(C) Iowa Capital Dispatch
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Home-heath CEO: State's claim of fraudulent practices amounts to a 'witch hunt' • Iowa Capital Dispatch [1]
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Date: 2025-07-03
An Iowa home-health agency accused of using falsified records and billing for care services that were never documented has engaged in “fraudulent practices,” a state board has concluded.
While the Iowa Board of Nursing recently cleared a Cedar Rapids nurse of any responsibility for some of the alleged issues, it did conclude records had been falsified by someone at Compassion North America, that Medicaid had been double-billed for some services, and that an unlicensed nurse was providing patient care for the company.
Joseph Lemor, the CEO of Compassion North America, said this week that testimony at the hearing was inaccurate and that the board’s conclusions were factually wrong and stemmed from a “witch hunt” by the board. He said the company plans to appeal the board’s decision to district court.
In July 2024, the Iowa Board of Nursing charged Lemor’s wife, registered nurse M’balu Kebbie, with improper delegation of nursing services and falsifying records related to the nursing practice or knowingly permitting the use of falsified information in such records.
A hearing on the charges was held in April, and although it was closed to the public, the board’s findings from the testimony and the evidence presented during the hearing were recently made public.
According to the board, Kebbie was first licensed by the board in April 2007. At some point, she began working for Compassion North America, a home-health care agency that is based in Cedar Rapids and run by her husband. Kebbie was the company’s director of nursing and human resources, according to Compassion’s website.
In September 2022, the board alleges, it received a complaint from a patient, “G.F.,” who alleged Compassion had assigned unlicensed staff to perform skilled nursing care tasks, and that the staff failed to complete documentation of the care provided in his home.
G.F., who is a Medicaid beneficiary, had sustained a spinal cord injury in a 2018 car accident that resulted in quadriplegia, and he now uses a wheelchair for ambulation. He also has a tracheostomy — a surgically created opening in the throat to facilitate breathing — and uses a ventilator.
According to the board, G.F. was hospitalized for several days in June 2022 due to a severe infection. He was then discharged to his home, with a physician’s order for temporary, 24-hour, in-home skilled nursing care, seven days per week. The care was to include maintenance of his tracheostomy, wound care, intravenous catheter-line care and medication monitoring.
Compassion North America was approved by Iowa Medicaid’s managed care organization, Amerigroup, to provide the services from June 29, 2022, through Aug. 29, 2022.
In addition to Kebbie, the board alleges, Compassion employees Elizabeth Smith and Maudalyn Pierre provided most of the services — although G.F. later complained the company never provided the 24/7 level of staffing that was ordered and approved, and also claimed the staff behaved unprofessionally.
The board alleges that after becoming concerned with the professional qualifications of the staff, G.F. and his mother informed the state that they had not seen any of the staff take notes or complete any documentation while in their home.
They alleged that after they asked Compassion to provide them with copies of their nursing notes and other records, the company never complied. The board says that after G.F. relayed his concerns about Compassion to Amerigroup, the managed care company “then terminated its contract with Compassion” at the end of August 2022.
Board: Nurse was ‘unlicensed’ at the time
A state investigator allegedly reviewed the work schedules of Compassion employees, which reportedly showed the company was not actually providing 24/7 care to G.F. as ordered. The caregivers listed on the work schedule allegedly included four individuals, only two of whom — Kebbie and licensed practical nurse Elizabeth Smith — were licensed nurses.
However, Smith’s nursing license had expired in January 2021 and was not reactivated until 18 months later, on July 6, 2022.
The state investigator reviewed thousands of pages of records subpoenaed from Compassion, the board says, and concluded Smith was the only nurse to document any nursing care for G.F. from June 29, 2022, through July 1, 2022 – during which time Smith was unlicensed.
In addition, the records regarding G.F.’s care did not always identify who performed the tasks or what specific care was provided. A comparison of Compassion’s billing records with the staff work schedule allegedly showed the company had submitted payment claims for skilled nursing services for which there was no corresponding documentation to indicate the care had ever been provided. There were also payment claims for services provided by a registered nurse that exceeded 24 hours in a single day, the state investigator testified.
