Minneapolis NutriMost Provider Has
Stephen Barrett, M.D.
Robert J. Shelton, who is doing business as NutriMost Wellness & Weight Loss and Dr. Shelton's Wieght Loss in Minneapolis, was disciplined by the Minnesota Board of Chiropractic Examiners in 1994. In 1993, he was asked to attend a conference to discuss a complaint (shown below) about his management of seven patients. In 1994, he signed a stipulation and order (shown below) under which he acknowledged that he had:
- Falsely notified one or more insurers that patients had not previously experienced the same or similar conditions
- Made a number of incorrect diagnoses or diagnoses not borne out by patient symptoms nor substantiated by patient records. For example, his diagnosis of a herniated disc in one instance was clearly ruled out by prior testing.
- Failed to maintain adequate patient records by failing to document improvement, treatment plans. changes and referrals
- Failed to maintain daily notes and to adequately document patient billings
- In connection with the use of TENS units, inappropriately recorded patient conditions prior to progress examinations.
Under the agreement, his license was suspended for 33 days, he was fined $5,000, and he was ordered to take a recordkeeping course and pass a special purposes examination.
Shelton continued to practice as a chiropractor but in 2014 began offering the NutriMost program as part of his practice. Records from the Minnesota board state that he voluntarily retired his chiropractic license in 2015. He now identifies himself as "Robert J. Shelton, PSc.D."
BEFORE THE MINNESOTA
BOARD OF CHIROPRACTIC EXAMINERS
In the Matter of
WHEREAS, on or about November 11, 1993, the Minnesota Board of Chiropractic Examiners (Board) instituted the above-captioned matter by serving upon Robert J. Shelton, D.C., (Respondent) a document entitled "Notice of Conference With Complaint Panel" a copy of which is attached hereto and made a part hereof; and
WHEREAS, pursuant to the Notice, Respondent and his attorney and representatives of the Board met on January 20, 1994, to discuss the allegations set forth in the Notice; and
WHEREAS, based upon the conference discussion, the parties wish to resolve this matter without the necessity and expense of a contested case hearing or other procedures by entering into the instant Stipulation;
NOW, THEREFORE, IT IS HEREBY STIPULATED AND AGREED by and between Respondent and the Board as follows:
A. During all times material herein, Respondent has been and now is subject to the jurisdiction of the Board from which he holds a license to practice chiropractic in Minnesota;
B. If the Board in its discretion does not approve this Stipulation, it shall be deemed withdrawn and of no evidentiary value and shall not be introduced or relied on by either party; except that Respondent agrees that, should the Board reject this Stipulation and if this case proceeds to hearing, Respondent will assert no claim that the Board was prejudiced by its review and discussion of this Stipulation or of any records relating hereto;
C. Respondent expressly waives formal hearing on all facts and legal conclusions referenced herein and any and all procedures before the Board relative to said facts and conclusions to which he might otherwise be entitled by law;
D. Respondent does not contest the facts and conclusions hereinafter following and grants that the Board may, for purposes of its proceedings relating to this Stipulation, consider the following as true:
1. Respondent's date of birth is April 28, 1961. He graduated from Northwestern College of Chiropractic in 1987. Respondent was licensed by the Board on January 14, 1989, and practices in Burnsville, Minnesota;
2. At the conference on January 20, 1994, the following conclusions, among others, were reached by the Board Complaint Panel with respect to the several allegations set forth in the Notice of Conference:
a. Respondent falsely notified one or more insurers that patients had not previously experienced the same or similar conditions;
b. Respondent made a number of incorrect diagnoses or diagnoses not borne out by patient symptoms nor substantiated by patient records. For example, Respondent's diagnosis of a herniated disc in one instance was clearly ruled out by prior testing;
c. Respondent has failed to maintain adequate patient records in that he has failed to document improvement, treatment plan changes and referrals. He has also failed to maintain daily notes and to adequately document patient billings. Additionally, in connection with the use of TENS units, Respondent has inappropriately recorded patient conditions prior to progress examinations.
3. Respondent practiced chiropractic without a renewed license from January 1 to January 20, 1994;
4. Proof at hearing of one or more of the allegations set forth in the Notice of Conference With Complaint Panel would empower the Board to take disciplinary action against Respondent's license and to assess Respondent the cost of the. proceedings. See Minn. Stat.§§ 148.10, subd. 1(11), (11)(a), (d) and (f); (14), (18) and (20) and subd. 3 and 148.105, subd. 1 (1992).
