Novus Hospice
Most of us have loved someone who has died. What you would give for even one more day with your loved one? What would you do if someone stole those last days from you?
The Department of Justice has recently released documents alleging that 15 Novus Hospice employees and one contractor knowingly participated in a scheme to defraud the government of Fraud amounting to 60M dollars. Two nurses, thus far, have signed statements agreeing that they deliberately over medicated patients at the request of Bradley Harris, the founder of Novus Hospice in Frisco, TX. A third employee, Melanie Murphey, the director of operations also signed a document admitting that she participated in a number of fraudulent activities and knew about the expedited patient deaths.
For reference, the original documents are linked below:
State Survey report with Julianne’s notes in red
The text messages that are included in the indictment and factual resumes tell this story with greater clarity than the necessary ‘legalese’. Here’s a few examples:
Brad Harris texted a nurse, Taryn Stuart to take over the care of a Continuous Care patient because the current nurses weren’t ‘doing there job’. He followed that with: I told that chick if she would just give her one mg of Ativan and turn her, she would die.
Taryn Stuart to another nurse, Jessica Love, referring to Brad Harris: Doesn’t think the Nigerian nurses are medicating properly. Wants me to go cause he knows I do it right.
Harris again: ‘(expletive) woman is still alive…..I need some boots on the ground.
After death, Taryn Stuart to Brad Harris: Just FYI, I’m going to quit being so good at cc so you won’t want to send me. LOL
Brad Harris: Haha. Nice work.
Jessica Love advised Taryn Stuart on the Jessica Continuous Care orders. It involved high doses of Ativan and Morphine. Additionally, the protocol involved removing oxygen or, if the family was present, turning it down to zero. According to Love, it worked like ‘a little charm’. Stuart agreed texting, ‘I know. That’s what I always do.’
The document does not state how the texts came to be in the possession of the investigators or how their authenticity was verified but they made their way into the two legal documents signed by nurses agreeing they were accurate.
There is more; so much more. Fraudulent orders and prescriptions for schedule II narcotics and signed certifications and Face-to Face documents that never happened are referenced. Blank DNR forms were notarized by office employees, including Amy Harris, wife of Brad Harris. Brad Harris instructed MDs on what their passwords should be for electronic signatures so he could write orders.
Jessica Love is special. By order of the state board, she should not have been employed by Novus. Her license was restricted and those restrictions included that she would not work in home health or hospice. The reason she was brought up before the board was because she signed a patient’s name to a document after the patient had died. The documents leading up to the revocation of her license are linked below.
All of this together paints a culture led by a man who had no interest in the well-being being of anyone other than himself and no respect for the regulations that shape hospice care. When a health care provider is owned by a toxic individual, the entire organization is poisoned.
If I had to guess, Brad Harris did not run a classified ad for nurses and medical directors willing to murder patients to manage length of stay numbers. He either knew or should have known about Jessica Love’s problems with the board. All of the other licensed personnel have clean and current licenses. Five of the 16 certainly knew that patients’ lives were terminated to manage the numbers; Brad Harris, his wife who worked with him, the office manager and the two nurses who signed the factual resumes. There are likely more.
What does this have to do with you? Besides Jessica Love, there are 14 other individuals who worked for Brad Harris and participated to some degree in the depraved actions that killed some patients before their disease followed the natural course. How much did the toxic environment that regarded patient lives as trivial and payment as a priority above all else contribute to the willingness of these individuals to consistently break the law including killing people?
I see people enter toxic environments with strong values and slowly those values are revised to the mean of the workplace. I assure you that I have never seen patients made to die before, but I have seen cloned notes that would not be paid upon review, missed visits, and patients who are not homebound. I have read about hospice patients with Alzheimer’s Dementia that in no way meet the criteria for hospice. This always occurs when a nurse or an agency puts profits over patients and it never turns out well.
If you stay in this business long enough as a manager, you will hire a rogue employee on occasion. If compliance starts at the top, these will be few and far between and your established employees will see the red flags long before you do and report them.
Good leaders don’t issue ultimatums such as, ‘You better have weights on your visit notes, or else you might not have a job,’ because when the choice is getting fired or documenting a fictitious weight, good nurses with a family to feed might choose the latter in a moment of weakness. When leadership builds a culture where compliance is the norm and yet allows for remediation of human error (that doesn’t involve fraud), sleep will come easily. It is expensive to commit fraud. I have never known a blatantly fraudulent provider to make money and develop a loyal staff.
