BOSTON — A deep dive by 25 Investigates into Massachusetts’ database of physician profiles has found several glaring gaps that keep patients in the dark about their doctors’ backgrounds.
State law outlines the exact information that the Board of Medicine has to make public.
- Details about board disciplinary action
- Restrictions on clinical privileges
- Criminal convictions for felonies and serious misdemeanors
- Court judgements, settlements, and arbitration awards specifically related to medical malpractice
But the board is not required to publicize Department of Justice settlements, state audits, or the outcomes of civil lawsuits unrelated to malpractice.
And Massachusetts’ public physician database doesn’t always have links to documents that provide details about board discipline.
That means it’s hard for people in Massachusetts to look up their doctor’s history beyond license disciplinary actions.
And 25 Investigates also found data showing that the state board of medicine is facing a growing backlog of complaints while rarely dishing out disciplinary action.
“Oh my God, who is this guy?”
25 Investigates delved into the case of Dr. Hooshang Poor, a geriatric physician who worked in at least 91 nursing homes and rest homes across Massachusetts from 2012 to 2015 alone.
His background of allegations includes billing fraud and improper prescribing of highly addictive drugs – as outlined by two high-profile DOJ settlements in 2019 and 2022 and a lengthy 2017 state audit. Poor disputed many of the findings in the state audit, and the 2022 DOJ settlement released Poor from state or federal civil liability.
Poor is also fighting an ongoing lawsuit alleging sexual assault filed by a former nurse in 2019.
None of those issues are listed on Poor’s physician profile.
That alarmed Massachusetts resident Patricia W., who researched Poor when he began treating her niece at Mattapan Health and Rehabilitation Center in Mattapan earlier this year.
“They gave me his name,” said Patricia W., who declined to publicize her last name over concern of legal retribution from Poor. “We tried to get in contact with them. He wouldn’t call back. So I decided to look him up.”
That’s when she and family members began sending each other increasingly alarming headlines about Poor.
“I was like, ‘Oh my God, who is this guy?’” Patricia W. said.
She added: “How is this guy still operating in the nursing homes? I’m like, ‘Why does he still have a license?’”
Poor’s patients are among the state’s most vulnerable: As of 2017, about 80% of his patients had both Medicare and MassHealth coverage.
He told 25 Investigates that he sees 500 patients each month. Poor briefly spoke with Boston 25 Investigative Reporter and Anchor Ted Daniel outside a Mattapan nursing home recently, but declined to sit for a taped interview.
Poor’s profile does disclose that in 2018, Massachusetts’ medical board put him on probation for providing poor care to four vulnerable nursing home patients.
But Poor’s physician profile doesn’t include a copy of his probation agreement.
To see that document – and other board records dating back to 2002 – users have to go to another section of the board of medicine’s website titled “View Board Actions.”
The probation agreement required Poor to undergo regular board monitoring for three years, have a board-approved worksite monitor and only practice at 13 specified nursing homes.
Poor’s probation ended last May.
‘Hidden from the public’
The state board’s website doesn’t make public any data about open complaints against individual doctors.
“You can’t learn what cases are being looked at until they’re closed,” said Andrew Meyer, a top medical malpractice attorney in Boston. “These cases take years. You can’t get information about complaints against doctors. They refuse to allow you to get that information. This is all hidden from the public and it should be public information.”
Meyer added: “All that time while these cases are awaiting resolution, whatever incompetence and harm these doctors are causing is allowed to continue. And the board takes no steps whatsoever to protect the Massachusetts patients against that.”
To learn if your doctor is involved in a lawsuit in Massachusetts requires a lot of time and know-how, according to lawyer Carmen Durso, who’s representing the nurse suing Poor.
“You have to physically go through an Internet search for each individual,” Durso said. “Of the 14 counties that we have, each county has their own Superior Court and they have separate dockets. You have to go through all that. You have to know where to search, how to search. So, no, the average person is not going to find out everything.”
Durso added: " I think it’s a structural issue with the court system. There are people in the court system who are working on making it better. But right now, it’s a mess.”
Poor’s profile lists no state board disciplinary action over his medical billing or prescription of controlled substances.
The state medical board declined to make a representative available to 25 Investigates for a taped interview.
Ann Scales, spokesperson for the Department of Public Health, stressed that the board is only required to publish details about medical malpractice cases.
The board’s email reads: “Regarding court judgements, the statute requires the Board to publish medical malpractice court judgments, all medical malpractice arbitration awards and all medical malpractice claims in which a payment has been made. BORIM is compliant with the provisions of the statute that tells us what we can publish regarding payouts.”
