My Recommendations For Fixing Grady Hospital

Introduction: If you haven't been following the plight of Grady Hospital in Atlanta, Georgia, here is a quick run down. Grady is one of the biggest hospitals not only in the Southeast but frankly in the entire country and the world. It has also been the scene to a great deal of corruption throughout the years. It has faced a series of financial crises throughout the years, however none are as critical as its current. Grady Hospital faces being closed down unless it is infused with cash to the tune of an estimated half a billion dollars according to some reports. Since Grady Hospital is the main hospital for the poor of Dekalb, Fulton and other area counties, this has become the subject of great debate and controversy. Because hospitals that cater to poor folks have limited profit potential, Grady is also naturally a public hospital. Thus, in the end, the taxpayers own it.

Enter the Grady Task Force which is a sort of consulting firm created by the Metro Atlanta Chamber of Commerce which has recommended a series of steps to save Grady. If you look at the link, you will see that for the most part the report is quite technical, however there is one recommendation which has become quite controversial. That is a plan to make the board quasi private. It should also be noted that Grady has paid four separate consulting firms about eight digits just in the last two to three years already. They have already hired another consulting firm even after the so called recommendations of the Grady Task Force.

I believe this plan, like the force itself, is nothing more than a sham and I wanted to offer my own alternative plan.

I want to point out that almost none of the ideas are actually my own, but rather those of folks that I have spoken with since I began tracking this story nearly two months ago. None of these folks ever saw any power at Grady, and I believe that after you read my plan you will see that there is no doubt that the wrong people are in charge. You will also see what it would actually take to turn Grady around.



The first thing Grady Hospital needs is some serious improvements in its infrastructure. For instance, its HVAC system is totally shot. Doctors have told me that sometimes it gets so bad at Grady that they themselves can't breathe. Now, imagine if you are a patient that has a breathing problem, what would such a state do to you. There is asbestos in the wall. The elevators are old and they breakdown all the time. There are patients that are in critical condition and time is of the essence. If they need to be moved from floor to floor, you simply cannot have the elevators broken. Doctors tell that this can be a regular occurrence. The computer system for tracking their medical records is old, from the seventies people tell me. Many times patients history can't easily be looked up, and thus allergies and other ailments may not be known. The building simply must be brought up to code.

If this is shocking to you, and you think this couldn't happen because the patients would talk, keep in mind the patients are the poorest folks in the area. They simply have no alternative and many times they don't know any better.

One of the tragedies at Grady is that they recently had a giant addition added. That's right, while their infrastructure was falling apart they added a huge addition about five years ago. If you want to know why, you maybe interested in knowing that powerful board member Robert Brown also owns an architecture firm and while the firm is equipped to add on to hospitals they can't fix elevators. (He is also a prominent member of the Grady Task Force and one main reason why the force is in my opinion a total sham)

Grady also needs to be held accountable, so money will be given in tiers. The state legislature will choose a committee to oversee upgrades in infrastructure, and money will only be given if standards are met.

The Grady Board, currently chosen by the Dekalb County CEO (currently Vernon Jones), needs to be elected and it must be split up by districts so that it evenly represents the folks currently treated by Grady Hospital. This board, which would serve four year terms, would be in charge of hiring and firing the Grady CEO.

Instead of paying Emory University and Morehouse (the two schools that supply the bulk of Grady staff) a flat fee for their services, the Grady Board would institute a tiered sort of grading system (based on JCOHA grades, patient feedback and whatever other measurements they chose). Keep in mind that as representatives of the people, the board would be giving Emory and Morehouse the people's money. This means they would be more inclined to grade the two schools harsher than softer. This would give the two schools that much more incentive to perform better.

Also, the two schools would be responsible for their own malpractice insurance. Unbelievably, at least at Emory, Grady pays for the malpractice insurance of Emory professors and medical students. Essentially, this means that Emory, a private institution, has it so the public, through a public hospital, covers its malpractice insurance. Not only is this an obscene misuse of public funds, but obviously can lead to all sorts of abuse. Obviously, if you aren't responsible for your own malpractice insurance, you are more likely to act a lot more recklessly. I believe that is exactly what Emory has done to tragic results. This will remove that motivation.

The state legislature would set up a committee that would be in charge of funding Grady. They would set their own set of benchmarks for receiving funding and would also be in charge of deciding how much Grady Hospital got. Since the legislators are also spending the people's, or their constituents, money, they would also be disinclined to grade easily. This would give the board more motivation to make sure performance is up to par. We saw just how tragic it could be in the case of State Senator Charles Walker when funds are determined by corrupt reasons rather than performance.

Grady would develop a new position called the Office of Conflict Interest. Each transaction, each finance, each so called deal, would be scoured by this office to make sure that say a board member's architecture firm isn't getting the deal because the owner is on the board. I believe there are many such deals like the one I refer to with Robert Brown and the addition his company got, and that can't happen. This hospital didn't just find itself in financial crisis for no reason. It got there because its financial dealings were corrupted. This office would be in charge of making sure every deal was on the level.

