07-01-2011, 02:31 PM #1
Afternoon session: JB objected to Gentiva records coming in as the witness did not down load the records....HHBP overruled due to busines records of Gentiva...bring jury in an bring the witness in and lets get going....
LB D - John Camperlengo - employee of Gentiva - Chief Compliance Officer of Gentiva largest home healthcare in US...legal affairs of the company ensuring regulatory ...compliance and general legal affairs of the company....Federal regulations Gentiva must comply with ....he is resposible for compliances.....retention policy patient files collected @ branch - sent offsite to a vender and electronic data bases...some outside venders....requirements to keep emails ....company policy to maintain 10 year for patient care retention requirement......electronic documents are maintained in Overland Park KS, separate security officer responsible for maintenance....Gentiva have one server for all locations? several servers for email but clinical managment system we have is maintained in Overland park....time stamp is KS time ....Gentiva regular course of business compile emails received and deleted by employees...when placed on server - even when deleted they are placed on server..,,,,emails are backed up maintained on tape ....offsite...we must make sure for HIPPA if ever a breach we would have to notify all patients .....data related to the use of particular data @ the work station....regular documentation what being worked on @ particular stations....records maintained under regular user id....everyone has unique login and id...can retrieve info from various servers....every employee has their own id login...yes first and mid initial and first five of last name....clinical management system time stamp is made in KS time one hour behind EST - time is recorded....Cynthia M. Anthony was employee of Winterpark Gentiva in 2008...on 6/24 officer asked me for employee records - after receive subpeona it included phone records, computer activity infor realtive.......some employee information...
JB - stipulation...
HHBP - 2008 Gentiva health employer 2008 - true and accurate 1/1/08 - 6/16/08 ....true and factual...exhibit received in evidence...
LDB- employee profile for CA....appears to be one familiar with Gentiva documents....1/3 way down page....network id login...cmanthon....
Mr. C - run thru IT dept and provided to state...series of documents ...marked RU RV RT RW & RX - last 2 are composites.....deleted, received and sent emails from Gentiva acct of CA for 3/17/08 week....
looks consistent with IT dept ...provide to Mr C for compliance of subpeona....emails are in standard form....introduce into evidence...no objects from DT....
enter into evidence....#339 - #343....
custodian of records for Gentiva subpoena records for week of 3/17/08 complied with order...document produced in response for subpoena for login cmanthon...., letter entered into evidence....publish during testimony...
provided 6/28....log in and log out UNITY system for each home health care office Gentiva uses....in that section next to cmanthon....w with a number ends in an "a"...cmanthony logged into her desk station on 3/17/08 7:02:03 CENTRAl time
b section...Unity is old system ...cannot toggle betwen 2 screens like windows....open 2 sessions....up until 3:28 3/21/08 ....2 logins result of the clinical manager system to utilize cliincal manager....you need to get info from one screen to enter into another screen have to have both open or if you close out screen you will lose all info....something about that tells you it is a desktop work station vs. laptop.....in our company we desginate work staion is a W if a laptop it is an L....terminal worked on ....same terminal used entire week. User cmanthon was @ work station 3/17/08 @ 8:02:02 EST login occurred....not all employees required to log in each day....if meeting that day don't have to log in...log in signifies the UNITY system will be activated...ended 16:42:41 and 16:52 those are log out times ....system is running off a system in KS....once you log out you are out....can you walk away from your desk all day...unity system stays up...you can ....if more than 5 hours it would auto lock you out but if only 15 min you would stay up....if yu log in and there is activity does system stay up? if you working and entering info you will stay on so long as you dont delay 5 hours....information is consistent for 3/18 - 3/20 as well....on 21st of March first opened 743:06 and second opened 7:43:20 CT ....16:37:30 and 4:31 central time in FL add one hour - correct....
LDB - approach witness with exhibit RZ for identfication...