The board can also open up complaints against doctors following DOJ settlements, according to Scales.
“Although BORIM cannot comment on the existence of an investigation, generally speaking, the Board may open a complaint against a physician as a result of a DOJ settlement and the Board previously has done so,” the board said in an email. BORIM refers to the state Board of Registration in Medicine.
Through a public records request, 25 Investigates obtained more than 100 pages of records concerning Poor. That includes redacted copies of five consumer complaints over his four-decade-long career.
The board didn’t take action on any of those complaints.
25 Investigates contacted over 40 nursing homes, hospitals and home health agencies to figure out where Poor works as an independent contractor and whether his employers are aware of his background.
Poor has worked as a medical director at Hellenic Nursing and Rehabilitation Center in Canton, and at Serenity Hill Nursing Center in Wrentham, according to the 2017 state audit.
Frank Grady, a spokesperson at Alliance Health, confirmed that Poor continues to see patients at Maples Rehabilitation and Nursing Center in Wrentham.
“He is not an employee of ours, but is there regularly following and treating patients,” Grady said in an email.
A BACKLOG OF INVESTIGATIONS
Massachusetts - home to venerable institutions from Massachusetts General Hospital to Brigham and Women’s – has the most physicians per capita of any state.
But the state medical board has long received criticism for failing to take a tough enough stance on discipline.
In a 2021 ranking by watchdog Public Citizen, Massachusetts ranked 25th in the country for its rate of serious disciplinary actions against doctors– lower than New York, Vermont, Maine and Pennsylvania.
“We have very low incidences of discipline for malpractice,” Meyer said. “Very, very, very low incidence of corrective measures being taken.”
25 Investigates has analyzed data showing the state board has become increasingly inundated with complaints about doctors, while rarely dishing out any disciplinary action.
The state medical board opened 955 new investigations into complaints in 2020, according to the board’s annual report.
That’s more than double from 430 in 2017.
The backlog of cases has skyrocketed in previous years.
The board had 1,282 pending investigations as of Dec. 31, 2020, up from 476 in 2017.
18 physicians agreed not to practice medicine during an investigation in 2020 – up from 12 in 2017.
And the data shows disciplinary action is rare.
“When it comes to disciplining substandard medicine, it’s almost unheard of that that occurs,” lawyer Meyer said. “Although there are numerous complaints of poor medicine in Massachusetts. their inability to follow through to examine and investigate those complaints of poor practice of medicine that are brought by consumers to the board works to the harm and detriment of the Massachusetts medical consumer.”
The board reported 50 disciplinary actions against medical licenses in 2020, a decrease from 54 in 2017.
Durso said doctors are typically represented by highly skilled practitioners who know the lay of the land well.
“They know how to represent people, so it’s difficult,” Durso said. “There are some lawyers who are assigned to the board, but not nearly enough and not enough resources. So it’s difficult to get a case heard successfully through the board. I will say that if the board is presented with strong evidence, they will certainly do what they’re supposed to do.”
He added: “And unless the board takes, unless the institution takes action to discipline them. It’s not going to show up anywhere.”
The Massachusetts Medical Society, which represents more than 25,000 physicians, declined a request for a taped interview through a spokesperson.
“The Medical Society does not maintain physician records nor develop standards of behavior,” spokesperson Thomas Flanagan said in an emailed statement. “Policies and procedures - as well as licensure, disciplinary decisions and records, and public information on a physician’s qualifications - are under the purview of the Board of Registration in Medicine, the state’s physician oversight agency.”
Ann Hester, a board-certified internal medicine physician, said patients increasingly have more options to research their doctors: from reviews on websites like Healthgrades.com, to report cards from the National Committee for Quality Assurance, to individual ratings from the Center for Medicare and Medicaid Services’ website Compare, to board certification data from the American Board of Medical Specialties.
“If a doctor has had three or five malpractice claims, if a doctor has had multiple disciplinary actions from the board, from hospitals, if they’ve been dropped from insurance plans, all of those things are red flags,” Hester said.
“PUSHED UNDER THE RUG”
Poor is set to go to trial in September in a lawsuit launched by a former nurse who claims he sexually assaulted her in a now-shuttered Canton nursing home in 2016.
The nurse, whose name Boston 25 isn’t releasing because she is an alleged victim of sexual violence, told 25 Investigates Reporter Ted Daniel that she’s suffered emotional anguish ever since.
She said she was standing at the nurses’ station when Poor put his hand on her back and groped her back, buttocks, up her legs and between her thighs.