E. NOW, THEREFORE, IT IS FURTHER STIPULATED AND AGREED that upon this Stipulation the Board may forthwith adopt and implement the following Order:
1. Beginning three (3) days from the date of this Order, Respondent's license. is suspended, During the suspension, Respondent shalt not provide or assist in the provision of chiropractic care to any patient or engage in any other procedure or practice which may be undertaken in this state only by licensed health personnel or by the lawful delegates, assistants, technicians or aides of such personnel. The suspension shall terminate without further proceedings thirty-three (33) days from the date of this Order;
2. Within sixty (60) days of the date of this Order, Respondent shall attend a recordkeeping course, approved in advance by the Board, of not less than four (4) hours;
3. Within 150 days of the date of this Order, Respondent shall provide patient records as may be requested by the Board to review for compliance with Minn. R. 2500.5000 relative to recordkeeping. Nothing herein shall be construed to limit or otherwise to be in derogation of the Board's authority to obtain patient records under Minn. Stat.§§ 148.104 and 214.10 subd. 3;
4. Respondent shall make arrangements to take and shall take the Special Purposes Examination for Chiropractic (SPEC) no later than September 1994. Respondent shall pass the examination with the recommended passing score of the National Board of Chiropractic Examiners of not less than 375. If Respondent fails to sit for the examination or fails to obtain a passing score, his license shall be suspended immediately upon written notification from the Board. Such suspension shall remain in effect until Respondent takes and passes the examination;
5. Any and all costs associated with Respondent's compliance with the terms and requirements of this Order, including the recordkeeping course under paragraph 2 and the SPEC examination under paragraph 4, shall be borne by Respondent;
6. Respondent shall reimburse and pay the Board a civil penalty in the amount of $5,000. An initial payment of not less than $1000 shall be remitted to the Board within sixty (60) days of the date of this Order. Respondent shall pay the remainder in three installments of not less than $1,333.33 each. Said installment payments are due not later than August 1, 1994, November 1, 1994, and February 1, 1995. All payments shall.be made by certified check, cashier's check, or money order, payable to the Minnesota Board of Chiropractic Examiners;
a) Respondent's failure to comply with any term, condition or requirement of this Order shall authorize and empower the Board to suspend Respondent's license for an indefinite period of time;
b) The existence of any violation or cause referenced in 7a), immediately above, shall be determined by the Board at a regular or special meeting thereof. Respondent shall be given not less than thirty (30) days notice of the meeting. The notice shall specify all allegations and shall be accompanied by copies of all supporting documents and any written statements to be submitted to the Board. Respondent may likewise submit documents and written statements and shall have the opportunity to address the Board at the meeting. The Board's decision shall be based upon its judgment as to the preponderance of the evidence;
c) Any decision of the Board under this part indefinitely suspending Respondent's license shall be final and binding upon Respondent and shall not be subject to judicial review or to a judicial stay pending any attempt by Respondent to seek such review. In the event the Board indefinitely suspends Respondent's license as provided under this part, Respondent shall not petition for reinstatement earlier than six (6) months from the date of suspension.
8. This Order and the Stipulation of which it is part, including all attachments hereto, shall be deemed to be public documents.
F. IT IS FURTHER STIPULATED AND AGREED that this Stipulation shall not in any way limit or affect the authority of the Board to initiate contested case proceedings against Respondent on the basis of any act, conductor omission of Respondent occurring before or after the date of this Stipulation which is not related to the facts, circumstances or requirements referenced herein;
G. Respondent has voluntarily entered into this Stipulation without threat or promise by the Board or any of its members, employees or agents, and after consultation with and advice from Respondent's counsel;
H. This Stipulation contains the entire agreement between the parties, there being no other kind, verbal or otherwise, which varies this Stipulation.
ROBERT J. SHELTON, D.C.
Upon consideration of this Stipulation and all of the files, records and proceedings herein,
IT IS HEREBY ORDERED that the terms of this Stipulation are adopted and implemented by the Board 24th day of February, 1994.
