“Where did Dr. Purcell fit in?”
“I’m just getting to him. Under the management company, you have Dow, or his equivalent. He’s the medical administrator of the facility, responsible for the day-in, day-out nuts-and-bolts decisions, which is where he may have gotten into trouble.”
“The three of you are partners?”
“Not really. That’s how Dow refers to us, but it’s not technically true. For the layperson, it’s the easiest explanation of our relationship. We couldn’t be in partnership with Dow or the management company that runs the business. Believe me, the government gets very testy about any agreement that isn’t the result of an arm’s-length negotiation: in other words, two unrelated parties not in collusion with one another. Dow could hardly make unbiased decisions about billing practices if he stood to profit. What you’re probably referring to is the fact he bought stock in Millennium Health Care, which is a chain we also own stock in. I guess that makes us partners of a sort. We’re all in the same business, which is service to the elderly in our community. Of course we had no real say in the matter, but Harvey and I both thought Pacific Meadows would be the perfect venue for a man with Dow’s experience and reputation. I see now he may not have had quite the head for business I’d been led to believe. The first we heard about this Medicare business was last May. I thought then, and I’m still convinced, any discrepancies would turn out to be simple clerical mistakes, a compilation of coding errors as opposed to actual inflation of the figures with any intent to defraud. Dow Purcell is just too fine a man to stoop to cheating in that way. My guess is, he either didn’t have a thorough understanding of how Medicare works or he got impatient with all the nit-picking nonsense the bureaucrats put you through. I can’t fault him for that. As a physician, his first thought is always going to be for the well-being of the patient. He might have bridled at seeing all the ridiculous amounts of paperwork get in the way of first-class care, or worse still, he may have felt the government had no right to dictate to him.”
“So you think he might have bent the rules a bit?”
“I prefer that explanation to the one the fraud control investigator seems to be taking. A better guess is he was careless, penciling approval on charges he should have examined more closely. The notion of Dowan actively debunking the government is incomprehensible.”
“Suppose he did, though. I don’t understand how he benefits. If Medicare or Medicaid is overbilled, aren’t those monies paid to the operating company? Seems like it’s really their responsibility, isn’t it?”
“Absolutely. But outside providers, such as ambulance companies and medical supply businesses, can collect thousands of dollars for services never rendered, or goods not delivered, or goods billed out at inflated prices. If someone in Dow’s position were in league with them, the contracts could mean thousands of dollars to the companies involved. For this, he’d receive remuneration-a kickback-perhaps under the heading of a professional discount or a referral fee. Now that HCFA-excuse all these acronyms, that’s the Health Care Financing Administration, which regulates Medicare and Medicaid programs-”
“Gets complicated,” I remarked.
“Very. At any rate, now that HCFA has stepped in, they’re insisting on documentation for every such transaction, including the lease agreement, which is where we come in.”
“But you don’t think he’s really guilty.”
“I don’t. At the same time, it isn’t looking good for him.”
“You think he left to avoid disgrace?”
“Possibly,” he said. “If he felt unable or unwilling to face the charges. I’m not sure how he’ll deal with the humiliation if they decide to prosecute. I’m not sure how any of us would deal with that. He’s a man in big trouble. I don’t like to think of him as a coward as well.”
“When did you see him last? Do you remember the occasion?”
“Of course. September 12, the day he disappeared. I took him out to lunch.”
“I didn’t realize that. Was this at his request or yours?”
“His. He called and asked to see me. Of course, I said yes. By then, I knew about his difficulties. I had some other business in that part of town so we met at a little place in walking distance of Pacific Meadows. Just a hole in the wall called Dickens, a mock English pub. It’s quiet and affords a measure of privacy, which I knew he’d appreciate.”
“Did he talk about the problems with Medicare?”
“Not directly. He did ramble on a bit about the ongoing investigation. He was clearly upset. He seemed to want reassurances that Harvey and I would come to his defense. I did what I could to put his mind at rest, but I told him I couldn’t condone anything underhanded. I don’t mean to sound pompous, but in truth, if the charges turn out to be provable, then Dow’s actions are not just unethical, they’re illegal. As much as I like and admire the man, there’s no way I’d be willing to cover for him, even if I could.”
“But why would he risk it? Especially at his age and station in life. He couldn’t need the money.”
“I’m not so sure about that. Dow always did well for himself financially, but Crystal is high maintenance. She costs him a bundle. He has two houses to maintain-you know he bought Crystal that beach house at her insistence. Nothing would do, but she had to have that place. Plus he has Fiona’s alimony, which is burdensome to say the least. Crystal likes to travel and she does it in style, including first-class airfare and accommodations for Griffith’s nanny along with everyone else. She’s the kind of gal who insists on being gifted-birthdays, anniversaries, Christmas, Valentine’s Day-she expects to receive jewelry and nothing cheap. She makes sure of that. Dana’s theory is she’s busy accruing personal assets in case the bottom drops out.”
The phone rang again. This time his eyes didn’t even flicker, so I went right on. “You think she married him for his money?”
He considered the question briefly and then shook his head. “I wouldn’t say that. I think she genuinely loves the guy, but she’s been poor all her life. She wants to make sure she’s safe just in case something happens to him.”
“What about the rumors of an extramarital affair on her part?”
“You’d have to ask Dana. She’s the one who spotted that piece of shenanigans. I prefer to steer clear.”
“Did Dr. Purcell say anything to suggest he might flee?”
Joel shook his head. “I don’t remember anything of the kind. Is that the direction the police are leaning in?”
“Well, they can’t rule it out. Apparently, his passport and a substantial sum of money are missing.”
Joel stared at me as though trying to take that in. “If he ran, he’d have to continue running for the rest of his life.”
“Maybe that’s not as bad as the alternative. From what you say, he was feeling desperate.”
“Exactly. He was horrified at the prospect effacing criminal penalties.”
“I talked to an attorney who thinks it wouldn’t be that bad. He might have to pay restitution, but he wouldn’t go to jail.”
“That wasn’t his perception. He was deeply depressed. The government’s getting tough. He knew they might well decide to make an example of him. More than anything we’re talking about the loss of face, something I’m not sure he could handle.” He paused, moving four pencils from one side of his table to the other.
I saw his gaze shift. “What’s going through your mind?”
He shook his head. “Something I haven’t dared say to anyone else. It crossed my mind-after seeing him that day-he might have been thinking of doing himself in. He was trying to cover his distress, but it might’ve been too much. He wasn’t sure Crystal would stick with him once the scandal came to light. You have to ask yourself just how despondent he was and how far he’d go to get relief. I should have asked how he felt. I should have done what I could to reassure him, but I didn’t.”
“Joel?”
We both turned to find Dana standing in the doorway.
“Harvey’s on line two. This is the second time he’s called.”
“Sorry. I better get this.”
“Sure, go ahead. I appreciate your time. It’s possible I’ll want to talk to you again at a later date.”
“Any time,” he said. He stood up when I did and the two of us shook hands across his desk. By the time I reached the door, he’d picked up the phone.
Dana walked me to the elevator with its two-person capacity, the interior about the size of the average telephone booth. I could have run down the stairs in the time it took. During its slow, whirring descent, I said, “What’s the story on Glint Augustine?”