Suspected hospice whistleblower hit with retaliation after a state inspection, judge finds

By: - April 29, 2021 4:05 pm

An eastern Iowa physician who has faced disciplinary charges on four previous occasions and been hit with an $18.1 million malpractice verdict is now facing allegations of incompetence. (Creative Commons photo via Pxhere)

An Iowa hospice company retaliated against an alleged whistleblower suspected of reporting patient-care concerns to state regulators, a judge has ruled.

According to state records, Judith Belcher had worked for Heartland Hospice Services of Davenport as a full-time medical social worker for four years before her termination in December 2020. At times, Belcher was providing services for more than three dozen Iowa hospice patients and their families.

Patrick Voss became Belcher’s boss in July 2020, and two months later, the Iowa Department of Inspections and Appeals initiated an on-site review of the company’s practices — allegedly in response to a complaint involving one of Belcher’s patients.

Records indicate the complaint alleged Belcher had been ordered to persuade a patient’s son to reverse the patient’s “code status” so that in the event of a medical emergency, the patient would not be resuscitated. Belcher’s employer allegedly concluded Belcher was most likely the complainant, or at least played some role in prompting the complaint.

The DIA investigator arrived at Heartland on Nov. 4, 2020, and allegedly spoke to Belcher, then to the management team. Immediately after the investigator left, the management team summoned Belcher to a meeting and questioned her about comments the state investigator attributed to her regarding Heartland and its efforts to “force” her to take certain steps in connection with a patient’s care.

Over the next six weeks, Heartland implemented a series of changes to Belcher’s  employment, which Administrative Law Judge James Timberland later ruled “appear to have been retaliatory.” The company removed from Belcher’s caseload her 40 Iowa patients and assigned 67 patients in Illinois. This increase in assigned patients resulted in Belcher consistently working  10 to 12 hours per day. Heartland then notified Belcher her documentation did not comply with corporate requirements and began requiring daily rewrites of her work.

The company then directed that the rewritten notes be submitted the same day the rewrite was assigned, adding to Belcher’s extended work hours. After reminding management of a scheduled day off work, which was part of a previously approved vacation request, Belcher was allegedly told by Voss to report to the Davenport office for a training session. When Belcher arrived, she found there was no training session and she was ushered into a disciplinary meeting where she was informed she was a poor social worker and would be assigned to shadow another, less experienced employee.

On Dec. 22, Belcher gave the company two weeks notice that she was quitting, at which point Heartland immediately terminated her. She subsequently applied for unemployment benefits, which Heartland challenged. That led to a hearing before Judge Timberland who ruled this week that Belcher was entitled to benefits due to Heartland’s conduct.

Timberland said the evidence in the case supported Belcher’s claim that Heartland retaliated against her in response to the state investigation, which the company blamed on her.

“The weight of the evidence establishes that the employer knowingly and intentionally made (Belcher’s) work situation unbearable,” Timberland ruled. “One substantial change involved removing (Belcher) from her Iowa duties, which would effectively terminate the line of communication between her and the Iowa Department of Inspections and Appeals, and eliminate the risk of (Belcher) initiating future complaints to that state agency.”

Timberland noted that the company “continued its campaign” against Belcher until she could no longer tolerate it and resigned. “This was likely the employer’s goal from the time of the state audit,” Timberland ruled.

After the November 2020 visit, DIA inspectors cited Heartland for failing to let patients exercise their rights without fear of reprisal, and for failing to provide a resident with hospice services in his or her home.

According to DIA, during the Nov. 4 visit to the Heartland office, a social worker at the company reported that a manager had instructed her to either get a particular patient to stay in a nursing home rather than his private residence or have him sign papers refusing hospice care. The social worker reportedly told the inspector she did not understand why management wanted the patient to refuse hospice services, but she had heard the patient’s home was infested with cockroaches and that perhaps the company’s nurses did not want to serve the patient at home because of that.

The DIA inspector’s report notes that a nurse involved in the matter “denied she had back-dated or falsified documentation, or that she had been asked to do these things,” but does not elaborate.

Voss, the Heartland manager, declined to comment when contacted by the Iowa Capital Dispatch.

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Clark Kauffman
Clark Kauffman

Deputy Editor Clark Kauffman has worked during the past 30 years as both an investigative reporter and editorial writer at two of Iowa’s largest newspapers, the Des Moines Register and the Quad-City Times. He has won numerous state and national awards for reporting and editorial writing. His 2004 series on prosecutorial misconduct in Iowa was named a finalist for the Pulitzer Prize for Investigative Reporting. From October 2018 through November 2019, Kauffman was an assistant ombudsman for the Iowa Office of Ombudsman, an agency that investigates citizens’ complaints of wrongdoing within state and local government agencies.