OF CHIROPRACTIC EXAMINERS
LARRY A. SPICER, D.C.
BEFORE THE MINNESOTA
BOARD OF CHIROPRACTIC EXAMINERS
In the Matter of
NOTICE OF CONFERENCE
TO: Robert J. Shelton, D.C., 2125 North Frontage Road, West Highway 13, Burnsville, Minnesota 55337
YOU ARE HEREBY NOTIFIED that a Complaint Panel of the Minnesota Board of Chiropractic Examiners has scheduled a conference to discuss activities which could affect your license as a chiropractor. The conference will be held on Thursday, January 6, 1994, at 10:00 AM, in Suite 20, Colonial Office Park Building, 2700 University Avenue West, St. Paul, Minnesota 55114.
Specifically, the Board has received information which indicates or alleges as follows:
1. You failed to practice chiropractic at a level of care, skill and treatment which is recognized by a reasonably prudent chiropractor as being acceptable under similar conditions and circumstances. Examples include the following:
a. With respect to patient BW:
1) You provided a diagnosis which was clearly ruled out by testing prior to the diagnosis. You informed Minnesota Mutual Fire & Casualty Co. that patient BW had a herniated disc, while the MRI report specifically stated "no disc herniation";
2) You failed to note a previous history of a related condition;
3) There is no documentation of improvement of the patient's condition, change in treatment plan, evidence of a referral or further evaluation:
4) There is no order for, or justification for, duplicate x-rays including AP, lateral lumbar and cervical;
b. With respect to patient JR:
1) The diagnosis is not supported by the history and examination;
2) Your examination of two areas is inappropriate since the patient intake form indicates only one area of involvement.
c. With respect to patient JH:
1) Examination notes do not show the range of motion in degrees;
2) Patient records do not support the charge for an extensive new patient examination;
3) There is no indication in the patient record of the need for hand x-rays for carpal tunnel syndrome which were taken on two occasions;
4) You failed to maintain daily notes from July 3, 1991, to August 23. 1991. In addition, there are no daily notes after January 13, 1992;
5) There are no patient notes to support the billing of $86.00 on September 11. 1991;
6) Patient notes dated October 4, 1991, do not indicate that any adjustment or manipulation was performed and state only "massage";
d. With respect to patient CJ:
l) Patient CJ did not present with an radicular symptoms; however, you made a diagnosis of acute disc herniation. In addition, she had no complaint of I..BP, yet you have a diagnosis of lumbar sprain/strain:
2) There are no patient records to support the charges of $66 on November 20. 1991;
3) Patient records do not support the need for the comprehensive examination performed on November 26, 1991;
e, With respect to patient KB:
1) Patient records do not support the need for the comprehensive reexamination on April 6. 1992;
2) The diagnosis of intercostal neuritis is not substantiated by the patient records. There is no evidence of thoracic sprain/strain;
3) Patient KH complained of dislocating her left shoulder. There is no evidence in the patient record that you examined her shoulder,
f. With respect to patient TJ:
1). On November 7, 1990, patient TJ slipped and fell on the ice. There is no evidence in the patient record that an examination was performed to determine the extent of any new injury;
2) According to the attending physician's report, you stated the existence of L5/S1 nerve root impingement and nerve root irritation at C1, C2 and C5. Standard X-rays are not diagnostic to enable you to arrive at this conclusion;
3) There are no patient records to support the charges billed on October 25, 1990;
4) There are no daily patient records for the office visit on February l, 1991;
5) On February 21, 1991, you charged $50 for a consultation; however, there is no mention of the consultation or documentation of the necessity for the consultation in the patient notes;
6) There are no patient records to support the charges billed on arch 18, 1991:
7) You charged $30 for an "activities of daily living" consultation on April 3, 1991; however this consultation is not documented in patient notes. Your report dated April 30, 1991, shows that his consultation consisted of a patient history which should have been included in the five extensive examinations you conducted:
8) There are no patient records to support the charges billed on April 29, 1991;
9) The charge for a comprehensive examination performed on April 29, 1991, is not supported by the patient records:
10) The need for an extensive reexamination on June 12, 1991, is not supported by the patient records;
11) There are no radiographic findings in the patient notes for each x-ray study taken after January 1991;
g. With respect to patient JR II:
1) One year post injury you diagnosed patient JR II as having "acute lumbar disc herniation with grade 3 muscle splinting," There was no indication from the patient history or examination that disc herniation existed. An MRI dated June 25, 1991, ruled out any disc involvement;