I am proud to know many hospice nurses and have been overwhelmed by their caring attitude. The joy they bring patients is a gift. The hospice nurses I know go the distance for their patients and are creative and intelligent in the ways they make patients comfortable. The true hospice nurse is sacred and I am a better person for knowing them.
I don’t know where the killer nurses at Novus hospice came from but I know where they will be going. Sadly, their plea deals include only one count of Medicare fraud and the maximum sentence is only 10 years.
The first sentencing is in October. I’ll keep you posted.
Leave your comments below or email me if you have additional thoughts.
I am sick. Reading those texts made me sick. How can they sleep? How can they do anything that normal people do? This kind of thing gives the public the idea that all Hospice nurses do is give fatal doses of Morphine. So far from the truth but so hard to squelch. I hope they all get the max and never allowed to work as nurses again.
I’m fairly certain they will not be working as nurses ever again. I debated for a few weeks about posting it for the reasons you mentioned but if we don’t take a stand against bad nurses, our silence may imply approval of the nurses.
I am getting an idea of how good Cops feel when there is an unjustified police shooting.
As an RN and the Compliance Officer for a large home health/hospice company, there are no words to say how appaled, saddened and heart-broken I am to have read this. All I can think is “How can I do my job better as a compliance professional to make sure we do not hire toxic, rogue individuals, and if we do, how to stop them ASAP”.
As a daughter who watched her father die of a horrible disease, pulmonary fibrosis, I cannot imagine having those last days with him eliminated by hospice workers who put profit before patient care.
I do appreciate that you published this and I hope it is a wake-up call to all of us in the healthcare field that this behavior won’t stop unless we each take the steps needed to acknowledge this behavior and stop it.
I am so sorry for the loss of your father. As painful as it is, it is satisfying to be there for your loved one.
I’m glad there are nurses out there like you who safeguard the care that is given to patients. People don’t often appreciate the influence on patient care that a dedicated Compliance Officer yields.
I have worked as a consultant for many years. I have observed that some practitioners do not practice according to the standards of nursing practice because they feel that the patient is going to die anyway. This case is the most appalling example I have encountered. The staff should have reported the owners to Medicare. Instead they are complicit in the early death of multiple vulnerable patients. Perhaps it is time to make it a requirement that all Hospice nurses must be Certified Hospice Nurses before they can provide care.
Priscilla Greene
In all fairness, it might very well be a whistleblower case. Note that the state came in on a ‘complaint’ survey and only Continuous Care patients were surveyed. Also, I keep wondering where those text messages came from. The identity of people who report this level of misbehavior are often protected until the final outcome of the case. But had it been me, I would have screamed from the rooftops until it was stopped. If federal investigators were on the code team, well, it wouldn’t be pretty.
Being certified may or may not help. But until there are enough certified hospice nurses, a requirement might have the unintended effect of creating a hospice nursing shortage and since nurses are a core service, they would all have to be employees of the hospice and couldn’t be agency. But it is a thought and could be done over time. But that won’t eliminate the Brad Harris’s of the world.
I’ve been following this case since it hit the news a while ago. The texts were including in the news. I feel for those families that were not aware that the hospice that was “caring” for their loved ones was actually killing their loved ones. It would take me a LONG time to get over the anger part of the grieving stages.
I am thinking this Bradley Harris had some dang great charisma. (I looked his picture up–wasn’t his looks) How in the world did he surround himself with like-minded evil persons? Did these nurses do this for the money? Did they think they were Kavorkians? What goes through someone’s head to make that person think that continuously medicating people like this is OK or right?? His goal was to increase profits and then sell. Were they all promised a piece of the action upon sale?
Obviously someone or ‘someones’ is/are whistleblowers. Someone intercepted those texts. Either someone inside intercepted or had told the government that was a usual mode of communication and the government intercepted. Did you know your text messages are available when you log in to your provider?
CMS always responds a couple of years after huge investigations like this…I foresee a tightening regarding electronic signatures. I also see ‘senile degeneration of the brain’ being added to the “no code list.” I have seen a lot of comments regarding hospice patients not receiving the medications needed because of the opioid crisis. Cases like this certainly do not help.