Grady would need to update its by laws. First, it would no longer be allowed to have retaliatory behavior against whistleblowers. People must be able to report malfeasance without the threat of losing their job. Joyce Harris lost her job when she blew the whistle on State Senator Charles Walker. I also firmly believe that Kevin Kuritzky was expelled for blowing the whistle on serious corruption as well. These are jus two examples and I believe there are many more. There needs to be a truly anonymous tip line so that malfeasance can be reported without threat of retaliation.

Grady Hospital can no longer be allowed to stall in providing financial records to outside sources. I have been told by more than one person that getting records can be maddeningly time consuming. In fact, I was told that by the time records were received the incident or incidents in question were so far in the past that most didn't care. For instance, it took my sources several years to finally figure out that Brown's company received the lucrative contract. Grady Hospital would now be the subject of stiff fines if records aren't turned over in a timely manner. Furthermore, an outside party, a judge or a lawyer, would act as a mediator, in disputes over records requests. Finally, the by laws would declare that Grady would from now on follow due process.

Grady Hospital would no longer be allowed to settle any lawsuits under seal. I have counted four Emory professors that I believe have been paid off. The case of Dr. Jim Murtaugh is the only one that has been unsealed so far and it provides a glimpse into just how far some will go to keep malfeasance quiet. This can't go on, and it will have to be outlawed.

From now on, meetings held on the finances of Grady Hospital would be open to the public and the media. Currently, those meetings, like many others, are held in secret. Secrecy is a bedrock of corruption. By turning Grady over to a private board, it would make it even easier to maintain secrecy, and it is this diarists contention that secrecy is the end goal of the private board plan. In order to fix Grady, we need the opposite of secrecy. We need everything to be open. Keep in mind that Grady is a public hospital. It uses public funds. The public has every right to know where those funds are going. Open finance meetings are one way to assure that.

With these recommendations Grady would actually have a chance to thrive long term. While I am sure there will be those that will poke holes in it, I would dare anyone to compare my plan, less than two pages, to the plan by the Grady Task Force.

Who Is The Real Sociopath?? (UPDATE)

Introduction: For anyone who hasn't been following my work, let me give you a quick recap. A few weeks back I passed along a story about purported corruption at Grady Hospital with the potential of Emory University staff, who account for all of Grady's staff, being in the middle of it. After that story was published, I was contacted Kevin Kuritzky. He maintains that he blew the whistle on much of the corruption at Grady Hospital and beyond. He was expelled from Emory Medical School with forty one days left. He claims it was in retaliation and Emory claims it was due to tardiness and other offenses. He has a civil suit against Emory University currently in the appeals court. I should point out that Kevin has been at least a source for several stories and I have also done a radio show together with Kevin Kuritzky.

While I in no way hide whatever biases I have, I believe that in the case of what follows the latin phrase, Res Ipso Loquitor (the facts speak for themselves), applies.

A couple of weeks ago I received this UNSOLICITED email.

Mike, Just wanted to let you know that you shouldn't get taken in by Kevin Kuritzky. The guy is a pathological liar and I have personally been taken in by his stories only to realize that he was flat out lying. I also know numerous other people who have experienced the same. It is quite sad because he is a very charming, intelligent person. He just uses these skills to manipulate people. Don't get taken in by him.

Mike--

Michael Ward MD,

MBA

Resident Physician

Department of Emergency Medicine

University of Cincinnati

So, who is Michael Ward MD etc, etc...and what is he talking about? According to the chic professional networking site, Linked In, Michael Ward MD etc., etc... is in fact a member of the staff at the University of Cincinnati. It appears that his path crossed with that Kevin Kuritzky a few years back at medical school at Emory University. If what Dr. Ward says is true, it makes the basis of a lot of my reporting suspect to say the least. In fact, my first comprehensive piece on this subject was based largely on the testimony of Kevin Kuritzky. I say this so that my natural biases are clearly laid out as I continue with my analysis.

The reason that I reveal this email now about three weeks after I got it originally is because through the grapevine I am told that I am told the P.R. arm of Emory University has been making similar claims to Mike King of the AJC. (in that case I believe the word sociopath was used in describing Kuritzky) It is also consistent with the comments of the mysterious pseudonym John in response to this story.

I was in Kevin’s class at Emory (well at one point as it took him several years to complete one academic year), and the allegations by Emory concerning his behavior, ethics and morals are accurate. He should not be taking care of patients plain and simple.

Ironically enough, the term sociopath is one which most of my friends have told me I have a disturbing and obscene fascination with. (Given that two of my favorite shows, 24 and The Sopranos, each delved into the topic at roughly the same time, "I had no choice" (or I just couldn't help myself, potato...) but to get interested in it) Anyone who has read my work knows that I have had personal contact with my fair share of sociopaths and and I see several of the world leaders and our enemies as sociopaths as well. While this by no means makes me an expert, I will use my experience with the phenomenon to try and separate fact from perception in this situation.

