NAPHSIS Conference June 2005 1
Funeral Director Fraud in New York City:Enforcement Using the Administrative Tribunal
Flor Betancourt, DirectorNYC Vital Records Registration
NAPHSIS Conference June 2005 2May 2005
What is the Administrative Tribunal?
Adjudicates New York City Health Code violations
Part of the Department’s overall enforcement strategy
Mostly for restaurants, day care, smoking law enforcement
35,000 cases annually
NAPHSIS Conference June 2005 3May 2005
Why issue Notices of Violations?
Hold funeral firms and their agents accountable for improper actions
Deter forging and altering death certificates
Encourage funeral directors to improve their practices
NAPHSIS Conference June 2005 4May 2005
NYC Death Registration
Two registration (“Burial Desk”) sites
Operates 24/7 in Manhattan
60,000 deaths annually
165 deaths registered daily
Permits required for disposition
Signatures of MD and FD required
NAPHSIS Conference June 2005 5May 2005
Quality Assurance
QA team reviews all death certificates
Questionable certificates investigated
Certificates are compared
same funeral home
same physician
Problem cases may be identified prior to registration
NAPHSIS Conference June 2005 6May 2005
Questionable Certificates
Different ink in legal and medical sections Signature of physician differs in both sectionsConfidential medical report appears alteredDates of signature, other dates not consistentTyped vs. handwritten sections of certificate
NAPHSIS Conference June 2005 7May 2005
Investigation
Contact hospital or physician
Obtain copy of death certificate
If alteration confirmed, obtain written statement
Contact funeral home
Obtain written statements from staff and agents
Determine Health Code violation
Issue Notice of Violation (NOV)
Submit NOV and evidence to Tribunal
NAPHSIS Conference June 2005 8May 2005
Notice of Violation
NAPHSIS Conference June 2005 9May 2005
NYC Health Code Violations
§ 3.19-Forgery of Signature [N=39]§ 3.21-Alterations to death certificate (including cause of death) [N=27]§ 205.03 (c) - Failure to report death certificate within 72 hours [N=1]§ 205.23 (a) – Removal of human remains without filing death certificate and obtaining permit [N=1]§ 205.25 (a) – Cremation of human remains without permit [N=1]
NAPHSIS Conference June 2005 10May 2005
Summary of Violations
Funeral Homes Issued Notices of Violations = 40
Total Cases = 521 violation = 36
2 violations = 15
3 violations = 1
Number of Violations = 69
NAPHSIS Conference June 2005 11May 2005
Outcome of Adjudications
N=52 Cases
81%
13%
6%
Sustained Dismissed Pending
42
73
NAPHSIS Conference June 2005 12May 2005
Range of Fines by Type of Violation
§ 3.19-Forgery of Signature$250 - $2000
§ 3.21- Alterations to death certificate (including cause of death)
$1000 - $2000§ 3.19 and § 3.21
$300 - $2000§ 205.03 (c) - Failure to report death within 72 hours and§ 205.23 (a) – Removal of human remains without filing a death certificate and obtaining a permit
$2000
NAPHSIS Conference June 2005 13May 2005
Factors Impacting Adjudication - 1
Judge’s level of knowledge
Funeral home admission or denial
Custodial responsibility of death certificates
Trade firm staff
Format and language of NOV
Laws, codes, regulations regarding confidentiality of death certificates
NAPHSIS Conference June 2005 14May 2005
Factors Impacting Adjudication - 2
Evidence, testimony and cross examination
Written statements from facility/MD/FD
Extent of investigation
Legal representation
Challenging the health department Did registration staff commit violation?
NAPHSIS Conference June 2005 15May 2005
Summary
Administrative Tribunal is an informal and relatively quick judicial proceedingNo attorney general or district attorney neededFuneral directors alter death certificates to minimize rejection riskEDRS should minimize, if not prevent, alterations and forgeries