the worst part about this case isn’t the legal implications at all. It is the clinical documentation that is now part of a patient’s medical history. It is the patients who were not seen. It is those patients who did not meet eligibility requirements and were seen.
So, while it may not take a lawyer to determine that the behavior here was illegal, I wonder if the lawyers and judges understand the gravity of the compromised clinical care. Do they fully understand the the harm that could come to a patient when a hospital or other provider relies upon fiction stated as fact in a clinical record? Do they even understand how easy it would be for a patient to die because medications or allergies weren’t documented appropriately?
There’s one way to ensure that they do. The judge presiding over the case, The Honorable Victoria Robertson, can be contacted at:
United States District Court
for the Eastern District of Michigan
Theodore Levin U.S. Courthouse
231 W. Lafayette Blvd., Room 123
Detroit, MI 48226
Chambers Telephone Number
Let Judge Robertson know, if she does not already, that this case is about so much more than fraud. If we, as nurses, do not speak up, who will? Who better understands the ramifications of fraudulent documentation than a nurse who has tried to take care of a patient who is relying on poor (though not fraudulent) documentation of a prior caregiver?
I hope they allow Ms. Cooper a computer in the Federal Penitentiary so she can spend her money on the internet. I hope the Amazon order is enough to offset any regrets she has about compromising patient care. Most importantly, she should take up a healthy lifestyle because there are many nurses who would not be comfortable taking care of her should she become ill.
I am so glad you point to the more insidious crime here.
The problem with the publicity that this and other more dramatic fraud schemes get is the impression that any agency who is “not THAT bad” must be OK.
As a CHAP surveyor for over 5 years I came to realize that 9/10 records I reviewed and clients I visited did not meet medical necessity requirements to bill Medicare for Home Health. None of these agencies had the intention to defraud the government, many were not making much more than a marginal profit so they believed they were OK.
Home health has become a sleazy business and its nurses who are going to have to redeem it.
Let’s see if I got this right. $5MILLION worth of FAKE home health visits? She and “others” must have worked day and night to generate that much documentation. FAKE patients, FAKE visits on people who did not require home health, and nobody noticed? Louisiana has some tuff Surveyors; they notice stuff. I think they would notice if the patient was non-existent or not in need of services. That’s a LOT of fake patients to accidentally get missed during a survey. OUR surveyors go right for the ONE patient who didn’t have ordered weights recorded by the CNA or the ONE patient who didn’t have a BM every 3rd aay not called in to the nurse or doctor.
OOps. Didn’t finish….got cut off or something. Anyway….How DO they do that? HOW? (Actually, I don’t think I want to know), but it’s fascinating to me that there are these people out there that think the almighty dollar is going to…what?….SAVE them? Do they have children? Grandchildren? “Look everybody, Nana got arrested and is going to prison!!” Do they think it will make them wonderful? Make them beautiful? Color me incredulous.
Read carefully. The Feds have a way of stating things in such a manner that anything pretty is stripped off the naked truth. Maybe they made most visits. Maybe thats how they got patients Medicare info. Maybe they told the patients they would have an aide come by several times a week if they were confined to the home, wink, wink, mod, nod.
I have dealt with everyone from true victims of unwarranted scrutiny to out and out sociopaths when working ZPICS. This is what I hear as though it makes a difference:
The black/white agencies do it all the time. (nowhere on Medicare enrollment paperwork is race listed)
Nobody can prove it. (keep on believing that so I continue to have a job)
What were we supposed to do when the doctor wouldn’t sign orders? (discharge the patient with an HHABN. Alternatively, you could have written the careplan timely.)
It’s not like we were committing fraud – (yes, that’s pretty much what it was like)
I’m going to sue the nurses (good luck with that – they didn’t sign the Medicare provider agreement and by the way, how is it that you have so many bad nurses and didn’t know about it until you were investigated?)
Here’s the really sad thing, Gail. The guys who do that are so bad at it that they are chronically broke. They feel like the big corporate agencies do the same thing. The corporate agencies have their own problems but I assure you that if a nurse hands in fraudulent visits, they are immediately termed and reported to the board. Their visits are backed out and the claim is rebilled if possible.
The true sociopaths have done nothing wrong. Just ask them.
After two years, I keep saying that nothing can surprise me anymore. My lawyer buddy keeps telling me we are not their conscience. Like you, I am incredulous and am fascinated by these fraudulent players the same way people can’t help but stare at and try to figure out a car wreck. And that the Feds take so very long.
One last thought. Patients are coached well for survey and the state doesn’t pay your bills. They are responsible for teaching OASIS but they make no claims to know PPS. Read your state regs. They do not address payment. And many times surveyors do notice things and report them. The Feds do not lose cases and there are so many opportunities that they turn down more than they take on. Then they take ten years to investigate. Oops – if any federal investigators are reading, that was not a personal slight at you.
Am typing on IPad. Please forgive Typos. Not to speak ill of the dead but what did Steve Jobs have against a delete key?
Don’t believe everything you read in the papers, feds have ways to make people pled gulity to crimes
If you don’t know the whole story intimately such as why aren’t you addressing the main culprit Sharma who profited for real with his wife and family members. Yes Beverly should have made a wiser decision but, were you there when she was working 18 hours a day? She has lost everything her marriage, her home, her license and her dignity. Do you know if she knew everything that was going on? Do you know if she was desperate to take care of a dying relative. You know about her where’s your post about about Sharma the ring leader? Did you know how wonderful she is and everybody makes mistakes! And if she does get sick who says she needs one of you nurses to take care of her God has back.
I do not know Beverly Cooper and the fact is that what you are saying is sadly true of many people convicted of fraud. Desperate people do desperate things. In Ms. Cooper’s case, she was exhausted, had a sick relative who was dying and was probably bullied by someone who could cost her her job. Turns out, he cost her a whole lot more.
And that is sad.
The standard is not what she knew but rather what a reasonable person in her position should have known. I wish she were the only nurse I knew of who got caught up in a bad situation. I couldn’t possibly have an opinion about whether she knew everything that was going on but nurses know that their documentation must reflect the patient. They also know that if anything is going on that is untowards they have a responsibility to report it. Sometimes, knowing isn’t the same as ‘proving’ though. In those cases, regardless of how dire things might seem, leaving a job is far better than sticking around to be arrested later. It is difficult to convince nurses of this.
The original article said that she was part of a complex scheme and ‘conspired’ with others as part of an organization that apparently was fraudulent. This was not a mistake. It was not accidental. She chose to be a part of the fraud. If she was not enriched but rather someone else was, they need to be jailed as well.
I wouldn’t be surprised if Ms. Cooper is wonderful. Therein lies the value of this story. It is not just gossip, etc. It is the real life account of a nurse who, by your account and others, was a decent person who went to jail. There are a million possibilities – was she bullied or did a greedy person take advantage of someone who was vulnerable because of fatigue and emotional frailty related to a dying family member? Did she believe she was doing the right thing but never bothered to look anything up even when it seemed ‘off’? Did she get scared and lie to a federal agent? The possibilities are endless but the outcome is the same.
Apparently you know Ms. Cooper. I certainly cannot write about her position regarding a case that is open but I would love to hear from her. I would like to know what she would advise other nurses to do and how to avoid the situation she found herself in.
And should she become ill, I am quite certain that all of us nurses would take care of her. She did something that was not so good. That does not mean that she is not so good. It means she made really bad decisions and all of us are capable of doing so at times.