A Brief History of Kickback Schemes at Chicago Hospitals

Edgewater Medical Center in Chicago. Photo via Flickr/Zolk

Edgewater Medical Center in Chicago. Photo via Flickr/Zolk

News broke yesterday that six have been arrested in an alleged kickback scheme at Sacred Heart Hospital on Chicago’s West Side. According to the Tribune, the hospital was performing unnecessary procedures on patients in order to increase the money it received from Medicare. The procedures in this case appear to be tracheotomies, which is where an incision is made into the neck and trachea so a person can have an airway other than their mouth or nose. Usually a tube is also inserted to help the breathing occur.

According to the Illinois Department of Public Health, Sacred Heart is a for profit hospital and in 2011 it provided $11,742 of charity care. What’s interesting is in the breakdown of patients and revenue in the annual report it says 38.2 percent of inpatients were Medicare patients but 60.1 percent of inpatient revenue came from Medicare.

Since the raid and arrests happened on Monday, this news story is still unfolding. What’s unfortunate beyond people being heavily medicated and having unnecessary procedures performed on them is if this is all true, this isn’t the first time there has been Medicare fraud committed by a Chicago hospital as part of a kickback scheme.

Edgewater Medical Center is an eyesore that has sat empty for more than a decade due to closing after numerous staff members were found guilty of Medicare fraud. The most detailed explanation I’ve found of the hospital’s closure comes from Ken Fager of American Urbex:

Vice president Roger Ehmen and medical director Dr. Ravi Barnabas were able to turn the nearly bankrupt hospital into a lucrative profit center. The pair tapped Dr. Sheshiqiri Rao Vavilikolanu and Dr. Kumar Kaliana to recruit potential patients. For years the doctors sent hospital employees into the Chicago community to find potential patients. It did not matter if they did not have heart conditions, were drug addicts, were unable to speak English or even had no health insurance coverage. Recruiters instructed the potential patients how to feign symptoms in order to mandate services rendered by Edgewater Medical Center. In return the patients were offered money, food, cigarettes and other amenities for their cooperation.

In addition to this doctors at Edgewater Medical Center performed unnecessary angioplasties, which is a procedure where arteries are widened. People were killed as a result of these procedures. As I said earlier, news broke, people were tried and the hospital closed. A simple look on Flickr for “Edgewater Medical Center” will return numerous photos from inside the hospital, many of which make it appear as if the staff simply up and left the building, forgetting to take the patient records and chemicals with them.

There are numerous questions to be brought up with both of these cases. What would compel these hospitals to do this? It’s possible that they did this simply so they could stay afloat as other hospitals in Chicago have had to close because they couldn’t afford to keep running. (RIP Michael Reese Hospital.) There are also questions that could be brought in about what it is with Medicare’s set-up that makes the use of dangerous procedures seem like a good way to increase hospital revenue. I’ve heard some things from doctors I know about the set-up of Medicare sometimes pushing them to treat more patients, but I don’t know how much of that is true.

I also find it interesting no one criticized Sacred Heart Hospital for how little charity care it provides since it’s on the west side of Chicago. Rush University Medical Center has been criticized for not providing a large amount of charity care–although it’s right next to John H. Stroger Jr. Hospital of Cook County–as has University of Chicago Medical Center on the south side. Again, numbers on charity care aren’t everything and I imagine its status as a for profit hospital came into play with the lack of criticism, but it does strike me as odd no one criticized this hospital.

Let’s hope this story doesn’t become worse as time progresses.

The Fate of Prentice

In the past month, the debate over the old Prentice Women’s Hospital seems to have fired up again. According to Deanna Isaacs of the Chicago Reader, Northwestern University sent out an email to members of the alumni association urging them to support the demolition of the Bertrand Goldberg building. (Isaacs also posted today that the hospital will get a hearing at the Landmarks Commission.)