2) You also listed acute cervical sprain/strain with headaches: however, there is no mention in the patient record of any neck pain or headaches;
2. You charged unconscionable fees or for services not rendered. Examples include the following:
a. X-ray fees for patient BW are excessive based on the fact that there is no written justification and some are duplicate views. The AP and lateral lumbar and cervical views duplicate films previously taken elsewhere;
b. The charge for the "extensive" examination of patient JR was excessive based on the limited nature of the examination;
c. Forty dollars for a new patient consult for patient JR is unconscionable and should be included in the initial examination charge;
d. On August 18, 1991, you provided a TENS unit for patient JR. The unit was returned on August 19, 1991. Charges for the TENS unit are unconscionable and should be limited to a single therapy charge and one day rental;
e. You charged patient JR for two manipulations at the Sunday extra fee rate when these manipulations were performed during the same visit;
f. You charged $50 for a telephone conversation lasting approximately 10 minutes with patient TJ's insurance agent to provide information to unanswered questions relating to the insurance company request dated March 2.2.1991;
g. You charged $75 for an extensive reexamination of patient TJ on March 29, 1992; however, there is no indication that an examination was performed;
h. The charge for a comprehensive examination performed on April 29, 1991, for patient TJ is. not supported by the patient records;
3. You perpetrated fraud upon patients and third party payers when you falsified information in a "Medical Necessity and Prescription for Durable Medical Equipment" form submitted ta Alta Health Strategies insurance. You stated that patient JR was monitored during a 14-day trial period, received thorough training on the TENS Unit, derived significant pain relief and that continued use of the TENS would result in significant alleviation of pain. Patient JR used the TENS unit one day.
The issues ta be determined at the conference are (1) whether the foregoing allegations arc true, and (2) if they are, whether the Board should revoke, suspend or take other action against your license. See Minn.Stat. § 148.10, subd. 1 (11) (a), (d) and (f); (14), (18) and (20) (1992). You are urged to attend the conference.
YOU ARE FURTHER NOTIFIED that one of the following actions could be taken as a result of the conference:
1. The Board Complaint Panel and you could enter into a stipulation permitting the full Board to issue a mutually agreed upon remedy or order:
2. The Board Complaint Panel could enter into an agreement with you for corrective action: or
3. If settlement is not possible. a contested case hearing may be initiated under the Administrative Procedure Act, with the full Board issuing its order following the hearing.
YOU ARE FURTHER NO'IIFIED that under the Minnesota Government Data Practices Act. Minn. Stat.§ 13.01 et seq. (1992), information given to the Board as part of an active investigation is confidential. Such information is used by the Board in evaluating complaints made against licensees. Pursuant to Minn. Stat. § 148.104, (1992), you are required to cooperate fully by responding promptly to any question raised by or on behalf of the Board relating to the subject of the investigation and by providing copies of client or other records in your possession. If you refuse to supply requested information, you could be subpoenaed and required to respond or an enforcement proceeding could be initiated against you. In accordance with the statutes, rules, and professional standards governing legal actions, information received at the conference covered by this Notice may in some circumstances be disclosed to certain other persons or entities, including the Board members and staff, staff of the Attorney General's Office, and persons whom they contact. Should this matter proceed to a contested case proceeding, information may be disclosed to the Minnesota Office of Administrative Hearings and any reviewing court,
YOU ARE FURTHER NO'IIFIED that you may choose to be, though need not be, represented by an attorney at this conference, that a tape record may be made of the conference, and that anything you say may be used as evidence against you should the matter proceed to a contested case hearing at a later time. Be further advised that the conference is designed to permit the Panel to seek and clarify information to provide you with an opportunity to clarify possible misunderstanding, and to allow the Panel and you to attempt to remedy the problems alleged without the necessity of instituting formal action.
Please confirm your conference attendance by contacting me at the earliest possible time.
Dated: Nov. 1, 1993
MINNESOTA BOARD OF
Larry A. Spicer, DC
Telephone: (612) 642-0591
This article was posted on September 18, 2016