Ken Hare In Depth: VA officials keep digging a deeper hole - WSFA.com Montgomery Alabama news.

Ken Hare In Depth: VA officials keep digging a deeper hole

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MONTGOMERY, AL (WSFA) -

The late, great Will Rogers once said, "If you find yourself in a hole, stop digging." That's advice that officials of the Veteran Affairs Department just can't seem to take to heart.

By now most readers know the gist of the horror stories about long waits for care and falsified waiting lists designed to hide those long waits and seriously ill patients who may have died while waiting.

But it just keeps getting worse. For instance, national news media are reporting that one whistleblower claims that in the past few weeks, Phoenix, Ariz., VA officials may have changed computer listings to hide the fact that patients are deceased in order to make it appear that fewer veterans died while awaiting care.

Meanwhile, here in Montgomery, a report has surfaced that a pulmonologist with the Central Alabama Veterans Health Care System copied old notes onto new charts for more than 1,200 patients at the Montgomery facility.

A letter from the U.S. Office of Special Counsel sent to President Obama outlined several problems -- including the Montgomery situation -- that show a "troubling pattern of deficient patient care" at VA facilities.

According to the letter, an investigation substantiated a whistleblower's claim that the pulmonologist copied prior provider notes into current patient records and that his action likely caused inaccurate patient health information to be recorded.

But here's the rub: Central Alabama facilities director James Talton told the Associated Press that the doctor is still employed by the VA because there is no indication the action endangered any patients.

What? Say that again? Falsifying patient records does not endanger patients?

That claim is absurd, of course. But it is that kind of runaround that is causing VA officials to dig the hole they created for themselves even deeper.

It is not just the Central Alabama VA facility where such claims are being made. Carolyn Lerner, who leads the U.S. Office of Special Counsel, wrote that the VA and the VA Office of Medical Inspector "has consistently used a 'harmless error' defense where the department acknowledges problems but claims patient care is unaffected."

News reports indicate such claims of patient care not being affected were made in cases where medical instruments were improperly cleaned or psychiatric patients went for years without being evaluated.

For instance, among problems reported by whistleblowers at the VA facility in Jackson, Miss., were "improper credentialing of providers, inadequate review of radiology images, unlawful prescriptions for narcotics, noncompliant pharmacy equipment used to compound chemotherapy drugs, and unsterile medical equipment."

 But apparently the VA did not feel these were issues that affected patient care. The special counsel's office is reviewing 50 such complaints from facilities around the nation.

Again, such claims are absurd on their face. But they apparently have been enough to keep anyone -- including the Montgomery pulmonologist -- from being fired.

It seems that it is almost impossible to be fired in the VA system -- unless, of course, you're a whistleblower who risks his or her job to report these abuses.

Meanwhile, CNN reports that 78 percent of 470 top senior managers qualified for bonuses last year by receiving ratings of "outstanding" or "exceeds fully successful." All 470 of them got ratings of "fully successful" or better.

Again, that is absurd. It is the Lake Wobegon Effect, where all children are above average.

Congress has suspended bonuses in the VA for a time span until investigations can be completed. But the VA should be asking every top manager whose rating was based in any way on falsified data to repay those past bonuses.

I wrote in a column recently that fixing what ails the VA should start with firings -- "lots of them." After learning about these latest disclosures, I am even more convinced that nothing will change without people being fired.

So let me repeat several of the recommendations I made in that earlier column:

-- Congressional watchdogs need to ensure that not just those schedulers who falsified records are fired. Any administrator who encouraged them to do so should be fired as well.

-- Any scheduler or supervisor who instigated or condoned falsifying records that resulted in their receiving bonuses should be the focus of a criminal probe. To falsify records may be a crime in and of itself, but to do so to receive a bonus sounds a lot like fraud, and should be treated as such.

--  Firings should not be limited to those who actively falsified or encouraged falsification of records. Those administrators who failed at their responsibilities to prevent such abuses should be fired or at least demoted, depending upon how culpable they are. And that includes top directors as well as those down the line. 

-- The entire bonus system in the VA (and probably other federal agencies as well) needs to be reassessed and overhauled, and maybe even ended.

Again, this is what should happen. But the more about the VA that becomes public, the less it appears that anyone will be held accountable.

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Ken Hare was a longtime Alabama newspaper editorial writer and editorial page editor who now writes a regular column for WSFA's web site. Email him at khare@wsfa.com.

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