One thing is clear. There is no doubt that one of these two side is certainly sociopathic, which in simplest terms is an individual devoid of empathy (in other words they are so selfish that nothing but their own self interest becomes relevant to them). Either Kevin Kuritzky has decided to lie pathological for his own self interest or his opponents want to paint him as such for theirs. Since, in this story, there is no middle ground we are absolutely dealing with sociopathology on one person's part.

If Kevin Kuritzky is himself a sociopath, then his compulsive lying would be a standard trait. There could be several reasons of self interest for his lying. He may have decided to get revenge at Emory for real or perceived wrongs. He may have thought that given the incendiary nature of his lies that they would bring him fame, or money, or both. There are in fact any number of self interest reasons for Kuritzky lying in this case.

On the other hand, if Emory University and their cohorts are sociopathic, they would look to smear Kevin because they know he is a threat. If in fact what he says is true, then their own sociopathic nature would have every reason to eliminate him. Remember, if Kevin is telling the truth, he is a hero. He is then trying to expose some of the worst corruption, leading to fraud, horrible patient care, and outrageous waste of tax payer money. Emory University along with several other people and group are the targets of his accusations. If he is telling the truth, then a sociopath would have every motivation to use every single means available to eliminate, marginalize and demean him.

Obviously, knowing the truth beyond all doubt is impossible, however in this case, it is my opinion that the truth beyond all reasonable doubt is pretty easy to decipher.

First, we know that Grady Hospital is now in such financial turmoil that it will likely need hundreds of millions to survive. We know that State Senator Charles Walker used Grady Hospital and other entities to commit an obscen amount of corruption. (He was charged with 137 felonies, convicted of 127, flipped on no one, and yet only got ten years in jail. Oh, and no one else, besides his daughter and the companies they ran were even charged) We know that in the mid and late 1990's Grady Hospital was the subject of an investigation and ultimately prosecution and settlement for Medicare fraud.

We know that in the mid and late 1990's Grady Hospital was the subject of an investigation and ultimately prosecution and settlement for Medicare fraud. We know that in the beginning of this millenia Grady was subject to an NIH investigation. While the investigation ultimately didn't lead to any arrests, fines or convictions, we do know that four Emory professors were ultimately paid off for their silence. We also know that 2004-2005 HHS conducted its own investigation. Here is the conclusion of that investigation.

there is an exteme and immediate threat to the health and safety of the patients

There is even evidence that in the case of one paid off professor, Dr. Jim Murtaugh, Emory and Grady paid him off without receiving permission from the board of trustees. Finally, even in the current civil case between Emory University and Kevin Kuritzy there is some questionable behavior on the part of Emory University. Court records show that Emory University couldn't produce hundreds if not thousands of documents in the case. In many instances, Emory even admitted to destroying certain documents.

The problem for Emory University, in my mind, is these are all clear characteristics of sociopathic behavior. Sociopaths remove every threat in the way of their goal. Between paying people off, expelling others, destroying documents, I believe they have exhibited that behavior in their goal of running a corrupt hospital. Given all of this evidence it makes Kuritzky's claims well within the pattern of evidence that anyone can discover by simply mastering the art of google.com. The only evidence that Kuritzky is a sociopath come in the accusations of Emory and their cohorts.

Even in the case of the email of Michael Ward, MD, etc, etc, there are no specific accusations. In our exchange by email upon receiving it, I invited Ward to give me specifics and I even emailed him my cell phone number. He never responded with any examples. In the case of the mysterious John it is also vague and unspecific allegations. Emory many times points to Kuritzky being expelled as evidence. Keep in mind it was Emory that expelled him. If they are the sociopaths, his expulsion would fit the behavior pattern of a sociopath to a tee.

In order for Kuritzky to be a sociopath, the pattern of behavior that Grady and Emory exhibited (keep in mind while the two entities are separate Grady is almost entirely staffed by Emory personnel and in many cases Grady higher ups move onto positions with Emory a la William Casarella) was either an anomaly or either a condition that was fixed in a few short years between the events I described and the time period of Kuritzky's accusations. Even that would be hard to believe because the HHS report coincided with the time period of Kuritzky's investigations. If you were to believe that, you would then have a very hard time explaining the current financial crisis at Grady Hospital.

Thus, in conclusion, those that I am accusing can say I have a bias, however I believe I have laid out a solid case for who is the sociopath here. While I must admit that I enjoy an obscene and disturbing amount of fun in delving into the condition of sociopathology, this question is central to what is going on. If Kuritky is the sociopath, then we need not worry about infusing Grady with more money because their administration is fit to receive it. If, on the other hand, it is Emory, Grady and beyond, that are the real sociopaths, then it is time for full fair and open hearings before even one cent is dolled out to what would be the very people that caused the mess.

If my supposition is right, then the likes of Kent Alexander, William Casarella, Ed Renford, Robert Brown, Vernon Jones, (and maybe even State Senator Charles Walker if that can be arranged) as well as those that would be the heroes in this mess: Kevin Kuritzky, Ron Marshall, Dale Cardwell, Joyce Harris and even all those that were paid off, need to be put under oath, on television, to answer truthfully their involvement in this crisis.