Smith reportedly told the investigator Compassion never provided her with a functioning computer, so she completed her documentation in a notebook that was left at G.F.’s home. According to the board, Kebbie had no explanation for the irregularities in the nursing documentation – including instances where it appeared Compassion had billed Medicaid twice for services related to G.F.’s care.
Board records show Kebbie denied falsifying or fabricating records related to G.F.’s care, and explained that her husband was the sole person responsible for billing. As for her role as the director of nursing, Kebbie denied knowing Smith’s license had lapsed and denied she was responsible for supervising Smith’s work.
Board rules on ‘fraudulent practices’
With regard to the allegation that Kebbie had improperly delegated to Smith certain tasks that were outside the scope of Smith’s license, the board concluded the documents supporting that claim were most likely fabricated by Compassion after the fact — and so, the board reasoned, there was “insufficient evidence” to support the allegation.
As for the allegation that Kebbie had delegated nursing responsibilities to an individual she knew was not licensed at the time, the board concluded that while Smith was supervised by Kebbie, “there is simply not enough evidence to conclude she knew the LPN’s license was inactive when providing care to the patient.”
However, the board added, the evidence did suggest Kebbie failed to properly delegate G.F.’s care to Smith. As the supervising registered nurse, the board said, Kebbie was responsible for the implementation of care plans, the supervision of Smith and the accuracy of medical notes.
Kebbie, the board said, had admitted she had not reviewed Smith’s documentation of G.F.’s care. As such, the board concluded, Kebbie had violated state regulations related to unethical conduct.
With regard to the allegations of falsified records, the board dismissed that charge as it related to Kebbie while noting there was evidence “someone associated with Compassion” had falsified documents.
Had Kebbie “properly reviewed her subordinate’s records or otherwise given G.F.’s care plan the appropriate amount of attention, she would have known fraudulent practices had occurred,” the board said. “Nevertheless, there is not enough evidence in the record to support the conclusion that (Kebbie) knew the records were falsified.”
Citing what it called Kebbie’s “lack of previous disciplinary history,” the board ruled that she could retain her Iowa nursing license subject to two years of probation that will entail some level of supervision by a board-approved monitor.
However, state records show that in 2012 the board disciplined Kebbie for briefly working as a nurse while her license was inactive. In that case, the board agreed to a settlement that called for Kebbie to pay a $50 civil penalty.
CEO: Board is engaged in a ‘witch hunt’
Joseph Lemor, Kebbie’s husband and the CEO of Compassion North America, said the board’s written findings are replete with factual errors, adding that the board’s ruling will likely be appealed to district court. No sanctions have been imposed on Compassion North America by the nursing board, whose jurisdiction is limited to the employees engaged in nursing.
With regard to Smith’s lack of an active nursing license, he said that at some point in time — he said he was unsure as to when — he checked with the board and determined Smith was properly licensed. But, he said, it was Smith’s responsibility to make sure she was licensed at the time she was delivering care to Compassion North America’s patients.
“It’s the personal responsibility of the nurse to make sure they’re not working without a license,” he said. “She has to defend that herself.”
As for the board’s assertion that Amerigroup terminated its contract with Compassion North America, Lemor said, “That is false. Nothing like that happened.” He said the company is still an approved care provider that is reimbursed by Medicaid for the services it delivers to Iowans.
Lemor said the nursing board is engaged in a “witch hunt,” adding that he questions whether the patient, G.F., actually filed a complaint with the board due to what he sees as irregularities with the patient’s alleged signature on documents.
The board’s assertion that his wife admitted having failed to review Smith’s documentation, along with the board’s finding that records were falsified, are also untrue, he said.
“We did not do anything improper,” he said. “We have nothing to hide.”
He said he is currently disputing the amount of money Compassion North America collected for G.F.’s care, saying the company was “extremely underpaid.”
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