After the email was sent out, I ended up try to think if I knew anyone who works in Northwestern’s Streeterville campus that actually likes Goldberg’s hospital. I drew a blank, but came up with a lot of people who think that it’s an “eyesore” that needs to be torn down. Some of these people, by the way, are Northwestern alumnists.

Goldberg’s hospital is not on my list of 10 Favorite Chicago Buildings and there are Goldberg buildings in Chicago that I actually like more than the old Prentice hospital, but I can also think of a lot of other shuttered Chicago hospitals that I find to be bigger eyesores and in need of demolishment, such as Edgewater Medical Center and Maryville, which I’m not a huge fan of because I lived a few blocks from it and it always creeped me out. I’m also a bit biased when it comes to Prentice because I’m studying science and understand the importance of modern lab spaces, although the gorgeous old building I have to do biology labs in works pretty well for the demands of a class of college students in 2012.

However, it seems to me that even though a lot of people in Chicago seem to have rallied around saving Prentice, I wouldn’t be shocked if the opinion of Northwestern alumni, faculty and staff is what could doom the building. These are people who seem to have not been convinced of the architectural and historical value of this building. Unless preservationists can convince this group to support saving the old hospital building, I think that it might be more likely that Prentice might be demolished.

On the other hand, if you are an employee of Northwestern’s Streeterville campus and you like the old Prentice Hospital, please let me know because I don’t want to misrepresenting this group of people.

More On Mob Attacks

While the situation in Boystown keeps getting a bit crazier and more depressing, Milwaukee experienced mob violence in the Riverwest neighborhood on Monday evening. In the incidents, about 22 teenagers looted a BP convenience store, prior to about 11 people being assaulted and robbed in Reservoir Park. With this incident, there is surveillance video footage from the store posted online for people to possibly help identify the suspects. As of yesterday, the Milwaukee Journal Sentinel reported that eight teenagers have turned themselves in, although another article from the Journal Sentinel says that on Wednesday four teenagers had been cited for disorderly conduct, theft, and curfew violation after their mothers called the Milwaukee police. (For a perspective from a mother that reported her children, Milwaukee’s ABC affiliate, WISN, spoke to one*.)

Today, charges were made against one person in connection to the Boystown stabbing. A longer window of time has elapsed between Sunday’s stabbing and a person being charged than the incident in Riverwest and seven people being charged. There are quite a few differences between the incidents, including that Riverwest residents haven’t started a Facebook page, there are two different police forces involved here, and Milwaukee is a little more than a fourth the size of Chicago. Another interesting aspect is that with the Milwaukee violence, both Milwaukee Police Chief Edward Flynn and Mayor Tom Barrett were present at a community meeting and addressed the crowd.

Although my mother and sister live in the Milwaukee area and I visit there frequently, I know very little about Riverwest and among the things I do know, I can tell you that Lakefront Brewery has a lager named after the neighborhood. I can tell you more about the climate in Boystown because I used to patronize some businesses in that area. But first, a discussion on identity.
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Racism, Crime, and Facebook

You see these all over BoystownThere have recently been stabbings and attacks in the trendy Boystown area of Lakeview, which is home to several gay bars and the annual Pride Festival and Pride Parade. As a result of these attacks, some Boystown residents have taken to Facebook, creating a Facebook page with some blatant racist remarks. (Sample quote: “‎I’m not racist, but those black kids have got to go!”) I would have been completely oblivious to the Facebook page had it not been for a friend posting a link for the page on his Facebook profile, showing disgust.

Sunday night, a 25-year-old man was attacked and stabbed by a mob of young people in Boystown. The attack was recorded and posted on YouTube, although the video is attached to the Tribune article I linked to. Judging from that video, some of the assailants appear to African-American, although I can’t say that accurately say what the ethnicities of all the assailants are because of lighting, angles, and the quality of the video. My immediate thought after viewing the video is why some residents are jumping to the idea that African-American youths should not be welcomed in their neighborhood.

But first, some background.

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