JB asks for stipulation...
excell spread sheet printed broke document in half due to landscape version of that document....this is a journal report for cmanthon for week of 3/17/08 thru 3/21/08 ...user id all activity under that user id during that week....all entries into Unity system....all changes to clinical records....first line has acronyms....various columns represent...unity created late 90's journal entry system...works off journals...first column is journal entry...second is date entered....journal time....central standard time - KS time ...hour hour min min sec sec time frame...it is really 07:02:02 KS time...journal journal user
2 items changed on that record @ 110 thru 1:22 Central time..business recoreds of Gentiva show user cmanthon working patient records @ a terminal in the office from 12:41 central time thru 13:22 ....1:22 Central or 2:22 EST....record continues all week in this same fashion....tues is the big day to lock down and go thru plans of treatment and send to Drs to verify the care....DR. sends Rx for homecare...send out nurse to patient home capture demographic data maintained on paper....data entry person enters what nurse has filled out...has diagnosis....info nurse filled out is accurate ordersin place to forward to medicare and track outcomes of patient....changes or alterations in patient after care of the patient....after 2nd day information is forwarded on to medicare....move down to afternoon hours of 3/21/08....line number 5069..column C job time.....afternoon of 3/21/08.....line 5086 activity user for cmanthon 13:47:44 Central time...someone hit enter button....didn't produce info on patient HIPPA law...identity of the patient is not required to track employee ....not at all....cmanthon was at the desk terminal - correct....thru end of the day....it appears to be activity throughout user id thru afternoon @ bottom of the page be able to see.....until 15:06:29 Central time is last entry on that computer equates to 16:06 or 4:06 EST....network login accounts password protected...how do you make sure patient records are secure...everyone has unique identfier....password changed every 90 days...do not share employee id company policy....no outside enttiy...only updates come from IBM on disc to our IT people who update.....publically traded company shabanes oxley requirement material process of an organization must be audited and we have internal audits...we are about patients and this is the most important......Sarbanes oxley act passed in 2002 following enron collapse public companies tested external and internal audit to make sure off balance not occuring sarbanes oxley compliant and on all FCC compliance. papers....Chief Compliance officer and CEO and CFO of the company Executive officers....Gentiva documents user cmanthon wasat a work station entering patient info Unity system between 1:30 and 3:00 pm ESt ....I have from 1:41 ....yes
cmanthon was entering info into patient records on 3/2/08 betwen 2:00 and 3:00 EST - yes correct....
no further questions
Cross- EXAm - JB ...were you contacted in summer 2009 to provide any of this documentation - no sir....last friday on the 24th....after Ms. A testified asked to provide info ....not asked prior to that to impeach CA? witness excused
Proud member of the AFKBPOFPOPL
07-01-2011, 02:31 PM #2
JB has a potential objection to the first witness. HHJBP overrules and says to proceed.
DIRECT EXAMINATION OF JOHN CAMPERLINGO
He is the chief compliance officer and general counsel for Gentiva. Headquarters are located in Atlanta. He is responsible for the legal affairs of the company.
He is responsible to see that Gentiva complies with Federal regulations.
Information retention? Most of their documents are patient files and those are collected and maintained at the branch, sent to an offsite location and then they are maintained in an electronic database. It is a company policy that they maintain records. Patient records are kept for 10 years. The e-docs are maintained in their Kansas location. There is a separate security officer responsible for maintenance of those. There are likely to be several servers for email, but the clinical management retention system is in Kansas, kept on the central time zone. Electronic time stamps will be one hour behind.
Emails sent or received by employees are maintained. They are retrievable, whether they are deleted or not. This is maintained on tape. They are subject to HIPPA and if there is ever a breach, they would have to notify all patients.
Does Gentiva record and compile data related to terminal work stations at particular offices? If it is maintained on a server, then yes. Under a particular user ID? Yes, everyone has a unique log in and ID and that information is retrievable.
Clock in and out times of employees? They use Unity - branch directors record certain information. When someone logs into the system a stamp is made in Central time and that is recorded and maintained.
Was CA an employee in Winter Park in March of 2008? June 24 he received a call from a detective from OCSO who asked him to retrieve some records. He requested a subpoena and once he received that it related to phone records, computer activity, internet activity and some other info related to CA.
Stipulation - CA was employed by Gentiva. Documents are true and accurate for employment from 1/1/08 to 7/16/08.
