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Columbia/HCA legacy follows Rick Scott to governor's mansion [The Miami Herald](Miami Herald (FL) Via Acquire Media NewsEdge) Oct. 21--From his poor poll numbers to his formidable fortune, Rick Scott's political standing revolves around Columbia/HCA. Scott was once hailed as a "wunderkind" for making the hospital chain the largest healthcare company in America. Then, he became a pariah after he and his company were investigated for Medicare fraud, leading to his ouster in 1997. Today, Scott avoids even mentioning the words "Columbia/HCA." "In 2010, the Democrats attacked me," Scott said at a debate earlier this month, omitting that he was first attacked by Republicans. "And I said when I ran a company I would take responsibility for the actions while I was CEO." But Scott never really did take responsibility at the time. Initially, he denied anything was out of the ordinary. He ultimately faulted others under him. For some former Scott allies, employees and supporters, the denial and blame-shifting is but one pattern of behavior Scott took with him from the board room to the governor's mansion. As at Columbia/HCA, Scott delegates responsibility to those under him and takes little responsibility for problems on his watch. When asked about any recent controversy at agencies under him -- from prison inmate deaths to a dysfunctional unemployment-compensation system -- he doesn't answer the question and refers it to his appointees. "There's a similarity with HCA in that you cannot just let the people below the executive run the show without the executive knowing what's going on," said former Lt. Gov. Jennifer Carroll. "The manner in which he runs government is letting underlings run the show. And they, the underlings, tell the boss what the boss wants to hear," Carroll said. "This may also be by design, where the governor may not want to have the knowledge to know what's happening so he can claim plausible deniability." At Columbia/HCA, Scott claimed he had no idea the company was, in the words of the federal government, committing "systemic" fraud in the chain of 340 hospitals and 550 home-health agencies. After FBI agents raided his company's offices on July 16, 1997, Scott appeared on CNN's Moneyline and downplayed the investigation as "a matter of fact in healthcare today." It wasn't. In all, the company committed 10 different types of fraud -- including phony Medicare billing -- that ultimately led to a record $1.7 billion in fines. Scott wanted to fight the charges and was finally pressured to resign, albeit with a generous compensation package. He was never criminally charged, and said he was never interviewed by authorities. Legacy of Columbia/HCA Years later, Scott drew on his wealth and spent $75.1 million of his own money to win the governor's mansion. But Columbia/HCA's legacy, and the brutal ads unleashed on him by his Republican and then Democratic opponents, left their mark. Scott barely won office, and his popularity has remained poor ever since. Democrat Charlie Crist in recent weeks has started airing ads reminding voters of Columbia/HCA in an effort to drag Scott's poll numbers down further in what is now a tied race. Poll numbers are important to Scott and his administration. His current chief of staff, Adam Hollingsworth, gave a pep talk to staffers when he took over in 2012, and made it clear that the administration cared about public-opinion surveys. Carroll singles out Hollingsworth and his predecessor, Steve MacNamara, as major problems for Scott in her autobiography published this year, When You Get There. She gives an unflattering portrait of Scott that echoes the observations of numerous other Republicans who did not want to be identified. They describe Scott as driven by political calculation and poll-tested talking points. Not everyone views Scott that way. Many of his current supporters and employees say the governor is engaged in what he truly cares about: Making Florida a better place to do business. Aside from job creation on his watch, Scott can also boast about cracking down on the scourge of prescription painkiller abuse in Florida and for settling contentious litigation over the Everglades. But Carroll said Scott consistently was unwilling to listen to bad news, even when she complained about potentially "unethical behavior" committed by MacNamara over government contracts. Scott wanted to hear none of it, she said. MacNamara eventually resigned. At Columbia/HCA, Scott similarly ignored warnings -- albeit of a far more serious nature. Year after year, in Securities and Exchange Commission filings, the company noted that the federal government had issued a "fraud alert" concerning some of the very types of incentives that Columbia/HCA made with doctors to get patient referrals to its hospitals. "He just doesn't tell the truth," said David Yarian, a Jacksonville physician who sued Scott for breach of contract at Solantic Urgent Care, a chain of walk-in clinics that Scott founded. Scott's defenders have long cast Yarian as "disgruntled" -- the same term they use to describe Carroll, who was forced from office amid an investigation into a phony charity that was linked to her former public-relations company. Carroll was cleared of any wrongdoing, but Hollingsworth and the governor's counsel pressured her to resign before news leaked out that she was interviewed by the Florida Department of Law Enforcement in 2013. The forced resignation, Carroll said, underscored Scott's lack of loyalty and empathy. Yarian said he doesn't think Scott cares about people who tell him what he doesn't want to hear. A healthcare compliance lawyer from Houston, Jerre Frazier, said he encountered Scott's aversion to bad news when he was hired by Columbia/HCA to find out why the feds were sniffing around the company before it was raided. He said he met with Scott and pointed out the "really big dollar amounts" of