“He took his hands and he was rubbing his hand on my legs, on my inner thigh,” she told Daniel. “It was a shock for me. I froze in the moment, didn’t know what to do, and this continued for a good 2 to 3 minutes until I felt like I got the strength to get up and move. And I went around the nurse’s station to the chart rack. He then followed me and he passed his hand up and down my back.”
Poor has denied that he sexually assaulted the nurse.
A Middlesex County Superior Court judge denied Poor’s motion to dismiss the lawsuit in 2020. Poor had unsuccessfully argued that the nurse should have filed a claim for workmen’s compensation instead.
This year, Poor filed his own lawsuit against the nurse. He alleged that she had lodged false claims against him with malice. He’s seeking an undetermined amount of damages - including attorney’s fees - for “economic” and “severe emotional distress.”
Poor’s counterclaim says the nurse “consented to any alleged physical contact or touching.”
25 Investigates obtained audio recording of an Oct. 10, 20190 court hearing at Middlesex County Superior Court in Woburn in which Poor’s attorney, James Grumbach, described the alleged conduct.
“But I believe there’s no question from the allegations of the complaint that this was a situation where the alleged incident, and it was a one time incident, it was a fleeting incident whether it’s 10 seconds or two minutes, whatever it is,” Grumbach said. “It’s a one-time incident in a nurse’s station. There’s no question that the plaintiff and the defendant who’s a doctor have the right to be in the work station, nurse’s work station, as part of their average-- their typical duties. Now the defendant says he brushed by her or passed by her. The plaintiff says he grabbed her and fondled her.”
The alleged victim said she never wanted to come forward in the first place.
“Honestly, I did not want to report it because I felt ashamed,” she said. “I questioned myself, like, what did I do for this to happen? And you’re going to deny it, too, asking yourself, did this really happen?”
But she did end up reporting the incident after sharing what happened with a colleague, who urged her to disclose it.
“I explained the situation to H.R., who in turn wasn’t really concerned about me or my feelings,” the alleged victim said. “I was asked: ‘Do you know by you saying this,’ someone said to me, ‘what about his livelihood?’ You are more concerned about him and his livelihood than what he did to me.”
The now-shuttered nursing home conducted an investigation that found her complaint was unsubstantiated, according to a redacted copy of the investigation obtained by 25 Investigates.
The investigators said they reviewed a video of the interaction with Poor and the nurse. Lawyers for the shuttered nursing home say they can’t find the video.
The investigation noted that Poor was often “friendly with staff, i.e. hugging, touching on shoulders, etc.”
And the investigation said he was “verbally counseled” about those interactions with staff.
The nursing home officials said the alleged victim would work Sunday through Thursday while Poor would only make rounds on Friday to ensure the two would no longer work together.
But the alleged victim said the nursing home’s investigation was faulty, and biased toward Poor.
“I felt like the incident was like pushed under the rug,” she said. “It’s like they just wanted it to go away. Instead of digging deep and finding out we’re getting to the bottom of what really happened. It was all about him and his credibility and his livelihood and not about me, the person who it happened to.”
She’s worried that Dr. Poor had sexually assaulted other workers: a claim she put in her lawsuit against him.
“I know one person who he made uncomfortable in whatever way and she did not want to come forward,” the nurse said. “So who knows how many other people are out there like myself?”
And, she’s concerned about patients in Poor’s care. She wants to see him held accountable.
“He should not be allowed near any patient or even doing patient care or seeing any patient, in my opinion,” she said
“What about the patients who were not able to have a voice or voice a concern or say something is happening?” she said. “And who knows if he’s doing anything to them? That’s my concern. I mean, I am able to speak.”
The alleged victim denied that she lodged false claims against Poor.
She says she’s coming forward to help others.
“I’m still, still dealing with it, it hurts,” she said. “Even right now here talking to you about it. But the more I talk about it, it’s like healing for me. And that’s my goal. If I can help one person, like I say, I don’t want to get teary-eyed. If I can help one person. It will be a goal of mine to not have somebody go through the same thing that I’ve been through.”
“May have compromised.. health and well-being”
Poor has for decades worked as an independent contractor for nursing homes around the state.
His physician profile lists one malpractice payment for internal medicine dating back to Feb. 16, 1998.
The details are sparse, only saying the claim is classified as “below average.”
That means the amount paid out is below the average of malpractice claims paid out for current physicians in the same specialty.
Doctors in Massachusetts and nationwide have expressed caution about relying too heavily on malpractice settlements – especially a single documented instance of malpractice in a decades-long career.
Massachusetts’ state board’s physician database includes a similar word of caution:
“Some studies have shown that there is no significant correlation between malpractice history and a physician’s competence. At the same time, the Board believes that consumers should have access to malpractice information.”
