As the FBI tells it, Brad Harris became a one-man private death panel as the owner and CEO of a Texas hospice.
“You need to make this patient go bye-bye,” Harris texted one his nurses at Novus Health Care Services, as recounted in an FBI search warrant affidavit.
The Feb. 5 affidavit, first reported by NBC 5 in Dallas, further alleges that 34-year-old Harris said of another patient, “If this f**k would just die.”
On at least four occasions, the affidavit says, Harris instructed nurses to administer overdoses to patients who had “been on the hospice service for too long.”
In one instance, Harris allegedly texted a nurse to dispatch a lingerer “by increasing the patient’s medication dosage to approximately four times the maximum allowed.”
The motive for the big hurry, the affidavit says, was money. Hospice care is no longer the province of nuns and other noble religious volunteers. It is now a multibillion-dollar industry where companies compete for patients who translate into taxpayer bucks.
To control the greed and the accompanying costs, the federal government imposes an annual “aggregate” cap for hospice care of $27,820.75 per Medicaid/Medicare patient.
But a hospice might bill much more than that for a lingering patient while counting on billing less for somebody who comes in and quickly expires. The FBI reports that Harris spoke of wanting to “find patients who would die within 24 hours.”
The problem business-wise comes if too many patients hang on for too long. The hospice exceeds the cap.
Then comes a greedster’s nightmare. The hospice is required to pay back whatever it has billed over the limit.
And Harris is not in it as even a moderately dedicated doctor might be. He is an accountant in a health-care industry whose principles are less Hippocratic than hypocritical.
Novus says on its website that its name is “Latin for ‘New,’ ‘Extraordinary,’ ‘Innovative,’” and describes itself as “a state of the art healthcare company.”
“Our company name and mantra of ‘Focus on Living’ accurately symbolizes the company’s goal—to ‘redefine hospice and palliative care,’” the site says.
The FBI alleges that Harris’s mantra was to Focus on Profiting and that he redefined hospice and palliative care by texting execution orders to nurses.
“As part of this scheme, Harris, who has no medical training or licenses, would direct his employed nurses to overdose hospice patients with palliative medications such as morphine to hasten death, and thereby minimize Novus’ [exposure] under the cap,” the affidavit says.
According to the FBI, one nurse refused to carry out a death order and resigned. The ultimate result of the three other instances is not clear, and there certainly could be others.
If anybody did die, that would seem to justify a homicide charge. The orders themselves would appear to constitute attempted murder at the very least, whatever the outcome.
As Ron Panzer of the private watchdog group Hospice Patients Alliance noted on Wednesday, “You have the intent to kill, which is murder.”
While texting death orders may be unique in health care, Panzer believes that such hospice killings by overdose are not as unusual as the public imagines. He can think of no prosecutions.
“In a hospice, they say, ‘Well, it’s an expected death,’” Panzer said.
But robbing somebody of life near its end is still killing. Even a few added hours can be time for a loving declaration or a tender reconciliation. A few extra minutes can give a family time to say farewell.
After the FBI affidavit concerning Novus was reported on NBC 5 and then the Dallas Morning News, a Texas woman named Shannon Long posted a message on Facebook:
“This story is absolutely heartbreaking but I felt driven to share it because my family was affected by it. We used Novus Health Care Services Inc. for my grandmother’s hospice care back in February 2015. Within 20 minutes of the hospice nurse’s arrival, he had administered a drug that he said would ‘make her more comfortable.’ Seconds after administering, he told my mother that she ‘might want to contact immediate family members, because they usually go quick after this.’ Within the hour, my grandmother was in a medically induced coma. She passed less than two days later. I really can’t form the right words right now, but I’m praying for the other families that were affected by this and hope that those responsible are brought to justice.”
Long subsequently wrote, “I must add that our family is/was very aware of the role hospice plays, which is making the dying patient more comfortable during their ‘transition.’ However, this nurse administered these drugs before telling us that it would put her in a medically induced coma, immediately. He didn’t ask, he just told us the drugs would relax her, then he medicated her. Had he informed us of this BEFORE administering the drugs, we would have waited for our family to arrive, to say their goodbyes.”
She went on, “At the time, my mother and aunt were so exhausted emotionally. I don’t think anyone knew what to do, or how to react. All we could focus on was making her as comfortable as possible. Even at this point, sharing this post is the only thing I know to do.”
A family friend wrote, “Our mom is in memory care [long-term care for Alzheimer’s disease, dementia, or other memory troubles] now, that’s why this guy is so scary.”
Novus was not making any comment on Wednesday, and Harris could not be reached. He has yet to be charged with any crimes. But the once booming company he founded in 2012 has been on a steep decline since Sept. 17, 2015, when the FBI first showed up at Novus headquarters in the Dallas suburb of Frisco, taking away 18 DVDs of emails.
“[Novus] shot up like a rocket ship, then it crashed and burned,” said Pastor Rodney Sprayberry, until a week ago the chaplain there.
“Except for the guy at the top, it was an incredible company.”
Sprayberry told The Daily Beast, “I never saw anything illegal or immoral” at Novus, but he allowed, “there were whispers and rumors about what might be occurring.”
He said nurses “found it very difficult to work with [Harris] because of the demands he made.”
Sprayberry noted, “Obviously hospice is an industry that is relatively competitive. In this area, very, very competitive.”
In the scramble, Novus allegedly brought in patients who did not actually merit hospice care. The FBI began investigating the company in October 2014 and determined that Harris himself designated which patients qualified, the judgment apparently less medical than monetary.
“He did this by having employees who were not doctors sign the certifications with the names of doctors also employed by Novus,” the affidavit says.
Of course, an accountant was not the best of prognosticators.
“If a patient was on hospice care for too long, Harris would direct the patient be moved back to home health, irrespective of whether the patient needed continued hospice care,” the affidavit says.
The patients he liked best when he was near the annual billing limit were the ones who died within 24 hours. Another patient on the roster added a quick $27,820.75 to the aggregate cap.
“Save my ass from the cap,” Harris is quoted as saying in the affidavit.
Novus had 277 patients in a mid-2014 census, which would have translated to a limit of $6,037,102.75. Anything over that—because billing for lingering patients was not balanced out by quick deaths—meant that Harris would have to give the government money he had figured on keeping as profit.
The FBI alleges that Harris sometimes solved the problem simply by directing the nurse to administer a fatal overdose.
If one of those patients died, then what started as a fraud investigation for the Inspector General’s office at the Department of Health and Human Services could conceivably become a homicide case like none other.
The question would be whether it is murder to kill somebody who was likely about to die anyway.
The answer would seem to be that life is life and that the final moments before the end can be precious beyond the measure of a clock or calendar.
If Harris is ever proven to be a murderer, Texas has a death penalty. And executions there are carried out with exactly what he allegedly texted his nurses to administer: a lethal injection.