Hospice pays $1M in cases as CEO pay jumps

Nonprofit settled excessive billing allegations.

A nonprofit company in West Palm Beach set up to comfort terminally ill people agreed to hand over more than $1 million in repayments and fines to resolve government allegations of excessive billing in settlements reached last October and in 2014, records examined by The Palm Beach Post show.

Meanwhile, other documents reveal a 37 percent pay hike to $954,071 for Trustbridge Inc. CEO David C. Fielding, with disclosures indicating Fielding set the pay of at least seven other officers at more than $300,000 each in the latest year on record.

The reaction from one woman who said the hospice fired her this year after she advocated for more supplies and staffing for patients: “Fury.”

Another employee has gone to court, claiming she was unfairly terminated because she could not get to work during Hurricane Irma.

The revelations come at a charitable organization whose mission is not to cure any disease, but to provide pain and anxiety medication and other “palliative” care to terminally ill patients, mostly in their own homes or residences such as assisted-living facilities. It competes to serve patients in two counties, Palm Beach and Broward.

At Trustbridge, the parent company of Hospice of Palm Beach County and Hospice By The Sea, officials note the company admit-

ted no wrongdoing in government settlements. They say policies on pay and other matters are consistent with industry standards and serve the company’s goal of providing excellent care.

“Our number one priority is to provide quality care to all of our patients,” said Chief Operating Officer Randy Prange.

But former employees say front-line workers are strug- gling to comfort dying peo- ple under stressful conditions, while executives have been cashing comfortable paychecks.

“My fury comes from knowing the salaries the executives are making,” said Lucinda Lantz, 61.

Lantz said she is a social worker who was fired earlier this year after writing blunt memos complaining about a lack of supplies such as adult diapers for individual patients and asking for more staffing for bedside care.

“As a social worker I didn’t get raises for years,” Lantz said. “I guess that didn’t apply to everybody.”

Company officials said patients and families are provided with supplies required by hospice regulations, with additional measures often provided to those in severe need, but “we do not pub- licly address issues regard- ing former employees.”

The overwhelming majority of Trustbridge’s patients are covered by federal taxpayers, at little or no cost to patients and families, through Medicare and Medicaid, records show.

That has not stopped the company and affiliates from soliciting charitable dona- tions — with the aid of former NBC host Matt Lauer until last year — or accepting unpaid labor from 650 volunteers to supplement paid workers. The company has responsi- bility for about 1,900 patients on any given day, company officials say. Patients or fam- ilies who choose hospice are required by law to have a diagnosis of six months or less to live and to give up curative care.

Topping the executive pay list is Fielding, whose annual compensation increased to $954,071, according to IRS Form 990 documents for 2016, the most recent year disclosed. That included $258,489 in “bonus and incentive” pay.

Those in the $400,000 club include Prange ($464,979); director of medi- cal education Richard Levene ($443,894); and vice president of medical affairs Lauren Kennedy ($414,664).

Fielding’s 37 percent raise is bigger than his 30 per- cent pay boost the same year a mother of three said the organization fired her because she could work only 30 hours a week while fight- ing breast cancer, The Post reported in 2014. The hospice’s retired founder, Stella Monchick-West, called the firing “unconscionable.”

Compared with other local nonprofit leadership roles, Fielding’s compensation has grown to nearly triple the pay of Palm Beach Coun- ty’s school superintendent in the nation’s 11th largest school district, and almost four times that of the head of the local United Way.

The school district over- sees more than 27,000 workers. Trustbridge officials say their operations employ about 1,400.

A hospice statement said the “South Florida health care industry is highly competitive due to a shortage of qualified personnel,” requir- ing “a unique set of skills in both care-giving and busi- ness operations. It would be unfair and inaccurate to make comparisons to other businesses and organizations.”

In 2014 and most recently in October, Hospice of Palm

Beach County agreed to pay a total of more than $1 million following reviews by the Flor- ida Agency for Health Care Administration’s office of inspector general and bureau of Medicaid program integrity, records show. The cases involved what government officials said were charges “inappropriately” billed to taxpayer-funded agencies.

The October 2017 settlement included nearly $750,000 in repayment to the government and a fine of about $150,000. The settlement had been reduced, after a hearing request by the hospice, from a proposed $1 million in repayment and a $213,000 fine.

Leading up to the October settlement, a government review found payments for 21 out of 63 payments audited in previous years involved “non-covered services” that were “ineligible for Medic- aid reimbursement,” according to records provided by AHCA.

That marked a sharp increase from a 2014 settlement over similar claims involving repayment of more than $180,000, when a fine was waived.

Trustbridge’s Prange said the settlements represent a fraction of the hundreds of millions of dollars of Medicare and Medicaid payments that have flowed to the hospice over the years, and arise from “continuous, routine audits and reviews as part of the oversight process.”

The organization has annual revenues of about $139 million, officials said.

“Our internal investigation determined that the payments in question largely involved technical billing issues,” Prange said. “We felt legal appeals would be a poor use of funds that we could better use for patient care.”

Another employee who said she was fired, nurse Jill Welling, claimed in a lawsuit filed in March she was unlawfully terminated after she received a mandatory evacuation order as Hurricane Irma approached last September.

Welling’s suit filed in Palm Beach County Circuit Court seeks damages exceeding $15,000. The suit claims protections under federal work-safety and state whis- tleblower laws, saying her and failing Seal employer ferred bodily, drive evacuation shift.” filed the vider does care severe ricanes, would tially its ney West who record, Irma. hospice’s ing nonprofit, Commission patients decisions ical In “Hospice, The At Prange “We patients,” patients, case. conditions declined end-of-life May, Joseph least of end services Palm a not during motion to adversely weather to she have motion said Approval injury the because facing and those one hospice get shut independent record apparently Beach def “risk he based lives a G. to to been noting hospice complex awaits to a other down medical was e speak since or or its conditions, mandatory attend Santoro to end-of-life work in and nded of seriously attorneys even argued. from in doing for death medical dismiss fired serving critical many a worker, Illinois. during a poten- 1978,” ruling. for attor- serv- med- Gold after Joint pre- pro- hur- the her the the for so to of of Prange stand in distress, tions able.” served 2017 AHCA for quickly ciencies,” to-date, complaints, deficiencies, 6,732 He “We times three but patients. that that said complaints. corrected we 12,079 were said. of may received Prange of family have great are the those, with while “We set We only received patients not said. company emotional members, those are expecta- no only and serving under- attain- cited “Year- right- cited defi- five we six in fully the do. to on directors ally compensation review But Trustbridge’s improve.” executive We recognized exemplary proud who and are “contracts is of always update making pay? our health work expert board staff a striving the execu- nation- they care and call to of tive the the which pany 990 compensation The hospice healthcare compensation filing statement we hospice’s compete,” says peer the industry committee said. group 2014 board’s within a com- and IRS in reviews the officers mittee’s approved directors.” compensation “and recommendation the by CEO’s then the board the pay of other com- and of is mation” the pensation is Trustbridge determined But company in “supplemental in of its all Inc.” 2016 said by other the “the IRS officers CEO filing, infor- com- of ous gain spigot in As the pay control Lantz organization has to not executives sees of left the it, everyone feeling financial gener- who as if challenging salaries?’ they’re “Am I surprised all Lantz nonprofit in it together said. by mission. “Abso- these in a lutely. was of promise.’” nurse’s being In aides my stated final so ‘we’re don’t weeks, short over- it