Whistleblowers detail ‘red flags’ at Charlotte community health center
WBTV Investigates: CW Williams Health Center under investigation by the FBI, U.S. DHHS OIG
CHARLOTTE, N.C. (WBTV) - The one-word subject line of Ann Wilson’s email said enough: “resigned.”
After just working just four days as the chief financial officer at the CW Williams Health Center, Wilson was emailing her direct report to say she’d be leaving her new position.
“I cannot operate under the circumstances at CW,” Wilson wrote.
That email was among hundreds of pages of documents—emails, text messages and internal financial records—provided to WBTV by Heather Piper, a financial accountant who worked at CW Williams for about four months this year.
Piper and a second former employee, James Wankel, spoke with WBTV to detail what they say are serious financial concerns in the health center’s operation.
Allegations from the pair of whistleblowers include poor patient recordkeeping, billing practices that led to patients being over-charged for services they should have received for free or at minimal cost, improper administration of grant funding and internal financial controls that did not align with generally accepted accounting principles.
WBTV has confirmed the whistleblowers’ claims are being investigated by special agents with the FBI and U.S. Department of Health and Human Services Office of Inspector General.
Piper, the financial accountant, said the problems center around what she called financial mismanagement by CEO Debra Weeks.
“She does not follow the policies and procedures herself; being the CEO, it’s her rules,” Piper said of Weeks, who had sole access to bank accounts and complete credit card statements.
“A company should never have a CEO handle all of the funds.”
In addition to calling WBTV, Piper and Wankel also alerted federal investigators.
A clinic designed to care for those most in need
The CW Williams Community Health Center was created in 1981 with a goal of providing medical treatment to people who otherwise couldn’t afford it.
It is a non-profit designed as a Federally Qualified Health Center, a designation that means the center receives federal funding and is part of the Public Health Service.
CW Williams also receives funding from state and local governments as well as private grants.
Publicly available tax data shows the center has annual revenue of more than $4 million.
But CW Williams almost folded in 2014, when poor record keeping and financial turmoil led Mecklenburg County to cut funding and other supports to ask questions. The center declared bankruptcy in December of that year.
The financial turmoil led the center to reduce its hours and reduce the number of needy patients it could serve.
Weeks, the current CEO, was brought on board in 2015 to turn things around. By May 2016, she was presiding over a press conference to announce a new $1.4 million federal grant, with U.S. Rep. Alma Adams on hand.
Today, Piper and Wankel say Weeks presides over an organization that can’t keep staff, doesn’t properly track grant funding and how that money is spent and doesn’t keep proper accounting records.
‘This is an excessive amount which is a HUGE RED FLAG.’
Piper provided roughly 500 pages of internal financial records, emails and text messages that she collected during the four months she worked at CW Williams.
One document she provided is a printed page of a credit card billing statement for December 2021 with a lime green Post-It note on the bottom and a note scrawled in red pen: “Everything highlighted has no receipts.” The no underlined twice for emphasis.
The highlighted items include $264 spent at a florist in Columbia, S.C.; two transactions on Amazon totaling $1,282; and $856.96 for an InTown Suites in Charlotte.
Another set of records Piper provided show a $315 charge for Cuban cigars Weeks bought for the CW Williams board chairman.
A credit card statement shows the purchase was made using a credit card that belongs to the center. But, the records show, Weeks claimed she paid for the purchase herself and submitted a reimbursement form.
An email sent by a woman contracted by CW Williams to serve as interim CFO sent on June 7, 2022 to Piper and another finance staffer questioned the large number of deletions made in the center’s Quick Books account.
“Please provide line item details for EACH item and why they were cancelled,” the contract CFO wrote, using all caps for emphasis.
“VOIDED CHECKS AND EXPENSES ARE HEAVILY SCRUTINZED during audit and any other financial reviews. This is an excessive amount which is a HUGE RED FLAG.”
An audit log of deletions in the QuickBooks software, provided by Piper, showed the deletions had been made by an account created by Weeks but listed in the name of a different finance employee.
“There were large amounts of money sitting under our payroll account but not for payroll. There were uncategorized expenses that were fed in through the bank but I had no documentation,” Piper recalled.
Weeks, through a spokeswoman, declined to answer questions on-camera for this story.
WBTV specifically asked about the credit card charges without documentation, submitting reimbursements for items paid out of CW Williams funds and Quick Book deletions but the center’s written statement did not directly address any of those items.
Auditors cite problems five years in a row
Questions about CW Williams’ financial recordkeeping have been raised by independent auditors in every audit of the center’s finances since 2017.
The audit for 2021 found material weakness in the center’s financial recordkeeping.
As a result, auditors found grant funding was not properly tracked.
Auditors recommended grant budgets be reviewed by staff applying for the grants with the accounting department, approval of expenditures of grant money prior to money being spent and training on grant reporting.
