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“We have a
proactive business strategy. Hal, you may not have noticed, but I built this
company on an idea and a business card. I promise I have a plan my friend.
Thanks rs”
--From
email sent by Richard M. Scrushy to his attorney, after the HealthSouth scandal
broke, and while they were discussing damage-control strategy. The company that
“he built” was the same company that he would later claim he had no knowledge of
what his top executives were doing. He was just the CEO.
The
HealthSouth Story: From Dream to Nightmare
A young, ambitious kid, after working his way from a
respiratory therapist to an executive at the Houston based healthcare company,
Lifemark, starts a company that is designed around exploiting changes in the way
Medicare is billed. A new market of healthcare is created because the billing
for hospital procedures is now defined and capped by the diagnosis, and not by
the individual procedures. These changes do not apply to rehabilitation, and so
hospitals are looking for ways to get patients out faster. At the same time, the
baby boomer generation is more active and is more prone to sports injuries,
which coincidentally generally require various rehabilitation services, so
HealthSouth enters this arena as well. The new company is also well positioned
to offer services to one of Medicare’s cousins, occupational medicine, or
medical services paid for by workman’s comp. It was a heady idea, and it came at
a crossroads, a place where 80's-style entrepreneurship would meet a sagging
health care system, and both would intersect an increasingly dominant insurance
industry, along with the government programs of Medicare and workman's comp. As
a young kid with dreams, his visions of grandeur and importance would one day
mature, with his company, into full blown narcissism.
Richard Scrushy, the young businessman, hand picks four
other founders from his colleagues at Lifemark, and begins to line up venture
capital. Two of the early lenders are Sage Givens and Charles Newhall, who would
be long-time board members at HealthSouth. The board, at HealthSouth, would
always be stacked with ardent Scrushy associates and supporters, and would
include members who were also on the boards of various HealthSouth subsidiaries.
Although more ethically questionable than illegal, it is easy to see how this
created an environment where the interests of the stockholders would be
subordinate to the interests of Richard M. Scrushy.
The company grows rapidly, and they are looking to go
public while expanding into all 50 states before conquering the rest of the
world. The goal is to be the first branded health care system, and to do this,
they attempt to consolidate and expand their offering via a series of
increasingly large mergers. HealthSouth wants to offer one-stop shopping that
will cover all medical needs, including diagnostics, surgery, pharmaceuticals
and insurance; along with their initial scope of rehabilitation, sports and
occupational medicine. At all stops along they way, their growth is trumpeted
and laurels are heaped upon Richard Scrushy, as a visionary.
As a prelude to going public, in 1986, HealthSouth
conducted an outside audit, but the auditors were not convinced that the books
were reliable. These auditors were fired by Richard Scrushy, and it was becoming
apparent that Mr. Scrushy had far-reaching and over-reaching demands, and he
would not allow his vision to be diminished by detractors. He was quick to cast
aside all criticism, and reports from inside the company, are that he ruled with
autocratic authority. Years later, after the scandal broke, around the time when
E&Y was also fired as the company's outside auditors, insiders were reporting an
aura of fear from a CEO that micromanaged every facet of his company.
Efforts to brand the HealthSouth name were conducted on
several fronts. HealthSouth created the Sports Medicine Council, which included
a collection of about a dozen pro athletes, with football star Bo Jackson, as
the President. The company also produced a traveling show, called “Go For It!”
for kids that promoted a positive message of staying in school, staying away
from drugs, and keeping physically fit. The stage show was an extravaganza that
featured singing, dancing, light shows, pro athletes and speeches by
motivational speakers. A version of the show was produced as a Saturday morning
program on ABC’s family channel. Also featured on the show was the Orlando
produced girl-band, 3rd Faze. Richard Scrushy was listed as their
manager, and it was soon clear that he hoped they would be big stars, and that
he would see his protégés win a grammy in a year or two. To further this goal of
becoming an entertainment mogul, Scrushy gave Sony’s Tommy Mattola 1.25 million
in stock options to explore “entertainment options” for HealthSouth. Although on
the surface, this foray into entertainment and music was supposed to help build
the HealthSouth brand, it appears that Mr. Scrushy was pursuing his own
interests with HealthSouth money. Scrushy brought in child actor, now
twenty-nine, Jason Hervey, as a vice president of media communications, and he
made overtures to other Hollywood insiders. Money is flowing now. There are over
1,500 HealthSouth facilities by the late 1990’s. Scrushy owns four or five
mansions with his third wife (who he has given an underwear business to), and
besides very large bonuses he has been receiving from HealthSouth, it begins to
be unclear where the line between Scrushy’s personal hobbies and projects ends
and the territory of the publicly owned HealthSouth business begins. Mr. Scrushy
is not only using HealthSouth resources for the TV show and over one million on
his girl group, but he is also using HealthSouth employees to manage his
finances, to work on his house, and to help with other projects he has. It is
hard to understand the justification for Jason Hervey’s $300,000 plus salary, a
man who has no experience in the healthcare industry, or in corporate marketing.
This relationship may become more clear when it appears that Hervey adopts the
role of Scrushy’s young pal, and confidante, and gives Scrushy a peripheral
Hollywood connection to indulge his emerging alter ego as some kind of
entertainment mogul. After Scrushy is fired from HealthSouth, Hervey continues
to work with him. At the same time, Scrushy is annoying his neighbors on a lake
in Alabama, where he owns property, by racing around in his cigarette boat, and
he has begun a process of having buildings, roads and stadiums named for him. He
begins offering donations from the HealthSouth foundation, with the agreement
that whatever is built with the money, will be named after him. HealthSouth also
donates to various political campaigns, including $10,000 to Senator Orin Hatch.
