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GODWIN v. VISITING NURSE ASSN. HOME HEALTH SERVS.

September 15, 1993

HAJAR GODWIN, Plaintiff,
v.
VISITING NURSE ASSOCIATION HOME HEALTH SERVICES, Defendant


KATZ


The opinion of the court was delivered by: MARVIN KATZ

KATZ, J.

 Following a bench trial, the court makes the following findings of fact and conclusions of law:

 I. FINDINGS OF FACT

 1. Plaintiff, Hajar Godwin (Godwin), is a former employee of the defendant.

 2. Defendant, Visiting Nurse Association Home Health Services (VNA), is a Pennsylvania nonprofit corporation with offices in Norristown, Pennsylvania.

 3. VNA is in the business of providing home nursing care and home health aides to patient-clients.

 4. VNA provides skilled nursing care, home health aides, and other services to individuals, some of whom are covered by the Federal Medicare Program. VNA is entitled to reimbursement under the Medicare Program for some, but not all, of the services it provides.

 5. VNA also operates one or more primary health care facilities as a separate part of its business. At these facilities VNA offers medical, dental, and other services to the public.

 6. At all material times, VNA was not entitled to reimbursement under the Medicare Program for any portion of the services rendered through its primary health care facilities.

 7. Beginning June 7, 1988, VNA employed Godwin as a bookkeeper-accountant. Godwin's job duties included preparation of various reports, payroll information, financial reports, and accounting and billing information. The plaintiff's duties included providing information and documents to be used to prepare cost reports to be submitted by VNA to Independence Blue Cross (IBC). The cost reports were used by VNA to secure reimbursement under the Medicare Program.

 8. IBC is a financial intermediary between the United States Government and Defendant. IBC reviews and approves cost reports submitted by Medicare providers. IBC reviews these reports to determine the accuracy and the appropriateness of the charges for Medicare reimbursement.

 9. Godwin represented to VNA that she had a Masters of Business Administration degree. She submitted a photocopy purporting to show her MBA degree. Godwin never received her MBA. Def. Ex. 2.

 10. VNA had some dissatisfaction with Godwin's work and work product. Nevertheless she received four raises (Sept. 1988 - $ 12; Nov. 1988 - $ 14; June 1990 - $ 20; Feb. 1992 - $ 23). The last raise came only four months before her termination. At that time, Godwin received a 15% raise. Godwin was the second highest paid person at VNA. Only Agnes Ferrara (Ferrara), VNA's Executive Director, made more money.

 11. Ferrara had a very strong policy and practice through which she worked to control operational details at VNA.

 12. On December 31, 1991, VNA received a letter from IBC dated December 30, 1991. The letter was addressed to Ferrara. This letter announced adjustments made by IBC with respect to VNA's 1990 fiscal year. This letter also requested additional information concerning the 1990 fiscal year cost report. IBC sought information concerning VNA's treatment of the expenses of consultants.

 13. On January 8, 1992, Ferrara responded to IBC's letter. She knew about IBC's inquiry concerning these matters from that point.

 14. VNA engaged Joanne Chicco ("Chicco") to prepare its cost reports. Chicco prepared the 1990 cost report.

 15. Godwin's duty was to provide Chicco with VNA information and records for use in preparation of the cost reports. Chicco was responsible for preparing the cost reports.

 16. The December 30, 1991 letter from IBC to VNA was referred to Chicco for response.

 17. Chicco did not respond to the request. Between January 8, 1992 and April 8, 1992, IBC made repeated oral requests for the back up documentation called for by the December 30, 1991 letter. IBC orally requested invoices of Jack Nelson (Nelson), a VNA consultant. IBC wanted to review these invoices to determine if VNA's accounting of Nelson's fees was appropriate.

 18. On April 8, 1992, IBC again wrote to Ferrara extending the deadline for submission of such ...


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