Finally, I invite the powers that be at Emory, Mike King, Dr. Ward, and even the mysterious John to respond at their leisure if they feel I have been inaccurate.

UPDATE:

If you are picking up the story of the Grady Hospital crisis anywhere in the middle, you are likely to get quite confused. This maybe happening if this particular story is your first exposure to the crisis. Thus, I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.

Kent Alexander: Power Broker (UPDATED)

There is a name that lurks behind the scenes in much of the scandal and corruption associated with Emory University and Grady Hospital and that person's name is Kent Alexander. It should be noted that there is little or no evidence ties Alexander to any wrongdoing on his own part. What is peculiar is how often he finds himself in the middle of scandal at Grady, Emory and beyond.

Kent Alexander first burst on the scene as the son of legendary Atlanta area attorney Miles Alexander. His first brush with fame came in the mysterious case of money laundering by BNL Savings, an Italian government run bank, to the government of Iraq on the eve of the first gulf war. The case is detailed in depth in the book, The Shell Game by Peter Mantius. At the time, Alexander was assistant U.S. Attorney for the Northern District of Georgia. He was the lead attorney for the U.S. on the case. At the time, King and Spaulding, arguably the most powerful and prestigious law firm in Atlanta, represented BNL. According to The Shell Game, Alexander met with an MI6 agent who told him of obscene amounts of corruption. The agent implicated the entire structure of the bank, and they claimed that for political reasons the intelligence apparatus of Italy, the U.S. and Britain looked the other way. The book claimed that the agent provided documentation of all the assertions.

For whatever reason, according to the book, Alexander left the meeting and decided to pin the entire scandal on the bank manager Christopher Drogoul who was in his twenties at the time. Drogoul was prosecuted and eventually convicted and upon his conviction the entire case was closed. This of course made the clients of King and Spaulding happy as well as the rest of the bank was spared prosecution. This was of course curious because of the sheer size and frequency of the crimes. This case also has some troubling parallels to another case I have referenced, State Senator Charles Walker. More than a decade later, while Alexander was now Emory General Counsel, State Senator Charles Walker was convicted of 127 felonies. He was the only one convicted and that case was also wrapped up after his conviction. Of course, it should be noted again that despite not flipping on anyone Walker received the outrageously light sentence of ten years for 127 felonies.

On the strength of the Drogoul along with other good deeds, Alexander was eventually promoted to U.S. Attorney a couple years later. (for reference this is the equivalent of posts once held by both Rudy Giuliani and Elliot Spitzer in their own districts) In the summer of 1996 Atlanta held the Olympics. The sad and ultimately tragic case of Richard Jewell is well documented and it doesn't need to be repeated. While the media has portrayed his role in the affair in a variety of ways, (he meaning Alexander himself) the facts stand out to me at least. He was the lead prosecutor. Jewell was under suspicion for almost ninety days and everyone agrees that ultimately there was absolutely no solid evidence against him.

About a year later, Alexander resigned from the U.S. Attorney's office. He landed on his feet with a cushy position with King and Spaulding. That would be the same King and Spaulding that was the fortuitous recepient of Alexander's narrow investigation of BNL. King and Spaulding is also the firm on retainer for one Emory University.

Alexander moved over to lead general counsel at Emory University in 2000. The two met each other at a fortuitous time because Grady, the hospital Emory helped run, was under investigation by the National Institute of Health. That investigation ultimately lead nowhere however four people that I have found were silenced with regards to the investigation: Dr. Sam Newcom, Dr. Jim Murtaugh, Dr. Diane Owens, and Dr. Jeffrey Sonnenfeld. Dr. Jim Murtaugh's case has recently had some new developments. Here is what State Senator David Shafer was able to recently discover.

Former Grady trustee Bill Loughrey tells me that the settlement with Dr. Murtagh was never approved or even accurately described to Grady’s board of trustees. He says that he was stunned to learn that tax dollars were paid to Dr. Murtagh, conditioned on his silence. He thinks the agreement is invalid and that the judicial process has been misused.

Let me explain for everyone. Dr. Jim Murtaugh settled with Emory University and Grady Hospital right around the time that this investigation was going on. He settled for roughly 1.6 million dollars and each side was under total communication lockdown. In fact, the lockdown was so extreme that even if either side was subpoened the court would need to be notified and there was time available for the subpoena to be quashed. This is of course important because it is very likely that Murtaugh had information relevant to the NIH investigation and this agreement allowed Grady and Emory stop Murtaugh from testifying. Furthermore, as lead counsel Alexander would be in control of the negotiations for his employer. He was in so much control that it is his signature next to Murtaugh's in the ultimate agreement.

Now, what Shafer is saying is that the board of trustees at Grady were never notified of the settlement. This is important because Grady is a public hospital and thus their portion of the settlement would then be tax payer money. As lead counsel, Alexander would be responsible for every bit of the agreement.