By the way, “certification” doesn’t always increase professionalism. This guy is (soon to be was) a certified public accountant. And then there are the SIX physicians…
Lisa, I had the same questions as you. I do not think, per the text messages, that the motivation was Kevorkianish. Kevorkian at least believed in what he did.
It is the texts from Taryn Wiggins Stuart that keep me awake. The Nigerian nurses weren’t doing it ‘right’. And she texted Jessica Love that that’s the way she ‘always did it’. She seemed to be bragging about her part in this. I was stunned to say the least. Take away the patient deaths and there is still a plethora of really bad behavior.
I cannot imagine anyone thinking it was okay to give someone who showed no signs of pain and was breathing at 8 times a minute morphine. There is a good chance that many of these patients did not receive narcotics prior to hospice. Surely that would be easy to check. If that is the case, then 40 mg every hour is obscene. After surgery many years ago, I had a pca pump that delivered one mg an hour. I threw up when it was increased to two.
I think you are right about the electronic signatures. The thing is, it really isn’t any different from docs signing off on plans of care or a stack of orders without reading them. It is simply more convenient. The docs who signed C2 blank prescriptions had to know that they were giving the hospice the murder weapon to kill these patients.
We know what Bradley Harris had on Jessica Love. I’m betting he ‘owned’ the others somehow, too.
There may always be one bad actor even though that person is certified but the basic concept I raised of requiring Hospice Certification of all nurses that are hired to work in Hospice is to guarantee baseline knowledge of acceptable practice. In the area where Brad Harris owned his Hospice chain I imagine there is competition. One less Hospice that can’t hire adequately prepared clinicians is not a loss in the greater scheme of things. The cost of training those who are not certified would be part of the investment start up cost. During the demonstration phase to obtain Medicare certification it would be necessary to hire one Certified Hospice Nurse.
I see your point and it may help. Nobody who was not interested in patient care would go to such lengths.
But I’m still trying to figure out how Brad Harris recruited 15 heartless and soulless individuals. Even though TX is a big state, I wouldn’t have thought there were that many people willing to kill patients in the whole state; much less gather together.
I am glad to see this issue come to light. I have seen nurses who have become like this, numb to the reality of what is going on with their patients. It is frightening. Sounds like a sick culture enveloping the entire business, and not simply one bad manager. The risk of health care for profit. Incredibly sad for the families and the patients. Those last moments will never come again. I have always tried to balance pain relief with the least amount of sedation so that patients can communicate with their families. Hospice is not about hurrying things along, it is about making the best of what time is left. I hope all of those people involved are never involved with health care again.
Carol, I agree with your philosophy. The time with family is precious and frankly, you can always give more meds but you can’t take them away. (Technically you can with Narcan but that is a very unpleasant experience).
In the UK, they have a special cocktail that uses cocaine and heroin. Patients are pain free and alert. It’s a shame but I can’t imagine using such a concoction without serious diversion in the US.
In the absence of that, nurses need to carefully titrate meds to adequate pain relief and then stop. I noted that the standard orders for Novus was for one quarter cc to 2 CCs for pain. Every dose was given at the highest dose except for those who documented 1 -2 cc’s (which is it??).
I am extremely pleased with the response of my peers. I almost didn’t write about this because it paints such an ugly picture of hospice. We know this is not the norm. We do need to be prepared to address it, though. If a patient told me this story, I would assure them that they were the victim of fake news.
Shocking depravity of people has been demonstrated through history. In nursing it is outstanding practitioners who teach others, those who implement regulations and enforce standards, and those who lead by example who protect patients particularly the most vulnerable. Sadly this seems to be missing. What is the missing in the system that enabled this to occur?
I wish I knew. I’m sure that as a consultant you look at the structure of an organization. I usually find it fascinating to discover who really makes decisions, who is or is not respected, etc.
I am not saying that non-clinicians should not own providers because there are many good ones. But I wonder if surveyors should investigate DONs more closely. I’ve seen Administrators intimidate nurses into keeping patients on service too long or when they are not homebound. The DON should have the ultimate power over clinical decisions. And that is not always the case.
Absolutely! And strong oversite on the part of the regulatory body.