The board’s caution continues: “To make the best health care decisions, you should view this information in perspective. You could miss an opportunity for high quality care by selecting a physician based solely on malpractice history… Settlement of a claim may occur for a variety of reasons which do not necessarily reflect negatively on the professional competence or conduct of the physician. A payment in settlement of a medical malpractice action or claim should not be construed as creating a presumption that medical malpractice has occurred.”
A sweeping 2017 state audit found Poor’s failure to establish guidelines for prescribing medications put patients at risk.
“Without prescriptive guidelines, the NPs and PA acted under their own authority and, in doing so, may have compromised members’ health and wellbeing when writing the 657 prescriptions they wrote during the audit period,” reads the audit. “Of these prescriptions, 211 were for narcotics, including fentanyl, oxycodone, and methadone.”
By December 2018, the state board of medicine had put Poor on probation following findings that he provided poor care to several vulnerable patients.
At the time, he was affiliated with New England Baptist Hospital and treated patients at nursing homes.
Poor conducted an “inadequate evaluation” for a 61-year-old man who was recovering in a nursing home from gastrointestinal bleed he suffered after surgery, according to board records. Poor also failed to examine the mental status of the man, who had a longstanding developmental disability and a diagnosis of dementia.
In another case outlined by the board, Poor failed to thoroughly examine a 62-year-old woman’s congestive heart failure and medical history. He also did not test her oxygen saturation levels or test her pulmonary function, despite her diagnosis of chronic obstructive lung disease.
While treating a 40-year-old woman with chronic low back pain following surgery, Poor didn’t properly assess how intense the patient’s pain was.
And Poor’s care for a 59-year-old woman with hypertension, congestive heart failure and renal failure was also lacking: he failed to document her vital signs and weight on a regular basis.
The consent order said Poor violated Massachusetts law and regulations “by engaging in conduct that places in question the Respondent’s competence to practice medicine including practicing medicine with negligence on repeated occasions.”
Poor also has a lengthy history of allegations of improper prescribing, fraud and other misconduct.
The 2017 state audit found Dr. Poor improperly billed MassHealth for over $200,000, including for services provided while he traveled abroad.
Poor disputed the findings, partly because he argued that his passport showed he was out of the country on different dates. The auditor said it had received its data from the U.S. Department of Homeland Security.
Poor also claimed his billing software caused some issues. But the auditor said investigators’ review found he still submitted inaccurate claims after he said the software was fixed.
In February 2019, Poor agreed to pay $680,000 to the Department of Justice in 2019 to resolve allegations he inflated Medicare and MassHealth claims while treating nursing home patients.
“Dr. Poor enriched himself at taxpayer expense by improperly billing Medicare and Medicaid,” then-U.S. Attorney Andrew E. Lelling said at the time.
And last June, Poor agreed to pay $100,000 in a settlement with the U.S. Department of Justice to resolve allegations he issued prescriptions for controlled substances without checking patients’ prescription histories.
The settlement says Poor issued 51 prescriptions to MassHealth patients at Stonehedge Rehabilitation and Skilled Nursing Center in West Roxbury, MA.
That includes 28 prescriptions for Schedule II drugs, which are highly addictive.
“Even though many of the patients for whom he issued a prescription had histories of substance use disorder, Dr. Poor did not review the patient prescription histories in MassPAT on any occasion before he issued those prescriptions,” reads the settlement.
The U.S. and the state of Massachusetts said Poor violated the Massachusetts Consumer Protection Act by failing to check those histories.
“Dr. Poor admits, acknowledges, and accepts responsibility for the foregoing facts,” reads the settlement.
The settlement didn’t release Poor from potential criminal or IRS liability.
“Proper prescribing practices prevent overdoses and deaths,” U. S. Attorney Rachael S. Rollins said in a statement at the time. “Simply put, the PMP saves lives and physicians who fail to comply with their statutory mandate to check the patient’s prescription history are putting their patients at risk.”
Hooshang Poor isn’t the only doctor with federal settlements who’s still practicing in Massachusetts.
25 Investigates looked at 21 Massachusetts doctors who have faced DOJ settlements and charges since 2015.
Hooshang Poor and ten other doctors still have active medical licenses after settling with the DOJ. One other doctor’s license lapsed, while another resigned.
The remaining eight doctors faced federal charges and six no longer have active licenses.
None of the doctors’ physician profiles mention federal settlements or charges.
The state medical board admonished one doctor over a federal settlement.
That doctor’s physician profile notes the admonishment but doesn’t provide any other details or the text of the admonishment. Another page on the board’s website says the doctor was admonished after entering into the settlement agreement.
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