A now-closed Charleston pain clinic employed gun-toting ex-police officers who essentially ran the facility and used a special machine to churn out large quantities of pain-pill prescriptions for patients while doctors watched from the sidelines, a state inspection report shows.
The former doctor in charge at Hope Clinic told inspectors: “I feel like I have no control over the clinic. I feel powerless.”
Hope Clinic closed its Charleston practice in late February. The state Office of Health Facility Licensure concluded that the clinic put patients’ health and safety at risk.
“One of our biggest concerns was they did not have trained medical staff involved in the assessment of patients,” said Jolynn Marra, who heads OHFLAC, a division of the Department of Health and Human Services. “After reviewing what was going on at that clinic, we had a real concern for patient safety and welfare.”
A Hope Clinic representative downplayed the report Sunday, saying any deficiencies could have been fixed quickly.
Hope closed the Charleston clinic after the inspection but before the state released its final report. Hope ultimately decided to close the facility after a doctor — who also had an ownership interest — resigned, a spokesman said.
“Without conceding the validity of any of the deficiencies, Hope Clinic contends that OHFLAC’s citations could have been remedied in a relatively brief period of time,” said George Manahan, a public relations specialist hired by Hope. “However, because the Charleston clinic was already winding down its operations when the OHFLAC report was issued and ultimately closed at the end of February, HOPE Clinic ultimately chose not to challenge OHFLAC’s report and facilitated the transition of patient care to other clinics and providers.”
The state cited Hope Clinic with dozens of infractions —most targeting the use of former law enforcement officers to review patient charts, take patients’ blood pressure and weight, and issue prescriptions for pain pills. Many patients never saw a doctor at the clinic. The ex-officers, who acted as de facto nurses, worked for a company called PPPFD Inc., which shares the same address as Hope’s headquarters office in Beaver, a Beckley suburb.
The former officers had no medical training.
“PPPFD runs the clinic,” a doctor told inspectors.
At the clinic, the ex-cops were called “narcotics auditors.” They routinely carried concealed weapons, according to the report. One former officer who worked at Hope left a loaded .38-caliber handgun in a black canvas bag atop a chair in an unlocked office, the report stated. Patients and staff frequently walked by the office’s open door.
“It’s a safety issue,” Marra said. “There are concerns when there are narcotics being prescribed and guns on site. The weapons weren’t secured.”
The inspectors cited Hope employees for numerous medication errors. Some patients got prescriptions meant for someone else. Other patients received prescriptions with incorrect dosage information, or for an excessive number of oxycodone pills, according to the report.
The “narcotics auditors” operated automated “Rx machines” that printed mass numbers of prescription slips for patients. The doctor signed the prescriptions without ever seeing the patients in many cases. The clinic had eight prescription printers.
Patients came from as far away as Kentucky, Virginia and Ohio to get prescriptions for pain pills, according to the report.
“They can choose just to pick up scrips,” a Hope receptionist told state inspectors.
PPPFD auditors also installed video surveillance cameras throughout the clinic. Patients fumed after being told by state inspectors that the video cameras shot round-the-clock footage in patient examination rooms.
Inspectors asked one woman whether she consented to be monitored by video in an exam room.
Her response: “Absolutely not. That makes me mad. I feel violated.”
Cleanliness also was an issue at Hope Clinic, which operated for years at 4407 MacCorkle Avenue SE in Kanawha City. Inspectors found a “copious amount of a brown substance covering an entire sink basin area and counter wall.”
A Hope narcotics auditor was asked about the stain. “If it’s snuff, it’s not mine,” he said. “It’s been there about a year.”
The report also flagged Hope for improper drug testing. The clinic required patients to urinate in a cup, but didn’t send urine specimens to outside labs for testing. Instead, the cups were tossed in the regular trash after employees gave the urine “a quick visual reference for abnormalities,” according to the report.
State inspectors asked a lab technician whether the clinic kept records of patients’ drug-urine tests. “Nope,” the lab worker replied, according to the report.
Hope’s doctor, who quit after the December inspection and before the clinic closed, told inspectors he pleaded with higher-ups at Hope’s main office in Beaver for more medical staff, but his request fell on deaf ears, according to the report. Hope’s Charleston pain clinic also had an exodus of patients to the Beaver practice, after the doctor started to decrease dosages of pain pills, the doctor told inspectors.
The doctor, whose name isn’t disclosed in the report, described the transfer of patients as a “shell game.”
Hope’s Beaver clinic also failed a recent inspection. The state has ordered that site to close by Friday. Hope is challenging the directive.
U.S. Attorney Booth Goodwin’s office is investigating Hope. In March, federal agents raided Hope’s office in Raleigh County.
Last week, the pain clinic issued a statement, defending its management and pill prescribing practices.
“Hope Clinic is a pain management clinic that provides important, compassionate and necessary care to a segment of society that has essentially been abandoned by modern medicine: law-abiding chronic pain patients,” Manahan said.
The state released the Charleston clinic inspection report after the Charleston Gazette filed a request under the Freedom of Information Act.
In an interview with state inspectors, the pain clinic’s former doctor summed up the Charleston practice this way: “There is no traditional medical model used for patient care.”
Reach Eric Eyre at ericeyre@wvgazette.com, 304-348-4869 or follow @ericeyre on Twitter.
