Godwin v. Visiting Nurse Ass'n Home Health Services

831 F. Supp. 449, 8 I.E.R. Cas. (BNA) 1345, 1993 U.S. Dist. LEXIS 18235, 1993 WL 361977
CourtDistrict Court, E.D. Pennsylvania
DecidedSeptember 15, 1993
DocketCiv. A. 92-6339
StatusPublished
Cited by8 cases

This text of 831 F. Supp. 449 (Godwin v. Visiting Nurse Ass'n Home Health Services) is published on Counsel Stack Legal Research, covering District Court, E.D. Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Godwin v. Visiting Nurse Ass'n Home Health Services, 831 F. Supp. 449, 8 I.E.R. Cas. (BNA) 1345, 1993 U.S. Dist. LEXIS 18235, 1993 WL 361977 (E.D. Pa. 1993).

Opinion

FINDINGS OF FACT AND CONCLUSIONS OF LAW

KATZ, District Judge.

Following a bench trial, the court makes the following findings of fact and conclusions of law:

I.FINDINGS OF FACT

1. Plaintiff, Hajar Godwin (Godwin), is a former employee of the defendant.

2. Defendant, Visiting Nurse Association Home Health Services (VNA), is a Pennsylvania nonprofit corporation with offices in Norristown, Pennsylvania.

3. VNA is in the business of providing home nursing care and home health aides to patient-clients.

4. VNA provides skilled nursing care, home health aides, and other services to individuals, some of whom are covered by the Federal Medicare Program. VNA is entitled to reimbursement under the Medicare Program for some, but not all, of the services it provides.

5. VNA also operates one or more primary health care facilities as a separate part of its business. At these facilities VNA of *451 fers medical, dental, and other services to the public.

6. At all material times, VNA was not entitled to reimbursement under the Medicare Program for any portion of the services rendered through its primary health care facilities.

7. Beginning June 7, 1988, VNA employed Godwin as a bookkeeper-accountant. Godwin’s job duties included preparation of various reports, payroll information, financial reports, and accounting and billing information. The plaintiffs duties included providing information and documents to be used to prepare cost reports to be submitted by VNA to Independence Blue Cross (IBC). The cost reports were used by VNA to secure reimbursement under the Medicare Program.

8. IBC is a financial intermediary between the United States Government and Defendant. IBC reviews and approves cost reports submitted by Medicare providers. IBC reviews these reports to determine the accuracy and the appropriateness of the charges for Medicare reimbursement.

9. Godwin represented to VNA that she had a Masters of Business Administration degree. She submitted a photocopy purporting to show her MBA degree. Godwin never received her MBA. Def.Ex. 2.

10. VNA had some dissatisfaction with Godwin’s work and work product. Nevertheless she received four raises • (Sept. 1988— $12; Nov. 1988—$14; June 1990—$20; Feb. 1992—$23). The last raise came only fo.ur months before her termination. At that time, Godwin received a 15% raise. Godwin was the second highest paid person at VNA. Only Agnes Ferrara (Ferrara), VNA’s Executive Director, made more money.

11. Ferrara had a very strong policy and practice through which she worked to control operational details at VNA.

12. On December 31, 1991, VNA received a letter from IBC dated December 30, 1991. The letter was addressed to Ferrara. This letter announced adjustments made by IBC with respect to VNA’s 1990 fiscal year. This letter also requested additional information concerning the 1990 fiscal year cost report. IBC sought information concerning VNA’s treatment of the expenses of consultants.

13. On January 8,1992, Ferrara responded to 'IBC’s letter. She knew about IBC’s inquiry concerning these matters from that point.

14. VNA engaged Joanne Chicco (“Chic-co”) to prepare its cost reports. Chicco prepared the 1990 cost report.

15. Godwin’s duty was to provide Chicco with VNA information and records for use in preparation of the cost reports. Chicco was responsible for preparing the cost reports.

16. The.December 30, 1991 letter from IBC to VNA was referred to Chicco for response.

17. Chicco did not respond to the request. Between January 8, 1992 and April 8, 1992, IBC made repeated oral requests for the back up documentation called for by the December 30, 1991 letter. IBC orally requested invoices of Jack Nelson (Nelson), a VNA consultant. IBC wanted to review these invoices to determine if VNA’s accounting of Nelson’s' fees was appropriate.

18. On April 8, 1992, IBC again wrote to Ferrara extending the deadline for submission of such documents to April 13, 1992.'

19. On April 13,1992, Chicco, on behalf of VNA, responded with certain information. Nelson’s 1990 invoices were not included in the material provided.

20. On-June 18,1992, IBC again wrote to Ferrara with a final request for the information originally sought in its December 30, 1991 letter.

21. VNA’s cost report for fiscal year 1990 claimed approximately sixty-six percent (66%) of Nelson’s fees as a Medicare reimbursable cost item. Reimbursement for fifteen point seven percent (15.7%) of Nelson’s fees was not sought by VNA as it attributed this percentage of Nelson’s services to fund-raising activities by Nelson. The final eighteen percent (18%) of Nelson’s fees also were not sought by Defendant. This percentage of his services were attributed to VNA’s primary health care operations which were not covered under the Medicare contract.

*452 22. VNA knew that fundraising activities of Nelson were not reimbursable under Medicare.

23. On June 19, 1992, Chicco informed Godwin it would be necessary for VNA to create false invoices indicating that Nelson performed administrative services on behalf of Defendant during 1990 to substantiate the inclusion of any of Nelson’s charges, and that she, Chicco, would have nothing to do with it and that creating the false invoices was a matter between Godwin and Ferrara.

24. During 1990, Nelson submitted detailed day-by-day monthly invoices to VNA. These invoices indicate that substantially all of his services during 1990 were related to fund-raising. Pl.Ex. 8.

25. Fund-raising consultation services were not properly included in VNA’s cost report for 1990.

26. At approximately noon on June 19, 1992, Chicco also informed Godwin that it would be necessary to create mileage logs for automobiles used by Ferrara, the cost of which had been included in the 1990 cost report.

27. On June 19, 1992, Godwin telephoned VNA’s Board President with concerns regarding the 1990 cost report.

28. On June 19, 1992, Godwin stated to another VNA employee that she believed she was going to be required to make and sign falsified documents.

29. At approximately 3:30 or 4:00 p.m. on June 19, 1992, Godwin informed Ferrara of Chicco’s advice as to the necessity of creating false invoices for Nelson evidencing performance of administrative services and automobile logs. Godwin informed Ferrara that she would not participate in creating nor preparing such documents because, to Godwin’s knowledge, Nelson, in fact, did not perform administrative services during 1990. Godwin stated she would not. create false documents and that she did not have the information to prepare the automobile logs for Ferrara’s car.

30. Ferrara directed Godwin to prepare such false documents. Ferrara threatened to terminate Godwin’s employment if Godwin refused.

31. Godwin refused to prepare such documents. As a direct result of that refusal, Ferrara summarily terminated her employment effective Friday, June 19, 1992.

32.

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831 F. Supp. 449, 8 I.E.R. Cas. (BNA) 1345, 1993 U.S. Dist. LEXIS 18235, 1993 WL 361977, Counsel Stack Legal Research, https://law.counselstack.com/opinion/godwin-v-visiting-nurse-assn-home-health-services-paed-1993.