Showing posts with label insurance fraud. Show all posts
Showing posts with label insurance fraud. Show all posts

Nursing: Who Stays, Why You Go

UPDATE 11.29.11:  Whistleblower wrongs change culture -

Whistleblowing Nurses Case Highlights Need for More Open Quality of Care Culture


The article linked above is part of a series.  The core issue is retaliation.  Retaliation is specifically what I endured and it is still on-going as is the extreme effort to maintain the cover up.  There has been NO investigation of my claim for starters.  Why does WA DOH wish to protect people who make false claims and engage in insurance fraud as well as crete an environment that is unsafe for patients? 


UPDATE 9.29.11:  I have recently learned that that an "investigator" with WA DOH, and WA DOH, are defendants in a federal civil rights litigation.  Dwight Correll, an employee of WA DOH, is one of the people who relied on false information about me and moved to carry it forward.  He ignored the fact that I prevailed in two cases involving the people who made the false complaint to him.  He put me in a situation that is equal to reckless endangerment, and was involved in fraud as well. He never investigated.  He relied only on the false statements and never inquired as to the facts. The kangaroo attack he created has now boomeranged back on him. I just wonder how many others have been harmed by this man.


9.28.11


I have been hearing about the shortage in nursing since the 60s when I started in this profession.  I have a college degree with honors in nursing and have completed graduate education as well as specialized education as a nurse practitioner (NP). I have also been an educator, an administrator, and a consultant in this arena.


I basically left nursing after a patient-caused injury in 1993.  I have not, however, left my focus on public health, and especially natural public health.


Why I find nursing a difficult profession would take up many pages, but I'd say for the purpose of the article that it is the nursing profession itself that left me puzzled.


I know the games hospital administrators play with nursing personnel.  They do not have to do this but it never fails that administrators always cut nurses when they have to tighten their belts.


Always, patient care suffers.
Predictors of Registered Nurses' Willingness to Remain in Nursing
http://www.medscape.com/viewarticle/746222?src=mp&spon=17
My experience with the nursing system basically showed me what kind of underhanded actions take place in the political confines of so called Quality Assurance Boards.


First I have to note that in this experience it was the Washington State DOH/QA office that acted against me based on a false claim by a nurse who was involved in insurance fraud and patient safety violations.  Yes, I was a whistle blower.


The state concocted an amazing pile of paper alleging all kinds of things in their attack against me. They did this to protect the wrongdoer who was a WSNA insider and UW grad.  How politically cozy was this?  Very!


Oddly my documentation was ignored by the state.  The then "executive" in this office, Patti Hayes, was provided with the proof yet she withheld it from  hearing officials.   This was documented through an investigation by my state representative.


Other irregularities were present too.  A member of the first hearing panel, an RN, appeared in the second panel I had to go to as a "Public Lay Member".  


How's this for conflict of interest and bias? It is all in the testimony I gave because the hearing "judge" denied me the right to provide evidence.  That's the same evidence that Patti Hayes received before the hearing.


Before I filed appeals even the AG representing the state stood up to the panel on my behalf.


The panel further retaliated by ignoring him and the factual evidence.


Of course I appealed.  And I pointed out too that I had filed under the WA Whistle blower Act, but was denied this protection.  Yet, as I later found out, the QA panel gave this protection to the person who filed the false complaint.


While there is more to this egregious abuse of process along with obstruction of justice and denial of due process rights, I had other support.


While the WA Medicaid fraud unit refused to take my complaint about this facility it so happened that DOJ was prosecuting them for insurance fraud in 10 other states.


I quickly gathered my evidence and went on a visit to the Region X inspector general for Health and Human Services. 


My evidence was verified not only by the OIG but several other law enforcement professionals, elected officials and an investigative reporter.  One funny thing was the fact that when the reporter contacted the QA office he was told all my records were lost.  I was told they were "archived".


Funny how this goes.


Eventually the state failed to reply to a second appeal I filed for cause, and in a timely manner.  On the advice of a friend who is a highly regarded attorney in Washington state, I filed a motion and order for default along with some additional action required of the state to correct their wrongful action.


Usually when in legal matters a challenged party will fail to reply, or default, when they know they have no grounds and their actions were false from the beginning.


Well, I prevailed but would you guess, the QA crowd failed.


The short of it is that with this level of integrity, if you can even call it that, why would you want to remain in the field?


I'm writing a more in depth story about this adventure, thinking I will call it "Nasty Nurse", but for now something else is on the burner.


An attorney or two, and another legislator, have are supporting my recent petition to the current Attorney General. I have requested he call a halt to the recent harassment I have received from this same crowd.  Added to this is a request that he remind the QA office of their lack of follow through on that default order.


The current AG wants to be governor and is running for this office in the 2012 election.


We'll see how it goes.


Just my words for the wise...  
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