Compassion North America is a home health agency located in Cedar Rapids, Iowa. The Iowa Board of Nursing recently found that an unlicensed nurse worked at the agency and that "fraudulent practices" occurred there related to billing and records. Those findings are now being appealed to district court. (Building photo via Google Earth; document excerpt from the Iowa Board of Nursing)
State regulators say they have never inspected and are not investigating a home health agency alleged to have falsified records, billed for services never delivered and used an unlicensed nurse.
State records show that Compassion North America, a home health provider based in Cedar Rapids, was incorporated in 2017 with M性视界传媒檅alu Madlene Kebbie, a registered nurse, as its director, but was not licensed by the Iowa Department of Inspections, Appeals and Licensing until September 2024.
When asked about that, department spokeswoman Diane McCool said it性视界传媒檚 possible the company was not providing any medical services in Iowa prior to being licensed last summer.
However, records from the Iowa Board of Nursing, which is administered by DIAL, and sworn testimony from a state health investigator at a hearing overseen by DIAL, indicate the company has been providing medical care for clients at least since June 2022.
In addition, the company性视界传媒檚 archived website indicates that in February 2021, Compassion North America was offering clients and patients a range of 性视界传媒渘ursing plans性视界传媒 and 性视界传媒渕edical intervention性视界传媒 to meet their care needs.
McCool said DIAL has never inspected Compassion North America due to it being inspected and accredited by a private organization, the Accreditation Commission for Health Care. She said DIAL does not have copies of the organization性视界传媒檚 inspection findings, and the ACHC did not respond to the Iowa Capital Dispatch性视界传媒檚 calls and emails on the matter.
Compassion North America性视界传媒檚 CEO, Joseph Lemor, who is married to Kebbie, referred questions on his company性视界传媒檚 licensing and accreditation to attorney David L. Brown, who indicated he had no information to share on those specific issues.
Lemor has said the state is engaged in a 性视界传媒渨itch hunt性视界传媒 with regard to Kebbie.聽 性视界传媒淲e did not do anything improper,性视界传媒 he last week. 性视界传媒淲e have nothing to hide.性视界传媒
DIAL: No investigation of home health agency
McCool said DIAL, as Iowa性视界传媒檚 regulator of home health agencies, is not currently investigating Compassion North America 性视界传媒 despite that the company falsified records, billed for services that appear to have never been delivered, and employed an unlicensed nurse to provide patient care.
Those allegations surfaced recently at a Board of Nursing disciplinary hearing for Kebbie.
In September 2022, the board alleges, it received a complaint from a patient, 性视界传媒淕.F.,性视界传媒 who alleged Compassion had assigned unlicensed staff to perform skilled nursing care tasks, and that the staff failed to complete documentation of the care provided in his home.
Compassion North America was approved by Iowa Medicaid性视界传媒檚 managed care organization, Amerigroup, to provide care for G.F. from June 29, 2022, through Aug. 29, 2022 性视界传媒 during which time the company was not licensed as a home health provider, according to DIAL.
A state investigator allegedly reviewed the work schedules of Compassion employees, which reportedly showed the company was not actually providing 24/7 care to G.F. as ordered. 聽The caregivers listed on the work schedule allegedly included four individuals, only two of whom 性视界传媒 Kebbie and licensed practical nurse Elizabeth Smith 性视界传媒 were licensed nurses.
However, Smith性视界传媒檚 nursing license had expired in January 2021 and was not reactivated until 18 months later, on July 6, 2022.
The state investigator reviewed thousands of pages of records subpoenaed from Compassion, the board says, and concluded Smith was the only nurse to document any nursing care for G.F. from June 29, 2022, through July 1, 2022 性视界传媒 during which time Smith was unlicensed.
In addition, a comparison of Compassion性视界传媒檚 billing records with the staff work schedule allegedly showed the company had submitted payment claims for services for which there was no corresponding documentation to indicate the care was provided. There were also payment claims for services provided by a registered nurse that exceeded 24 hours in a single day, the state investigator testified.
Board cites 性视界传媒榝raudulent practices,性视界传媒 fabricated records聽
According to the board, Kebbie had no explanation for the irregularities in the nursing documentation 性视界传媒 including instances where it appeared Compassion had billed Medicaid twice for services related to G.F.性视界传媒檚 care.
With regard to allegations that Kebbie had improperly delegated to Smith certain tasks that were outside the scope of Smith性视界传媒檚 license, the board concluded the documents supporting that claim were most likely fabricated by Compassion after the fact 性视界传媒 and so, the board reasoned, there was 性视界传媒渋nsufficient evidence性视界传媒 to support the allegation.
The board also found the evidence suggested Kebbie failed to properly delegate G.F.性视界传媒檚 care to Smith, and alleged Kebbie admitted she had not reviewed Smith性视界传媒檚 documentation of G.F.性视界传媒檚 care.
As for the allegations of falsified records, the board dismissed that charge as it related to Kebbie while noting there was evidence 性视界传媒渟omeone associated with Compassion性视界传媒 had falsified documents. Had Kebbie properly reviewed her subordinate性视界传媒檚 records, the board said, 性视界传媒渟he would have known fraudulent practices had occurred.性视界传媒
Citing what it called Kebbie性视界传媒檚 性视界传媒渓ack of previous disciplinary history,性视界传媒 the board ruled that she could retain her Iowa nursing license subject to two years of probation. However, the board性视界传媒檚 own records indicate that in 2012, it fined Kebbie $50 for briefly working as a nurse while her license was inactive.
Nurse appeals board sanction
Earlier this week, Kebbie性视界传媒檚 attorney filed an appeal of that decision in Polk County District Court, arguing the sanctions are 性视界传媒渦nreasonable, arbitrary, and excessive.性视界传媒
In her appeal, Kebbie alleges the matter should never have proceeded to a disciplinary hearing because the board 性视界传媒渆rred in its rejection of a settlement agreement性视界传媒 she and her attorney negotiated with Assistant Attorney General Samantha Wagner.
Kebbie also claims Wagner had suggested that continuing-education courses 性视界传媒渙r even a simple essay性视界传媒 describing the proper process for delegating duties would have been an appropriate way to address Kebbie性视界传媒檚 conduct.
The appeal also takes issue with the fact that the state性视界传媒檚 only witness at the hearing, aside from Kebbie, was state investigator Kathleen Beebout. In the absence of corroborating testimony to back up Beebout性视界传媒檚 claims, Kebbie alleges, the board lacked a factual foundation to support any of the allegations against her.
Kebbie also claims the board性视界传媒檚 allegation that she admitted failing to review a subordinate性视界传媒檚 care for G.F. is false, and says Wagner admitted the state 性视界传媒渉as no reason to disbelieve that Ms. Kebbie is a caring nurse, that she works very hard, and that the services she provides herself are excellent.性视界传媒
The state has yet to respond to the appeal.