Wankel, the former employee-turned-whistleblower questioned how the center used grant funds.
In his job as a licensed clinical social worker at the center, Wankel said he got virtually no grant-funded resources to support his programs.
“We have money coming in from the opioid crisis. We have money coming in from the ABC stores. All that money is earmarked for substance abuse and that’s the program I primarily was,” Wankel explained.
“Then out of all those funds, I got four $25 gift cards to Walmart and we’re talking, I believe the grant from ABC with $50,000. And I don’t know what the rest of the grants were, because we were never told how much money there was available.”
In responding to the audit, Weeks blamed turnover in the finance staff for the poor recordkeeping.
She echoed that in a written statement for this story.
“However, the internal controls cited were related to staff transitions within the finance department, including the training of new team members,” the statement said.
“CWWCHC has also hired an experienced Chief Financial Officer and will continue to implement improvements to the organization’s internal controls.”
The audit response from Weeks also notes that CW Williams hired a grants manager as a result of recommendations from previous audits. Weeks defended the center’s handling of grant funding in her statement to WBTV.
“Additionally, CWWCHC ensures that grant funding is only used for approved, eligible expenses as outlined in grant award letters,” she said. “To request grant funding, CWWCHC staff members submit requisitions, which must be approved by their respective managers.”
‘Square peg. Round hole.’
Wankel said he noticed poor record keeping in his clients’ files as soon as he started at CW Williams.
“Patient records were incomplete. Not improper forms, not the right forms, outdated forms, just general mismanagement about patient health information,” he recalled.
As a result, he said, he’d often spend time going over information his clients had already given previous providers.
Week’s statement claimed otherwise.
“Patient medical records are also maintained by CWWCHC providers and staff following the Health Resources and Services Administration and North Carolina Medical Board standards and guidelines,” she said. “CWWCHC also maintains a staff-led Continuous Quality Improvement (CQI) committee which operates with Board oversight while conducting regular audits on patient charts.”
Not only did the poor record keeping waste time, Wankel said, he also saw it led to patients being billed incorrectly.
“Because the paperwork wasn’t done right, some of those individuals had $3,000, $4,000 bills that were being sent monthly because in their paperwork in the system, a box wouldn’t check correctly,” he recalled.
“And so they’re getting billed full price for services that they should have been only paying $35.”
“So how does their billing practices square with their mission and the model that their rules are supposed to be following?” a WBTV reporter asked.
“Square peg, round hole.”
In one case, Wankel recalled a suicidal patient being denied a visit because her account showed he had an unpaid balance.
“I was not informed of it. I was in the back. And she called me up, bawling that, you know, they turned her away due to some supposed error of some sort,” he recalled.
Weeks, in her statement, said the following about the center’s billing practices:
“Eligible patients who provide documentation for discounts based on the Federal Poverty Guidelines are also billed based on a sliding fee schedule. Similarly, Emergency Financial Assistance (EFA) may be provided to patients after staff submit a completed application. This service is provided based on timely submission of EFA applications, need criteria and availability of funds. The application must also be accompanied by backup documentation to demonstrate those needs.”
Here is the full written statement Weeks issued in response to a detailed list of topics provided by WBTV:
The C.W. Williams Community Health Center (CWWCHC) has worked diligently over the last 41 years to provide access to the highest-quality comprehensive family health and ancillary services, regardless of a person’s ability to pay. As part of our fiduciary responsibility, we are required to conduct annual audits through an independent, third party.
During our annual audit, it was found that our financial statements were presented fairly in all material aspects. While internal controls were mentioned, they were not related to any questioned costs, expenditures or allegations of wrongdoing, as all transactions - including wire transfers, credit card charges, reimbursements, and also access to accounts - were properly approved within CWWCHC’s policies and procedures. However, the internal controls cited were related to staff transitions within the finance department, including the training of new team members. CWWCHC has also hired an experienced Chief Financial Officer and will continue to implement improvements to the organization’s internal controls.
Additionally, CWWCHC ensures that grant funding is only used for approved, eligible expenses as outlined in grant award letters. To request grant funding, CWWCHC staff members submit requisitions, which must be approved by their respective managers.
Patient medical records are also maintained by CWWCHC providers and staff following the Health Resources and Services Administration and North Carolina Medical Board standards and guidelines. CWWCHC also maintains a staff-led Continuous Quality Improvement (CQI) committee which operates with Board oversight while conducting regular audits on patient charts.
Eligible patients who provide documentation for discounts based on the Federal Poverty Guidelines are also billed based on a sliding fee schedule. Similarly, Emergency Financial Assistance (EFA) may be provided to patients after staff submit a completed application. This service is provided based on timely submission of EFA applications, need criteria and availability of funds. The application must also be accompanied by backup documentation to demonstrate those needs.
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