New York State commission cracks down on alleged ethics violations by hospital staff

'Gifts' from five imaging OEMs spur investigation

Gifts from equipment vendors-mostly meals, lodging, limousine rentals, and airline tickets-have landed top staffers of the Nassau Health Care Corporation in hot water. The New York State Ethics Commission is investigating seven administrators and physicians of the hospital, including the chair of the radiology department at Nassau University Medical Center in East Meadow, NY, for unethical behavior. The administrators and physicians are accused of violating state laws.

Nassau Health Care president and CEO Richard B. Turan described the investigation as a witch-hunt. He promised to mount a vigorous defense against allegations he called astounding.

"Everything we did was in the best interests of the healthcare corporation," he said. "Nobody personally benefited from anything that went on. People volunteered to do extra work on their own time, and what they've gotten in return is being ostracized and humiliated."

The allegations are connected to a competition to determine the award of IT contracts valued at $12 million to $24 million. Much of the work the Nassau seven did involved visits to clinical and corporate sites, as well as after-hours business dinners. Expenses tied to those meetings constitute the bulk of the state's case against Turan and his colleagues.

"Nobody knew they were doing anything that could be perceived as being improper," he said. "There was no attempt to hide what was going on-nobody thought anything was wrong."

Many in the imaging community have become accustomed to business meetings that go beyond the offices and conference rooms of hospitals. Vendors often pick up the check when discussions spill into restaurants and nightclubs. The same is true when physicians and administrators visit clinical sites or factories to see equipment or speak with users.

All of these practices apparently fall on the wrong side of the law, if the hospital official is an employee of New York State, as is the case for those employed by Nassau Health Care. The 1500-bed healthcare system includes a 631-bed tertiary-care teaching hospital, an 889-bed skilled nursing facility, and seven community health centers. It is considered a public benefit corporation and, therefore, subject to New York State ethics regulations. The state takes a dim view of public servants accepting gifts, and it has a very broad definition of the term "gift," said Walter C. Ayres, spokesperson for the New York State Ethics Commission.

"No statewide elected official, state officer, or employee shall directly or indirectly solicit, accept, or receive any gift having a value of $75 or more whether in the form of money, service, loan, travel, entertainment, hospitality, thing, or promise or in any other form," he said, quoting from the state law pertaining to New York public officers.

The law provides for a penalty of up to $10,000 per violation for accepting illegal gifts of $75 or more, he said. Penalties can be imposed by the state ethics commission. State officers may also be prosecuted under criminal law for a class A misdemeanor, which carries a maximum prison sentence of one year per violation. Officers found guilty of accepting illegal gifts under $75 can be fined, suspended, or removed from office, but their penalty must be meted out by the state agency for which they work-not the ethics commission.

The seven Nassau Health Care staff are charged with 87 ethics violations, most of which fall in the $75-plus category. Documents filed by the New York State Ethics Commission allege that over a two-year period these officials received "gifts" totaling $10,272.93 from five vendors: Cerner, Eclipsys Solutions, Fujifilm Medical Systems USA, Philips Medical Systems, and Siemens Medical Solutions USA. At the time, the vendors were vying for IT contracts valued up to $24 million.

All but three of the 87 gifts were for transportation, meals, and lodging. Costs ranged from $6.44 for pizza to $780.83 for airfare, lodging, dinner, drinks, and entertainment. The three exceptions were two gifts of hockey tickets at $85 each and a $99 "recognition for promotion" gift purchased from Successories.

An examination by DI SCAN of the alleged offenses found that group gifts were common. One executive dinner was given to three Nassau officials. Other allegations of ethics violations were leveled against an administrator and two physicians for gifts of "airfare, lodging, dinner, drinks, and entertainment" pertaining to a trip to Kansas City, MO. The same three were singled out again for receiving gifts of airfare and limousine service to Boston.

Turan scoffs at charges that he or any of his staff have done anything wrong. He decries the allegations as exaggerations that have besmirched the good names of dedicated healthcare workers. He pointed out that the five vendors have since been fully reimbursed for the expenses, a fact confirmed by at least one vendor. But that doesn't matter to the ethics commission.

"Paying for a gift, after coming under investigation, does not solve the problem," Ayres said.

The next step is for a State Public Hearing Officer to hear arguments, determine guilt or innocence, and advise the ethics commission of the findings and any recommended penalties. The five-member ethics commission will then accept or reject the advice. The process could take only a few months, or it could take a long time, according to Ayers.

"A lot depends on how quickly people want this to come together," he said. "People can delay this as long as they want. There is really no set time for things to occur."