South Carolina hospice doc never met a patient who wasn't terminal, yet profitable

Doctors looking for a business model to help them stay profitable in tough economic times should consider the sure-fire plan cooked up by Reliant Hospice in Columbia, South Carolina.

Dr. Joseph Washington Jr., as Reliant's medical director, was supposed to check patients when they first arrived and assess whether they were good candidates for long-term care. Here's how this process worked with one patient, according to the South Carolina State Board of Medical Examiners.

In August 2006, a patient the board calls V.W. showed up at Reliant. Washington did not obtain a medical history, did not complete a physical examination and did not complete an assessment of V.W.'s current illnesses. Despite this lack of information, he declared that V.W. had uterine cancer that would kill her in the next six months.

So V.W. was enrolled as a Reliant Hospice patient. Why would Washington and Reliant do this with V.W. and allegedly with hundreds of other patients?

As the medical board noted, V.W. had "Medicaid insurance, and therefore, Reliant benefited from the Medicaid payments received as a result of having [the] patient in their facility. [Washington] prescribed multiple narcotics and controlled substances to [V.W.] not substantiated by any medical records or evaluations."

Here's another business tip from Washington's experience. Don't do anything that might tip off the U.S. Drug Enforcement Agency.

The DEA became concerned about the massive quantities of drugs being prescribed by Washington, and so, in December 2008, the agency entered into an agreement with Washington in exchange for his testimony. According to the medical board, Washington spilled the beans about Reliant saying, that it had "solicited individuals to enroll as patients without the knowledge of the individual or the individual's primary care physician." He admitted that "he did not meet or physically examine the patient, did not know who the patients were and did not know the nurse practitioner who attended to the patients."

The DEA liked Washington's testimony enough to at least allow him to continue prescribing some drugs. They barred him from prescribing Schedule 2 and Schedule 3 drugs for a couple of years, though.

The medical board must have liked the testimony, too. While the board did charge Washington with "dishonorable, unethical or unprofessional conduct that is likely either to deceive, defraud or harm the public," it also did very little as a result. It ordered Washington to pay $2,036 to cover the board's investigative costs, a far cry from the amount of money Reliant was able to obtain in Medicaid funding.

Final question: What did the board buy for that $2,036? The medical board documents provided by the board are scant on details. The bulk of the complaint against Washington is based on the DEA's agreement with Washington. And just finding the board's documents is a chore. The state Department of Licensing, Labor and Regulation provides a "Licensee Lookup" that contains all state licensed professionals in one big box. When you type in a doctor's name and choose "Medical Board" you are given what appears to be a helpful link that says "Click here to view Order." Clicking doesn't provide you the order at all. It only takes you to a calendar that forces you to click through every month of the year until you find the relevant document. If I werea businessman as savvy as Washington, I'd ask for a refund.

Jenn Harris contributed to this report.

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