By 2004, Grady was again in the middle of another scandal. This one involved State Senator Charles Walker. Again, despite being convicted of 127 separate felonies, Walker was the only one charged and convicted in the case. Not only is it logical to think that it is impossible to commit this much crime on your own, one only needed to be in the courtroom hear of other's involvement. The lead prosecution witness, Joyce Harris, accused much of the higher ups at Grady of all sorts of wrong doing: from witness tampering, intimidation, and kickbacks. Despite it not only making no sense that one person could commit so much crime on their own, and having the star witness accuse others, somehow the powers that be wrapped up their investigation by only convicting Walker himself, and he got only ten years for all those counts.

Now, you might be saying well that's Grady and Alexander was employed by Emory. That is true however the entire Grady staff was Emory faculty and most of the Grady upper level management was also employed by Emory. Thus, while they may seem to be two separate entities to some they are in reality quite interlocked.

Alexander then resurfaces in the case of whistleblower, Kevin Kuritzky. Kuritzky was expelled several months after another investigation of Grady was completed. This one was done by the Center for Medicare and Medicaid Services of the Department Health and Human Services. The conclusion of that report was scathing.

an immediate and serious threat to the health and safety of the patients

is what HHS concluded. Emory maintained that Kuritzky was expelled for missing required clerkship training involving patient care, lying to his professors, and engaging in other unprofessional, dishonest and unethical conduct, while Kuritzky maintains that it was retaliation for blowing the whistle on many of the same type of practices mentioned in the report. While Emory outwardly maintains even today that his expulsion had nothing to do with any incendiary charges on his part, I have found an email from Alexander to the then assistant U.S. Attorney that indicates otherwise.

Amy (Amy Kamenshien then Assitant U.S. Attorney for the Northern District of Georgia) as you know we have had several discussions in the past regarding Dr. Murtaugh and his allegations regarding Emory/Grady. Recently he has had contact with former medical student Kevin Kuritzky. You may in the near future be hearing from Kuritzky or his attorneys and I would advise not pursuing it further. Hope all are keeping well,

Kent.

Clearly, Alexander expected that Kuritzky was going to say something and he moved to pre empt the investigation. Kuritzky ultimately ended up pursuing his case civilly and that is still pending.

Alexander had one more run in with Kuritzy of note. According to Kuritzky just as the legal process for his civil case was starting, (Before any formal paperwork was even filed) Alexander arranged a meeting between Kuritzky, his attorneys and Emory attorneys, headed up by Alexander of course, and finally a mediator. According to Kuritzky, at this meeting Alexander addressed Kuritzky in this manner,

if you pursue this further, we will smear you so badly that even North Korea won't touch you

According to Kuritzky this was said in front of his attorneys and the mediator who went to the third grade step of calling a timeout in its aftermath. The parties were separated into two different rooms so that everyone could cool down, however Alexander wasn't formally reprimanded for this statement.

The last notable moment in Alexander's tenure came last month when he responded to an Atlanta Journal Constitution editorial regarding unsealing the records of the Dr. Jim Murtaugh case. ( those records have been unsealed and of course I even referenced them earlier)

The AJC's Oct. 5 editorial "Come clean on lawsuit" resurrects (and misstates) old charges of conspiring to misuse government funds, charges the government reviewed seven years ago and declined to pursue. This has the devastating effect of casting public suspicion on two entities —- Grady Memorial Hospital and Emory University —- that are working together in an increasingly challenging environment to meet the health needs of the most vulnerable members of our society.

The editorial surprisingly calls on Emory and Grady to open the sealed settlement and court records in a case involving Dr. James Murtagh. For the record, Emory and Grady did not move to seal the record; Murtagh did. Emory had already supported unsealing the proceedings —- the complete, entire record —- as had Grady. We simply awaited the doctor and court's approval. Judge Wendy Shoob has since unsealed the record, which is now of course fully open to the public. The real victim in all of this is Grady, the largest public health hospital in the Southeast. Grady is struggling to survive while misinformation circulates that, unintentionally or intentionally, diverts attention from the real issues.

This statement is absurd on its face (and I should note never countered by the AJC). Murtaugh was paid a huge sum of money (1.6 million dollars) and then told to shut up. That is hush money. It is unlikely that he would be the one that would try and keep those records sealed. It was after all Emory and Grady that paid him not the other way around. They paid him and he was silenced. You do the math. Second, since he was silenced, making this bold face lie is easy since they know he is under order to remain quiet no matter what. Finally, while he was paid the money both parties agreed to a total media blackout. Again, I may not be an attorney however it appears to me that Alexander just violated the terms of the very agreement he helped broker.

The case of Kent Alexander is much like everything about Emory and Grady. There are more questions than answers. Did Alexander receive his cushy position from King and Spaulding as a result of his favorable prosecution in the BNL case? Did he use his influence to squash the NIH and Walker investigations? Did he knowingly violate the policy of the Grady Trustees when he entered into an agreement with Dr. Jim Murtaugh? Did he try to intimidate Kevin Kuritzky?

