Seeing Red

After years of taking it on the chin, Bob Goeggel struck back at his competitor. Thanks to his accusations of fraud, the state's largest ambulance company is on the operating table and the feds are doing the cutting.

Walk into Bob Goeggel's office in the former police-precinct headquarters near Carondelet Park, and two things strike you: the enormous size — Goeggel decided against splitting off a conference room after getting the contractors' estimates — and the enormous fish.

There it hangs, the crowning achievement of several summer vacations spent deep-sea fishing off the shores of Hawaii — a 525-pound, 12-and-a-half-foot-long Pacific blue marlin, captured after an hourlong struggle near Kailua-Kona. A nearby photo shows an exhausted Goeggel, forcing a weak smile, nearly as dead as the big fish suspended next to him.

The world's record blue marlin is more than three times as big, but Goeggel's nine-year-old trophy is still an eye-popper — even if what visitors see is only a fiberglass replica fabricated in Fort Lauderdale. It's not the only trophy up there, either. There's the bill of another marlin, clipped from a 518-pounder and mounted, along with a dozen or so photos of Goeggel; his wife, Kathy; son Rob; and daughter Mary Elizabeth, memorializing their efforts to reduce the world's stock of mahi mahi, ono and tuna.

"Mr. Salvati stated that the hospitals and Abbott knew that billing Medicare for this transportation was against the law, discussed that it was against the law, and 'did not ... care.'" - from Bob Goeggel's lawsuit
"Mr. Salvati stated that the hospitals and Abbott knew that billing Medicare for this transportation was against the law, discussed that it was against the law, and 'did not ... care.'" - from Bob Goeggel's lawsuit

Ask Goeggel about the wall of fish only if you've got time to burn. He'll tell you more than you want to know. Fishermen are like that.

It's been a few years since Goeggel last bopped about the Pacific. Money's been tight, and there hasn't been much time. "It's been way too long," Goeggel says. "There have been so many things going on in the last few years, it's just not been practical to even consider going."

Lately Goeggel's been casting his line in St. Louis and, it turns out, has just hooked the biggest fish of his life. The owner of the largest private, for-profit ambulance company in St. Louis appears to have caught his longtime nemesis, Abbott Ambulance Services.

Thanks to a whistle-blower lawsuit Goeggel filed in late 1996, the federal government has just accused Abbott — the state's biggest ambulance provider — and its former chief executive officer, Terrence W. Dougherty, of systematically looting the Medicare program.

The alleged fraud, which the federal government says stretched back to the mid-1980s, may have cost taxpayers millions of dollars, may have given Abbott a competitive advantage that allowed it to double in size in the past decade and — as suggested by information Goeggel uncovered — also directly benefited Abbott's owners, Barnes-Jewish Hospital and St. Louis University.

Abbott and its executives dispute the federal government's allegations; Barnes-Jewish and SLU similarly say Goeggel's accusations are without merit. Nonetheless, attorneys for Abbott and the U.S. attorney's office began quiet negotiations to settle the case — a move that likely would have kept details of the case from becoming public.

Bob Goeggel made sure that wouldn't happen.

He's not about to let this fish slip away.

At 56, Bob Goeggel seems a little young for a dinosaur, but it's not clear exactly where in the modern health-care delivery system this Marlboro-smoking, blunt-spoken businessman fits. Mind you, this is no button-down policy wonk — not with the desk piled high with court filings; walls cluttered with Cardinals memorabilia and inspirational messages; one bookcase packed with binders of mind-numbing Medicaid and Medicare minutiae, another with light fare, like Bob Burnes' history of the Big Red and a copy of Party Jokes.

Goeggel began in the business in 1963 as a part-time attendant for the Pfitzinger funeral home in Kirkwood. Back then, the business of transporting accident victims, the sick and the elderly was less complicated, and most ambulance service in the St. Louis area was offered by funeral homes, Goeggel recalls. "They had a vehicle capable of horizontal transportation that they didn't use a lot." It didn't take much to get a job, either. "You needed zero qualifications to work on an ambulance," Goeggel says.

Things changed in the early 1970s, when the state began regulating ambulance services, licensing vehicles and setting training requirements for employees. That's when funeral homes began leaving the ambulance business. Goeggel bought Pfitzinger's ambulance service, starting with three vehicles and enough people to staff two.

When he started his business, Goeggel says, there were at least 16 private, for-profit ambulance companies competing in St. Louis and St. Louis County. The field would be winnowed down as companies were acquired and standards toughened. Goeggel, whose ambulances in those early days operated mostly in South City and County, would be one of the survivors. In 1984, he bought Gateway Ambulance Services and dropped the Pfitzinger name. "Gateway" sounded more St. Louis to him, what with the Arch and all.

Today, Gateway runs about 15 ambulances and has 63 full-time employees.

Like Goeggel, Terry Dougherty built his company with a series of acquisitions, starting with Collier's Ambulance Service in 1970, then North County in 1971 and Guy Mullen in 1980.

Unlike Goeggel, Dougherty sold his company. In 1984 — the same year Goeggel bought Gateway — St. Louis University bought Abbott. Dougherty remained as president and chief executive officer; Abbott converted to a not-for- profit corporation. In 1988, Barnes Hospital, which had been shopping for an ambulance service, too, bought a 50 percent interest in Abbott.

Dougherty, who at one time had operated Abbott from offices behind a pet store in St. Ann, was now running Missouri's biggest ambulance company for Barnes and St. Louis University Hospital, two of the area's biggest medical institutions. Within months of the Barnes deal, Dougherty and his wife, Sharon, paid $891,900 for a 15-room home on Forest Ridge Place in Clayton and, befitting his status, began hosting charity fundraisers and making an occasional appearance in the society pages. Goeggel stayed put in the Bedford Oaks Drive house in Kirkwood — currently appraised at $196,070, according to St. Louis County assessor's records — he and his wife bought in 1978.

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