Connections’ community support programs are once again blocking the publication of key cases – this time concerning the quality of care for thousands of patients.
Just like the roadblocks US Attorney David Weiss was met During his search for records and documents from the nonprofit, Eric Huebscher, of Huebscher & Co. in New York, was prevented from accessing records that would allow him to monitor the quality of care provided to the clients while embarking on a Chapter 11 bankruptcy.
Huebscher was appointed patient care ombudsman at the end of April as the nonprofit entered into bankruptcy proceedings to sell the majority of its assets to pay off debt and transfer operations to a new owner.
The ombudsman is responsible for ensuring that the quality of care does not suffer when a business declares bankruptcy – a role required for healthcare companies that file for bankruptcy.
But in a June 28 report, Huebscher said Connections management had banned access to complete patient records as well as its dosing system; refused a request for addresses of 400 residential facilities that Connections owns or leases; and he was prohibited from speaking to patients about their care.
“In summary, the (mediator) found that access to patients and records was intentionally limited, resulting in both an ineffective and incomplete discharge of liability,” Huebscher wrote in his report filed in bankruptcy court. âThe debtor’s lack of commitment is worrying. The (ombudsman) considers that the problems identified in this report already existed before the tabling of Chapter 11. “
In recent years, Connections executives have been less than cooperative with officials seeking files from the association, which prompted Weiss to go to federal courts in June to deny the nonprofit’s request to delay federal proceedings against it for fear that the files would not be handed over.
During Weiss’ civil investigation that led to the federal charges, Connections executives called for “repeated extensions to its duty to produce documents in response to civil inquiries, and then produced its documents on an ad hoc basis. blow over a period of several months â. The association then delayed providing the requested financial information and “abruptly halted discussions,” Weiss said in court documents.
The association quietly filed for Chapter 11 bankruptcy in April, less than two weeks after the federal government slapped Connections and its senior executives with lawsuits claiming the nonprofit defrauded the government of more than $ 4.5 million and failed to properly document its distribution of narcotics.
NON-PROFIT BANKRUPTCY:Amid fraud allegations, Connections files for Ch. 11 bankruptcy
This latest lawsuit calls for civil penalties under federal laws that require organizations like Connections to keep strict records and accounts of their controlled substances that they are allowed to distribute. The lawsuit claims that Connections has a long history of not keeping these records and in some cases has created and falsified records after the fact to appear compliant.
The lawsuit specifically lists former CEO Cathy McKay, current CEO Bill Northey and Connections general counsel Steven Davis as defendants, claiming executives failed to adequately train employees and ensure compliance with federal and state regulations. .
Connections blamed a climax of unsustainable lawsuits, federal allegations, the loss of a $ 60 million contract to provide behavioral and physical health in Delaware jails and the COVID-19 pandemic for bankruptcy.
Since then, the soon-to-be-extinct nonprofit has requested the deferral of federal charges, citing the need to focus on transitioning to its new owner, Conexio Care, Inc. The sale of Connections assets for $ 12.75 million has been approved. June 15 in bankruptcy court.
Connections lawyers continue to decline to comment on the case. A woman who answered the phone at Chipman Brown Cicero and Cole, the law firm representing the association, said Thursday they were not speaking to the press.
When asked to comment on the ombudsman’s report and whether any of Huebscher’s findings are of concern, Jill Fredel, spokesperson for the Delaware Department of Health and Human Services, said the “priority of the ministry during this transition period is to ensure that our clients continue to receive safe, high-quality care and services.
Impact on bankruptcy unknown
Responsible for ensuring consistent patient care while Connections goes bankrupt, Huebscher struggled to determine whether treatment had been adversely affected by the filing.
The bankruptcy code empowers a court-appointed patient care mediator to oversee the âquality of patient careâ provided by the debtor during the bankruptcy process, including speaking with patients and doctors, and filing a quality of care report.
But Huebscher was banned from speaking to patients and denied full access to records, preventing him from independently verifying all patients supported by Connections and determining whether each of them between them had access to their electronic records. He was also denied access to the non-profit organization’s dosing system, which Huebscher challenged given the federal lawsuit alleging mismanagement of controlled substances.
Nor has it been able to monitor a key state program Connections participates in – Dynamic Community Treatment Services (ACT) – because management would not provide addresses to 400 rental units housing customers. of Connections. However, audits conducted by the state of Delaware ârevealed consistent and unresolved issues with appropriate staffing levels against ACT programs,â Huebscher wrote.
Among the records he received – which included the results of the state’s investigation and corrective action plans, policies and procedures, grievance and complaint logs, and COVID incidence rates – 19, among others – Huebscher could not determine whether care deteriorated during the bankruptcy.
While the ombudsman was not allowed to speak to patients, he received several complaints mainly related to methadone dosing. He also received information related to housing issues, including concerns about paying rent, and some about employee conduct.
The ombudsman also expressed concern about the number of overdose deaths in Connections care. According to the June 28 report, in the previous 30 days, Connections had reported five overdose deaths. The association has reported 28 and 77 deaths in the past 180 and 365 days respectively, the report says.
“Based on discussions with several professionals in similar clinical settings, it would appear that the incidence of internal mortality in debtor institutions is high,” Huebscher wrote.
Despite the obstacles, Huebscher visited a handful of Connections service sites and spoke with employees “engaged and engaged in their roles and responsibilities.” None of the employees interviewed expressed concerns about their ability to provide care.
The problems discovered existed before the bankruptcy
What Huebscher found were many “alarming” issues that existed before the bankruptcy declaration and have continued to persist, including insufficient staff, lack of business operational compliance, lack of independent internal reviews of employees. medical records and a lack of checks and balances.
During the monitoring period, Huebscher asked Connections management if any reviews had been performed internally to ensure compliance with state regulations.
No records were provided and Huebscher was told that the association “relied on the state to provide information on debtor compliance.”
The extent of state oversight of Connections’ operations or the management of millions of dollars in federal and state taxes remains unknown.
A Freedom of Information Act request to the state auditor for any connection audit turned out to be empty. The State Budget and Management Office told the News Journal on Thursday that the various departments are responsible for managing their contracts with third parties.
A FOIA request to the Department of Correction yielded a report – the one conducted by Christiana Care following numerous Delaware Online / The News Journal reports insufficient health care in prison, which also prompted the state Justice Department to investigate. A similar request to the Department of Health and Social Services is pending.
Typically, companies have strong corporate compliance programs that ensure rules and regulations – from internal compliance measures to federal laws – are followed by all employees. But even though Connections had a program, Huebscher said it lacked details on how the nonprofit would monitor its compliance, and management did not provide evidence that employees had been trained or understood. their compliance obligations.
Connections was also “unable or unwilling” to provide evidence that its corporate compliance program had been reviewed internally; found problems; carried out an analysis on the reason for any problem; or whether corrective action has been taken, according to the report.
The ombudsman concluded that the association’s dependence on the state to ensure compliance was a “significant and material flaw in the overall operations” of Connections. Business compliance programs are essential and mandatory to participate in federally funded programs, Huebscher said.
The nonprofit’s policies on patient rights, how to file complaints and provide information about care were also half-baked. The policies set out the requirements, methods of reviewing clinical practices and record keeping, and describe the committees responsible for oversight, but Connections was unable to provide information on the existence of the committees, Huebscher said. .
âThe Ombudsman’s review of many other policies and procedures revealed a similar gap between the requirement and the underlying policy and actual practice,â he wrote.
Contact Amanda Fries at [email protected]