Only the powers that be know the answers to these questions, however I do know that Grady Hospital may collapse. I know that there needs to be a huge infusion of cash in order for it to survive, and it appears to me that the same people that put it into this position continue to call the shots. I know that if I were a tax payer that was ultimately flipping the bill I would want all of the questions I raised answered, under oath, by Alexander himself, before even one more dime went into Grady Hospital.

For further information on Kent Alexander and this scandal in its entirety, please follow this link to listen to my buddy Snooper discuss this matter further.

UPDATE:

For the most part, if you find your way to one of the stories regarding the Grady mess, you will likely get lost in its many mazes. I actually don't believe that this is one of them. I believe that this story speaks for itself, and no matter your incoming knowledge you should be able to follow. If not let me know. That said, you should also know how Alexander fits into the overall scheme of things. Thus, I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.

What if John Gotti Headed Up the Task Force To Stop the Mafia

Robert Brown's tenure as head trustee for Grady Hospital is eventful for sure. Upon taking over in the mid 1990's the hospital faced a series of issues from budget problems, to corruption, to egregiously poor health care. In 1998, Grady Hospital settled with the state of Georgia for $4.5 million dollars in a suit of Medicare fraud. The investigation covered four years and several of those involved the tenure of Robert Brown. While the Attorney General found no criminal violations, the sheer number of the settlement speaks for itself. Had this been the only run in with the law that Grady had under his tenure, it frankly wouldn't be an issue. It wasn't though. The most egregious case of criminality came when State Senator Charles Walker was charged with 137 separate offenses and convicted of 127 of those counts. (unbelievably Walker, his daughter and the companies they ran were the only ones charged or convicted) Grady was one of a handful of hospitals that was the target of much of this criminality.

This criminality began in the late 1990's and lasted all the way until his indictment in 2002. As I have already pointed out, a source told me that the chief prosecution witness, Joyce Harris, accused Robert Brown of several incendiary crimes along with pointing a huge finger at Walker. Harris accused Brown of such things as witness intimidation and accepting sexual favors for contracts at Grady. Harris is not the only one to point the finger at Robert Brown as far as corruption goes. Here is what Ron Marshall of the Grady Coalition had to say about Robert Brown, (from an article emailed to me. I can't seem to locate it online)

It was Robert Brown who insisted that no-bid contracts be given to former Senator Charles Walker, who is now serving ten years in prison for 127 felonies, many of which were committed at Grady with Brown's knowledge.

Furthermore, I am holding onto a 223 page report filed with the Dekalb Ethics Committee that charged Robert Brown with among other things: quid pro quos, retaliation, kickbacks, and obstruction of justice.

Since corruption doesn't exist in a vacuum, Brown's tenure was often met with financial woes. While the current financial woes facing Grady are the most extreme they have ever been, this is not the first time Grady has faced financial turmoil. For instance, here is how things looked in 2001 for Grady.

Board members of the state's largest public hospital want to know how the struggling charity-care provider plans to dig itself out of deepening financial trouble.

Grady Memorial Hospital's 10-member board is scheduled to meet July 23 to, in part, review recent audit results showing the hospital suffered a $17.2 million loss last year and is now operating in the red.

"We were told [Grady] would have an $8 million shortfall this year and that [CEO Edward Renford] would come up with a proposal in July to fix it," said board member Bill Loughrey.

Grady leaders have remained tight-lipped about specific plans for a recovery, but a spokesperson for the hospital said discussions are under way and that any changes would be cleared through patients and employees of the hospital first.

In fact, the current plethora of editorials and analysis that can be found in any current Atlanta area newspaper have a familiar ring to them.

Finally, and most importantly, the Center Medicare and Medicaid Services (CMS) of the Department of Health and Human Services did an exhaustive investigation of Grady Hospital that ended right around the time that Charles Walker trial ended. Here is the scathing conclusion of that investigation. (Again, I hold onto a hard copy myself though I cannot find it online) They identified...

an immediate and serious threat to the health and safety of the
patients

It was after this scathing report came out, that finally Robert Brown was forced out of his position at Grady. Not to worry, upon leaving Grady, Robert Brown was able to snag a lucrative position on the state's transportation board MARTA.

Now, let's get back to the unconventional title of my piece. In my opinion, if there things weren't rotten at Grady, Emory University, and Atlanta at large, along with investigating State Senator Charles Walker, the powers that be would have investigated Brown to see if he should occupy the cell next to Walker. If things weren't rotten at Grady, Emory, and Atlanta at large, the powers that be would investigate Brown's architecture firm R L Brown & Associates and see if he ever gave his own company any sweetheart deals while he served as the Chief Trustee at Grady Hospital. If things weren't so rotten though, someone besides Walker would have been charged with some crime, because I find it impossible to believe that one person could be convicted of so many crimes and no one else did anything wrong.

