“Simple. For the six months Augustine rented from us, Dow would go off to work and the next thing you know, Crystal would come sneaking out her backdoor, through the trees, and into the cottage. She’d be there an hour or so and then slip back home. Meanwhile, Rand minded the baby, taking him for endless walks around Horton Ravine. It got to be the talk of the neighborhood.” We reached the first-floor foyer.
“Couldn’t there be another explanation?”
Dana’s smile was jaded. “Maybe they were having tea.”
Santa Teresa Hospital-St. Terry’s-is located on the upper west side, a neighborhood once devoted to open farmland, working vineyards, dairies, and stables, all with sweeping views to the mountains on the northern edge of town. Early black-and-white photographs of the area show wide, dusty roads, shanties flanked by groves of citrus and walnut trees, all leveled long ago. It’s a world that appears curiously bald and flat: rural expanses planted with pampas grass and star pines that look like mere sprigs. A few unpretentious structures from that era remain, tucked like vintage treasures among modern-day buildings. The rest-churches, the original county courthouse, the wooden boarding houses, the dry goods establishment, the early mission, the trolley car barn, and numerous snazzy three-story hotels-were razed by intermittent earthquakes and fires, Nature’s demolition crews.
It was not quite two o’clock when I parked on a side street and walked a block and a half to St. Terry’s front entrance. The wind had picked up and the trees seemed restless, stirring uneasily. Occasionally a miniature rain shower would shake loose from the upper branches. The very air seemed gray and I was happy to pass into the hospital lobby through the sliding glass doors that parted at my approach. On my left, the coffee shop was sparsely occupied by hospital employees and visitors. I inquired at the information desk and was given directions to the office of the Director of Nursing Services. I passed a ladies’ restroom and made a brief detour before I continued my quest.
I found Penelope Delacorte in a small private office with a window looking out onto the street. Overhead fluorescent lights contrasted sharply with the gloom outside. She was seated at her desk, using her pencil point to trace the lines of print on a photocopied memorandum.
When I knocked on the doorframe, she peered at me above a pair of half-glasses with tortoise-shell frames. She was in her early fifties, at that stage where she hadn’t quite decided whether to dye her graying hair. I pictured her in arguments with her hairdresser, unsure of herself when it came to permanent versus temporary rinses. They likely also argued about the cut; Penelope clinging to the shoulder-length page boy she’d probably been wearing for years. Her bangs were too short and I wondered if she chopped them off herself between appointments. She removed her glasses and set them aside. “Yes?”
“You’re Ms. Delacorte?”
“Yes.” Her attitude was cautious, as though I might be on the verge of serving her with papers.
“Kinsey Millhone,” I said. “I’m a private investigator here in town and I’ve been hired to look into Dr. Purcell’s disappearance. May I have a few minutes?”
Without much in the way of encouragement, I’d entered her office, slipped off my rain garb, and eased myself into the chair near her desk. My shoulder bag and the slicker I left in a pile at my feet.
Penelope Delacorte got up and closed her office door. She didn’t seem happy with my presence. She was close to six feet tall, slim, conservatively dressed-a navy blue coat dress with small brass buttons up the front. Her low-heeled navy blue pumps were plain and looked vaguely orthotic, as though prescribed for fallen arches or excessive pronation.
She sat down and put her hands in her lap. “I’m not sure what I can tell you. I was gone by the time he … went missing.”
“How long did you work for Pacific Meadows?”
“I was the administrator there for the past eight years, until August 23. I worked with Dr. Purcell for the last forty-seven months of that.” Her voice, like her manner, was carefully modulated, as though she’d set her internal dial to “Pleasant.”
“I thought he was the administrator.”
“His title was Medical Director slash Administrator. I was the Associate Administrator, so I suppose you’re correct.”
“Can you tell me why you left?”
“Genesis, the management company that oversees the operation of Pacific Meadows, received notification that Medicare was conducting a rigorous audit of our records.”
I raised my hand. “What prompted them to do that? Do you have any idea?”
“Probably a complaint.”
“From?”
“One of the patients, a guardian, a disgruntled employee. I’m not sure what it was, but they seemed to know what they were doing. Apparently, the clinic was suspected of any number of violations, from overpaying our suppliers to submitting false or inflated claims for services. Dr. Purcell was in a panic and blamed the bookkeeper, Tina Bart, which was absurd and unfair. Ms. Bart was working for Pacific Meadows before I arrived and she was faultless in her performance. I went to bat for her. I wasn’t going to let them push it all off on her. She didn’t make the decisions. She didn’t even pay the bills; Genesis did that. She processed purchase orders and prepared the room-and-board bills for each resident, including central supply, therapy, anything other than medication. This was Medicare, Medicaid, HMOs, private insurance, and private pay. The same information crossed my desk as well. She didn’t generate the paperwork. She forwarded what she was given.”
“Why isn’t Genesis considered responsible for the problem if they pay the bills?”
“We supply them the information. As a rule, they don’t stop to verify the data, nor did Ms. Bart.”
“But she was fired, anyway.”
“Yes, she was, and I turned in my notice the very same day. I was determined to file a complaint with the Labor Relations Board.”
“What was their response?”
“I never got that far. I had second thoughts and decided not to go through with it. Tina Bart didn’t want to make a fuss. She was as reluctant as I was to call attention to Dr. Purcell’s situation.”
“His situation?”
“Well, yes. We’re all fond of him. He’s a darling human being and a wonderful doctor. If he didn’t have a head for business, that wasn’t an actionable offense as far as we were concerned. I’m being candid in this. He just had no clue when it came to the Medicare rules and regulations-which items were billable and which would automatically be disallowed, co-payments, deductibles, claims for fee-based services. I grant you, it’s enormously complicated. Make one mistake- god forbid you put a code in the wrong place or leave even one window blank-and the form comes right back at you, usually without a hint about where you’ve erred.”
“But Dr. Purcell didn’t do the billing.”
“Of course not, but it was his job to review the TARs-”
“The TARs?”
“The Treatment Authorization Requests. He was also responsible for reviewing CPT codes and approving the cost of any ancillary services or DME’s. I have to emphasize, he was always genuinely concerned and very innovative when it came to patient care and well-being-”
“You don’t have to work so hard to defend the man,” I said. “I’ll take your word for it. What I hear you saying is when it came to the day-to-day management, he was incompetent.”
“I suppose, though it seems too strong a word.”
“Didn’t Glazer and Broadus realize what was going on?”
“It wasn’t their place. They purchased the property from the previous owner, did extensive improvements, financed and built the annex. The rest was up to Genesis and Dr. Purcell. Please understand, this is just my personal opinion, but I’ve worked with a number of doctors over the course of my career. It almost seems that the better a man is at the practice of medicine, the worse he is at business. Most of the doctors I know have a hard time admitting this about themselves. They’re used to being gods. Their judgment is seldom questioned. They have no awareness of the limits they face, so they’re easily duped. They may have medical knowledge, but often not an ounce of common sense when it comes to money management. At any rate, I didn’t mean to digress. I’m just trying to explain how Dr. Purcell could have gotten himself into such a mess.”
“Didn’t you explain it to him?”
“On numerous occasions. He seemed to listen and agree, but the errors continued to accrue.”
“But if you suspected he was screwing up, couldn’t you have gone to the operating company yourself?”
“Over his head? Not if I wanted to keep my job.”
“Which you lost, anyway.”
Mrs. Delacorte pressed her lips together, color warming her cheeks. “I felt compelled to resign when Ms. Bart was fired.”
I said, “Do you think Dr. Purcell was intentionally cheating the government?”