Documents marked as Exhibit 338?
He identified the document as an employee profile of CA. It indicates what her ID and log in was - CMANTHON.
The records include deleted, sent and received emails.
RT composite, RU, RV, RW composite and RX composite. He identified them as the deleted, received and sent emails to the Gentiva account for CA for the week of March 17, 2008.
He directed IT (Mr. Paul Stein - VP of IT) to provide the records to him to comply with the subpoena.
Emails in Outlook form.
Items marked as Exhibits 339-343.
He asked for the log in and log out times for CA for the week of March 17, 2008. It was part of the subpoena request. He was shown Exhibit RY and identified it as the log in info. Document marked as Exhibit 344 and published.
The title of the document is History Log Report for CMANTHON.
She logged on and opened a session in Unity on 3/17 at 7:02:02 Central Time.
Next - B session - Clinical managers open two sessions. They were opened within a 2 seconds. That is consistent right up until 3:28 on 3/21/08. The two log ins are consistent. Two have to be opened to toggle between two screens.
They designate work stations with a W and laptops with an L.
102937 is the terminal. The record shows the same terminal was used the entire week.
The records show that CA was at a work station on March 17, 2008 beginning at 8:02:02 EST.
All employees are not required to log in at the beginning of the work day.
A log in signifies that an employee is activating the Unity system.
The record for 3/17/08 ended at 16:51. These are the log out periods.
The system is running off a server in Kansas, but once you log out, you are out. If you walk away from your desk, there is a 5 hour timed log out.
If you log in and you are conducting activity on the system, it stays up until you log out so long as you don't delay 5 hours.
Explanation for March 17 is the same for the rest of the days of the week.
On 3/21/08 there were two sessions - 7:43:06 and 7:43:20 CST. Both sessions were logged off at 16:37 CST.
Composite Exhibit RZ - (JB - we stipulate to RZ as well). Marked as Exhibit 345. The original format is an EXEL spreadsheet and was published. He identified it as a journal report of the user CA for the week of March 17, 2008 through March 21, 2008 - all of the activity under the user ID during that week - all entries into the Unity system.
The first line - the columns - A is journal entry, the second is date, the third is journal time (CST), work station, journal user, job # that tracks the number for the record, job library is the data base on which this is held, job objective and job program are technical terms.
Records are maintained electronically - they are not replaced - you just keep adding and adding on top of.
At 7:03:13 there are three entries at the same time which means that three items on that page were changed. That continues throughout the day for 3/17 under the B session. There was no activity on the A session.
Afternoon hours of 3/17/08 and 3/18/08 - Line 110 - 12:41:27 - that would be 1:41:27 EST. Regarding activity from 110 to 133 - he can't tell the specific patient changes that were made to the file, but there at least several that were made, changes to patient profiles in their Unity system during that time.
The records show that CA was working on patient records at a terminal in the office from 12:41 CST down through 13:22 CST - (1:41 EST to 2:22 EST).
The record continues all week. Tuesday was the heaviest day because they produce all their plans of treatment on that day. The manager of clinical practice is responsible for making sure the patient is properly diagnosed, the nurse's notes are accurate, the orders are accurate.
Afternoon of 3/21/08 - 1:00 CST - Line 5086 - entry at 13:27:44. Somebody hit the enter button to enter data in a patient record at a desk terminal under CA's log in. The activity continued thru the end of the day - until 15:06 (CST).
The log in accounts are password protected. Everybody has a unique identifier and an individual password that is changed every 90 days. They try to get employees to not share passwords, but it does happen.
They are subject to external and internal auditing.
Sarbanes-Oxley - an act passed in 2002 following Enron collapse, requiring publicly traded companies be audited.
The records show that CA was entering info on 3/17/08 between 1:00 and 3:00 EST. On 3/21/08 she was entering info between 2:00 and 3:00 EST.
CROSS EXAMINATION BY JB
Were you contacted in the summer of 2009 to provide this info? No, it was last Friday.
You weren't asked to provide any info prior than that to impeach CA?
Witness is excused at 2:30