Things are rotten, so instead of being investigated, Robert Brown finds himself as a prominent member of the Grady Task Force. The task force was set up the come up with solutions to the current fiscal crisis. Robert Brown, who oversaw Grady as it tumbled into financial crisis, is now one of the people in charge of getting it out of the crisis. Excuse me, if this doesn't seem like John Gotti being asked to come up with solutions to dealing with the Mafia.

The problem is this. Grady Hospital is a public hospital and so it is run with tax payer money. Grady's financial woes will probably take an influx of roughly 100 million dollars of tax payer money. If the funds are being directed by the very people that created the problem, then each tax payer is about to sink more of their money into a black hole of corruption and incompetence.

Re Examining the Case of State Senator Charles Walker

For more than a decade State Senator Charles Walker was among the most if not the most powerful politicians in the state of Georgia. His reign came to a humiliating end in June of 2004 when he was indicted on 142 separate counts of corruption related charges. His indictment read like an alphabet soup of terms straight out of your favorite law or cop show: wire fraud, conspiracy, tax evasion, extortion. If it was on your favorite lawyer show, he was probably charged with it. Of those 142 charges, he was convicted on 127 counts.

The scope and breadth of his crimes was staggering, shocking, and ultimately it is the back bone of the widespread corruption that is currently leading to the potential closing of Grady Hospital. Walker used a network of power and influence to either get into bed with powerful people or strong arm those that refused to play ball. For instance, Walker ran a newspaper and anyone that wouldn't play ball would be threatened with negative publicity from his newspaper. He used his ability to procure government funds as a string to get hospitals to hire temps at his temp company.

Here is where the case gets shocking. After being convicted on 127 counts he was sentenced to ten years in jail. Now, normally, when someone receives such a light sentences after being convicted of so many things, we would assume that he flipped on others. In this case, he didn't. In fact, besides Walker, his daughter, and the companies they ran, NO ONE, NO ONE, was charged or convicted of anything. Furthermore, the authorities would have us believe that the proper sentence, without ratting out anyone, for 127 separate convictions is ten years. There are people busted with drugs that are serving more time than that. It seems the corruption that Walker pulled off was nothing compared to the corruption involved in investigating and executing his case.

In fact, we don't need to speculate as to whether or not others were involved in the corruption. One only needed to be in the courtroom on the day that Joyce Harris, the chief prosecution witness, testified. According to a source that was there when she testified, she accused Walker of demanding a quid pro quo. Grady is a public hospital. Walker, who again was one of the most powerful politicians in Georgia, was able to influence just how much money they received. He demanded that the temp company he ran hire up to 50 people per day (if you read the link Grady normally hired a handful per day) in order to receive funds. Harris testified to a lot more than just Walker. She accused Grady CEO Ed Renford, and Tim Jefferson Chief Legal Counsel of Grady, of threatening her safety if she blew the whistle. She accused Robert Brown, President of the board of Trustees of Grady Hospital, of accepting kickbacks and sexual favors. She accused William Casarella, Chief Medical Officer at Grady, of looking the other way. Yet, despite these incendiary accusations and 127 separate convictions of Walker, the powers that be at Grady were never investigated.

In other words, first, the authorities would have us believe that this guy was able to pull off so much criminality that it lead to the conviction on 127 separate counts, and that he pulled all of this off on his own. Furthermore, the authorities would have us believe that a proper sentence for the conviction on 127 separate charges is ten years in prison.

Furthermore, right around the time that Walker's trial was ending, the Center for Medicare and Medicaid Services (CMS) in the Dept. of Health and Human Services issued a report on Grady. Here is the conclusion of the report.

the conditions at your hospital pose an immediate and serious threat to the health and safety of your patients

You think that is shocking. What is really shocking is what happened to all of the players that were not only involved in the corruption of Walker but the conditions that lead to the scathing conclusion of that report.

The only one to lose their job as a result of the Walker scandal was Joyce Harris the one person who tried to stop the corruption. Ed Renford retired with a pension that pays him six figures per year. Tim Jefferson continues in the exact same position. William Casarella was actually promoted within Emory University. Robert Brown did eventually lose his sweetheart position but that was due to a separte scandal.

The reason this is important is because Grady is on the verge of collapse and its collapse threatens the entire medical system in Atlanta and Georgia. As a friend and Atlanta resident recently told me, the people the are the most scared are the other hospitals because Grady treats the patients no one else wants. Now, the legislature is debating whether or not to feed Grady with millions of more dollars. Make no mistake, Grady is in this mess because it is obscenely corrupt, and the exact same people that caused the corruption continue to be in power now. If they are fed more money, that is the ultimate throwing good money after bad.

If people are serious about saving Grady the first thing they need to do is clean house. You cannot save Grady if the same people that put it in this mess are in charge of getting it out. I hope the good people of Georgia will wake up to the obscene levels of corruption that have put this essential hospital on the brink of collapse and that they demand that the resolution is once and for all no longer the same old same old.