potential liability. Scott, Frazier said, didn't want to hear it. "We're not doing anything different than what anyone else in the healthcare industry is doing," Frazier recalled Scott telling him. Frazier said Scott made sure to have a "completely clear desk. He wanted no paper trail, no records, no fingerprints." When a document was handed to Scott, he often gave it back, Frazier said. Secretive As governor, Scott's administration has tried to keep correspondence in emails limited so as not to create records of conversations. Frazier said he believed Scott had to know about the possibility of fraud at Columbia/HCA. At the least, Scott created an environment that inevitably led to fraud because the company demanded unrealistic double-digit profit increases annually, Frazier said. And, he said, Scott was guilty of believing his own spin. "At HCA, he was really into marketing that gave a distorted picture of the company as a leader in quality of care," Frazier said. "It wasn't. The company was about profitability first under Scott." Jobs governor As candidate and governor, Scott's message is all about job creation. But since being sworn in, Scott has moved the goalposts on the job-creation promise outlined in his 7-7-7 plan he unveiled in 2010. Scott now takes credit for every job created while he was governor, instead of new jobs created on top of the old forecasts, as he originally said. Scott also falsely denied he was backtracking on his jobs promise. Still, the unemployment rate has dropped on his watch, and the number of jobs has grown, just as it has nationwide. Early on, Carroll said, Scott made it clear he wanted fewer people filing for unemployment. Aside from whether too many people were wrongly collecting government checks, Carroll said that reducing the number of filers would help marginally reduce the unemployment rate. So Scott signed legislation in 2011 making unemployment benefits harder for some to get. His jobs agency, the Department of Economic Opportunity, installed a new unemployment-benefits system that had more than 100 technical defects and wrongly withheld payments from thousands of job-seekers when the system launched a year ago. When asked about the system, called CONNECT, Scott refers questions to the agency. When pressed earlier this year by WFLA-TV for an explanation, Scott blamed the vendor. "Deloitte Touche didn't do their job right, so they've been fined, they've been fined millions of dollars and fined every day that it wasn't working," Scott told the station. "But they've worked diligently to fix it, and they are fixing it, and so everybody will get paid and is getting paid." But now, Florida is the worst state in the nation for providing timely payments for jobless workers. Preliminary data indicate only 27 percent of claimants were paid on time over the past three months. The year before CONNECT, the on-time payment rate was 78 percent. Childrens deaths Another agency under Scott, the Department of Children & Families, has also released figures that show a rosier picture of reality. Citing DCF data, Scott brags on the campaign trail that fewer children in state care have died under him than under Crist. What Scott doesn't mention is that the state reclassified deaths from abuse or neglect, making the numbers plummet. The reporting change was proposed in the last months of Crist's term, in late 2010. Within months of Scott's swearing in, DCF began discussing excluding some childhood deaths from state tallies. Subsequent Miami Herald investigations have also shown that DCF artificially reduced the number of verified fatalities by not closing cases, holding investigations open for months so that deaths were not put in final tallies. In some other cases, child deaths that were about to be officially verified were later un-verified by higher-ups. Another series of deaths of state wards has been unfolding at the Florida Department of Corrections, where 82 fatalities are under investigation by the Florida Department of Law Enforcement. Some guards allegedly beat, scalded or chemically restrained some inmates to death. After a series of Miami Herald investigative reports into claims of widespread abuse allegations and cover-ups, DOC fired almost 50 prison employees and has hired an ombudsman to oversee the treatment of mentally ill inmates. Scott's chief inspector general, Linda Miguel, in 2012 ignored warnings about problems in the department and denied whistle-blower protections for four inspectors who allege they were threatened and retaliated against for trying to expose corruption. Scott has refused to tell reporters even when he was first informed of the incidents, and he would not say whether he supported the actions of his inspector general. "The inspector general doesn't have the subpoena power and things like that when there's an investigation," he said. "So the right thing's happening. There's an investigation going on." The Scott campaign is banking on voters realizing the number of jobs lost under Crist vs. those gained under Scott. Scott's team knows that voters care only so much about prisons or the unemployment website compared to the state's jobs picture. Crist wants to keep the focus on Columbia/HCA. "During the federal criminal investigation into that fraud, [he] had to plead the Fifth Amendment 75 times to not answer questions from those attorneys," Crist said at the first debate between the two candidates, on Telemundo earlier this month. "The difference between the two of us: I'll take responsibility," Scott said at the first debate. "If I've done something wrong, I'll take responsibility. Charlie never will take responsibility for anything." Contributing to this report: Miami Herald staff writers Mary Ellen Klas and Carol Marbin Miller and Tampa Bay Times reporters Adam C. Smith and Michael Van Sickler. ___ (c)2014 Miami Herald Visit Miami Herald at www.miamiherald.com Distributed by MCT Information Services |