There are clouds on the horizon for the health care
industry, especially as it has been mapped out by HealthSouth and Scrushy.
Health care reform is looming, and some of the reimbursement loopholes that
HealthSouth was designed to exploit are being closed. Expansion is slowing, and
for the first time, growth expectations are not being met. How does this play to
the kid from Alabama who’s in love with himself and in love with what he built,
who having spent almost two decades only hearing lavish praise heaped on himself
and his accomplishments, while he reaped the rewards by lining his pockets and
his world with beautiful homes, beautiful women and beautiful cars. The wall
street expectations are not being met, so while telling the public that
everything is fine and that business is booming, he is simultaneously telling
his top executives to “fix” the problem. These high-level executives, in turn,
directed lower level employees to change the books, file false documents, or
make bogus wire-transfers. These soldiers-of-the-scandal appeared to have their
silence and complicity bought by having artificially inflated titles and
salaries. In retrospect, and long after the original charges come out, it will
be hard to place exactly where the culture of ambition fused with, and was
overrun by, the culture of greed. HealthSouth has always produced glowing
reports about their progress and about the future. They have also heaped praise
on Richard Scrushy’s leadership and guidance. And now he was being forced with
having to answer to the gloomy outlook, and the negative response that a
downturn might bring. So confronted with something he has never been able to
face, Scrushy could try to extend the limelight, maintaining the mantle of glory
and power by first glossing the problem and then changing reality to match his
wishes and dreams. It is unlikely that Richard M. Scrushy could handle anything
less than glowing reports and praise. Even now, even under a mountain of
charges, he can only blame those around him, and he can only try to feebly
distance himself from the company that he always took credit for being it’s sole
architect and builder. It is easy to place a time when things began to change in
the industry but it is hard to overlay HealthSouth’s response. So at the very
top of the organization, was it always about maximizing wealth? Were the values
of quality and affordable health care dropped a long time ago? Or was it always
just about the money? Was it always just about exploiting the hopes and fears
and wishes of the people’s dream for a better healthcare system, just to build
one man an empire?
Within days of making public statements about the health of
the company and the robustness of HealthSouth’s stock, Scrushy sells 75% of his
holdings. And money begins to appear and disappear from the corporate books. An
intentional mis-interpretation of Medicare’s guidelines for reimbursement causes
$175 million dollars to be added to the ledger. Almost simultaneously, fraud is
being committed against medicare, the corporate books are being altered to
artificially inflate the company’s assets, to meet market expectations, and the
company is officially saying that it’s stock is sound and that there are no
problems. HealthSouth’s stock which was trading at $21 plummets to $4. Inside
the corporate headquarters, meetings are held to discuss what to do about the
bookkeeping problems and whatever was once a company that had anything to do
with the development of affordable health care options has now become a company
who’s sole purpose, from the high-level management perspective, is to maximize
the cash flow being skimmed off by the highest executives, to keep the
stockholders in the dark about the true financial well-being of the company, to
cover their tracks by creating and filing false documents, and by “finding” 175
million as a result of intentionally mis-billing Medicaid patients.
As a result of the ensuing government investigation,
seventeen HealthSouth executives were indicted. This includes all five of the
company’s CFOs, since they went into business in 1984; the low level managers
who “fixed” the books and the higher-up executives who directed them to do it.
And Richard Scrushy was indicted on 85 counts of fraud. All of the executives
below Mr. Scrushy pleaded guilty in exchange for cooperation in the
investigation of Health South and in Scrushy’s trial.
In hearings held before a congressional sub-committee,
investigating the scandal, Richard Scrushy invoked his 5th amendment
constitutional rights, and refused to answer questions from committee members.
This was particularly disturbing, because just days before the hearing, Mr.
Scrushy answered many of the same questions on national TV, without a lawyer
present, when they were posed to him by a reporter. This approach of
simultaneously being evasive and uncooperative to investigators while using the
media and other channels to appeal directly to the people and ultimately the
jury pool would kick off his overall strategy of using deceptive behavior to get
away with his own pattern of deception. He has since taken to the airwaves on a
TV show, sponsored by an African-American church, that he has been attending, in
a show that seeks the truth by blaming the media for his downfall, the same
media that he zealously courted when HealthSouth was riding high, and back when
all the mirrors that he held up, only reflected Richard M. Scrushy. Some of the
jury tainting has been muffled if not pushed underground by a gag order placed
on the proceedings, by the judge.
Now the ambitious kid from Selma, Alabama is all grown up,
but even though he is often credited with being the driving force behind making
the first brand name health care system in the country, it never seems that he
came to know boundaries in the adult world, he did not seem to understand where
his hobbies and his toys and the little things he needed ended, and where his
company and the realm of his employees, customers and stock holders began. It’s
a mixed up world. Give a kid millions of dollars so he can buy anything or
anybody he wants, and surround him with people who are afraid to say “No” to him
because of his bullying tactics and implicit threats of violence, and then put
him in charge of a major corporation, where countless employees, suppliers,
stock holders, and customers depend upon him, and you have a world where this
dream has become a nightmare to so many, many people. You can change lives and
fortunes with the stroke of a pen, but things can’t be “fixed” in the board
room.
[I’m reminded of the movie,
Fargo, where in the end the chief of police recounts all of the carnage left
behind, and she says, “And for what? For a little bit of money. There's more
to life than a little money, you know. Don't you know that? And here you are and
it's a beautiful day. Well I just don't understand it." -- Don't you know
that, Mr. Scrushy? A lot of people got hurt. It is a great day, but I just don't
understand it.]
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