(Updated)

Much of the story about Grady Hospital is so confusing that anyone that winds up in the middle is likely to be confused. I don't believe that this particular one is an example of this, however, you should also know how State Senator Charles Walker fits into the entire puzzle so to speak. Thus, I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.

Also, please follow this link so that you can hear me and a colleague discuss the Walker case along with several other matters related to Grady and Emory.

Grady and Emory: Culture of Corruption (Update)

As I have delved deeper and deeper into the evolving narrative that links Emory University, Grady Hospital and potential malfeasance, I have realized that is very important to separate facts and evidence from speculation, assertion, and conclusions. For now, I want to report only facts, in other words, things I can verify.

Thus, it is a fact that Grady Hospital is at the center of a culture of corruption. I know this to be a fact because one only needs to do a google search to see that there is documented corruption at Grady Hospital

...he wanted Grady to hire as many as 50 a day, though the public hospital - operated under the Fulton-DeKalb Hospital Authority - had previously hired as
few as three a day. Harris adds that her boss, then-Grady CEO Edward Renford,
demanded that she "schmooze" Walker more and cautioned her not to make him
angry.

But Harris says she made the Augusta lawmaker angrier by not hiring more temps. She claimed in a sexual harassment and discrimination lawsuit that she was fired in 1998 partly because of her complaints about payments to Walker. Grady denied her allegations. Her lawsuit was dismissed in 2002.

But she wasn't the only one accusing Walker of shady dealings. Before Democrats lost power, when lobbyists came to his Capitol office seeking favors, he reportedly would pat the head of a toy dog on his desk and ask, "What's in it for my little friend?"

According to a federal indictment, Walker's temp company earned $2.5 million from Grady between 1996 and 2000. His corruption trial begins May 23 in Augusta. Harris hopes to testify against him. Her 1999 TV interview about the senator helped spur inquiries into his dealings.

Now, let's look at more facts. Joyce Harris, the whistleblower, is no longer working at Grady and in fact doesn't even work in Georgia. Ed Renford (referenced in the article as Grady CEO)recently retired with a rather nice retirement package.

Furthermore, let's look at two more high level people at Grady who weren't mentioned in the article. First, there is lead counsel Tim Jefferson who not only continues to be employed by Emory but as chief legal counsel. Then, there is Chief Trustee of Grady Robert Brown. He is no longer employed by Grady but if you click this link you will see why.

Again, I don't want to deal with anything but facts. The facts are that there were four people people that there were four people in a position of power when this scandal broke. The whistleblower lost her job and everyone else kept theirs. Again, I only deal in facts...as for assertions, speculation, and conclusions, those I will leave to the audience.

Now, let's look at another completely unrelated bit of corruption at Grady Hospital.

By contract with the Fulton-DeKalb Hospital Authority, the Emory Medical Care Foundation provides physicians to treat patients at Grady Hospital. Most of these services are billed to the Georgia Medicaid program.

Since July 1997, the State Health Care Fraud Control Unit, composed of prosecutors from the Georgia Attorney General's office, Georgia Bureau of Investigation agents, and auditors from the State Department of Audits, has been investigating Emory's Medicaid billing. The State concluded that there were two specific areas in which Medicaid billing by EMCF was not in compliance with the policies and procedures of the Georgia Medicaid program. First, the State contended that from 1993 through mid-1997, EMCF billed for outpatient obstetrical services at higher service levels than were warranted by the documentation, a practice known as "upcoding." Second, the State's review also indicated that during the same period Medicaid billings submitted for services provided by residents and interns under the supervision of teaching physicians were inadequately documented and did not comply with Medicaid rules concerning "teaching physician presence." Although the investigation revealed that inappropriate billing and documentation may have occurred, the State found that all of the patients whose records were examined had, in fact, received treatment. The quality of services provided by Emory physicians was not an issue
in the investigation.

Attorney General Baker stated that "Emory cooperated fully with the investigation and the investigation revealed no evidence of criminal wrongdoing." He further commended Emory for its role in consistently providing high quality health care to the indigent citizens of Fulton and DeKalb counties.

Under the terms of the agreement, the Emory Medical Care Foundation expressly denies any wrongdoing, but has agreed to pay the Georgia Department of Medical Assistance a lump sum of $4,502,693 to settle all possible claims. The Foundation also agreed to several compliance provisions, including continued implementation of a compliance office and program that were initiated in 1997. The State considered this compliance program, in addition to Emory's cooperation with the investigation, to be strongly mitigating factors in the settlement of the case.

Of course, if you still aren't convinced maybe you should .re read this, or this.

(Update)

Much of the story surrounding Grady has many tentacles and thus one could get lost in the middle of it. I have found that to be the case for many readers with certain pieces. I don't believe this is one of them. I believe this piece speaks for itself, and it should be easy to follow no matter how big your exposure to the entire case. That said, I also think that everyone should understand how this culture of corruption fits into the overall picture. Thus, I have put together a summary of the entire fiasco that tries to put all of its moving parts together in one piece. Please read it for guidance. Also, please check out the recommendations that I and my colleagues have put together for fixing Grady Hospital.