Hospice Fraud Investigation - Los Angeles News | FOX 11 LA KTTV

Hospice Fraud Investigation

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Award Sylvia Myers received when she retired early from her job as a bus driver to care for her dying husband. Award Sylvia Myers received when she retired early from her job as a bus driver to care for her dying husband.
Kathy Cares sign in Cartersville, which also closed its doors. Kathy Cares sign in Cartersville, which also closed its doors.

A Lamar County woman claims a for-profit hospice company took advantage of her dying husband, pocketing thousands of Medicare dollars without ever showing up to help.

Every year for-profit companies bill Medicare billions of dollars for hospice... caring for the terminally ill who agree not to seek much more expensive end-of-life procedures. So why are there so many allegations these days -- that loved ones... and tax dollars... are being abused?

"He was always there. He always had my back no matter what. Good, bad or ugly, he still had my back. I really miss him, too." Sylvia Myers said while looking at photos of her late husband Grady.

"We were predicted to only last five days," she remembered wistfully. "And that was by his preacher cousin. And we lasted 33 years."

But it was that last one... year 33... that was the most difficult. Grady suffering a stroke and then a heart attack. Sylvia ran into a family friend who said his company could help. She gave him Grady's Medicare number. The hospice company... Kathy Cares... came by the first time, but Sylvia says she wasn't home.

What happened next led to a complaint of Medicare fraud... and questions still not answered.

"I hadn't heard anything else from them period," Sylvia told Fox 5 I-Team reporter Randy Travis. "I hadn't seen nothing. No papers. I hadn't signed no papers. They haven't been up here to help me."

So last summer Sylvia figured that hospice offer to help had passed.

With no professional help for her husband, Sylvia had to take early retirement from her job as a school bus driver, costing her thousands of dollars in future pension money. Then, last fall, she had to go back to work part-time to pay for his meds, not realizing that Medicare was already paying someone... for services she says her husband never got.

That's right... while Sylvia says she was borrowing walkers and a wheelchair from neighbors... struggling to buy adult diapers for Grady... records show Kathy Cares was billing Medicare for five months of home hospice -- collecting $23,749.

"I would be shocked if this wasn't happening all over the country every day," says Birmingham attorney Jim Barger. His law firm

leads the country in False Claims lawsuits against hospice companies accused of Medicare fraud.

"It's easy to do. There's no one to police it. There's rarely anyone to detect it."

Barger does not represent Sylvia Myers and has never filed suit against Kathy Cares. But he says her story is sadly familiar.

"If she was denied that care and the taxpayers paid for it, I would say, I'm not a prosecutor but that would not just be a civil fraud. That would be criminal."

In her complaint to Medicare, Sylvia accused that family friend who worked for Kathy Cares -- a man named Stoney Sullivan -- of "lying about taking care of Grady."

The I-Team tried to find Sullivan at his home in Barnesville. His car was there, but his brother said he wasn't home.

A few minutes later they spotted Sullivan driving the same car leading away from the house. He briefly slowed down, but refused to answer any questions.

Kathy Cares director of operations Riley Holmes told us the company did its own investigation and found quote "no problems." She said they've forwarded their response to Medicare. She would not answer our main question: why their patient's wife says she never saw a single nurse on any of those five months they claim they helped her husband.

Kathy Cares has since closed its residential hospice facility in Cartersville and last month vacated its office at Atlantic Station. Out of the hospice business for good.

That does little to comfort the widow who says she feels like the company treated her like a fool.

"They got me to give information so they could make money," Sylvia said. "They don't care about people."

 

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