In Part Two we juxtaposed the VA’s purported “core values” with how their performance is perceived.
On January 30, 2021,“VA’s Survey of Healthcare Experience of Patients” was published online by the US Dept of Veterans Affairs Vantage Point – the blog of the VA.
They made the mistake of opening up the website to comments by veterans. Comments which were quite a shocker to the editors I’m sure. I quickly copied them in case the website later took down the article. The article began with “The best information we receive on how well VA serves Veterans comes from Veterans themselves. Shortly after a visit to a hospital or clinic, Veterans may receive a survey that asks them about their visit.” But look who is doing the survey: The VA Office of Quality and Patient Safety, Analytics and Performance Integration Division, Office of Performance Measurement.
Look how fast Veterans responded with comments, in their own style of writing, to that article printed on January 30, 2021…
(Veteran) Robert Taylor, February 1, 2021 at 7:18 am:
I had good care at the temple VA hospital. Sadly the hospital/clinics were overwhelmed with new patients. My care went to poor when a PhD in pharmacy attempted to treat my diabetes.
I then transferred to Shreveport VA hospital and my care was spotty.
Terry G McCreary, February 1, 2021 at 8:13 am:
Overton Brooks VAMC doesn’t care for patients. I am in serious pain with my rt knee. I am being put aside.
Joseph Frigge, February 1, 2021 at 6:02 am:
When lab warnings are ignored by Primary NP for over a year then when it is finally addressed it’s too late. I have full blown Cancer. Another time I called for increased pain in my back and shoulders. Again I was ignored and not given anything. I finally ended up in a local ER where I received a shot for the pain and given 80mg of Prednisone per day to fight severe infection. Still no apology from the VA.
David Schrader, February 1, 2021 at 4:23 am:
Most of my healthcare providers have been great.
I am diabetic and been having substantial spikes in my blood sugar tests.
The Southern Nevada Healthcare system hospital refuses to let me see an endocrinologist. That has been over two years since I have been in to see an endocrinologist. I would rate this situation as a minus 10. This has been before the Chinese COVID-19, so the VA can’t use COVID-19 as an excuse.
Dennis Keogh, January 31, 2021 at 9:43 pm:
Tried getting help with billing. Could never get to a person in billing for my question. (Yes Vets get billed for healthcare).
Robert Vangelisti, (typed his in capital letters) January 31, 2021 at 7:56 pm:
THE WORST CARE EVER. I’m 72. I’VE CALLED EVERYONE AND SO FAR NO ONE WILL CALL ME BACK. WITHOUT ANY RESEARCH YOU ARE A JUNKY IF YOU NEED PAIN MEDS. OR MEDS.TO BREATHE OR TO EAT THANKS
Yvonne Bivins-Washington, January 31, 2021 at 7:51 pm:
The VA Biloxi, MS is most bias with Black RNs doing orientation. If the powers at be doesn’t like you, you’re gone, especially if they feel threaten by your wealth of knowledge.
Paul J Glova, January 31, 2021 at 7:44 pm:
I live in Tennessee and the VA healthcare that I receive here is the worst care that I have ever experienced. The funny thing is when you mention it to someone who works at or with the VA here, their reply is “yeah, I know”. And nothing ever gets done about it.
Nathan Jackson, January 31, 2021 at 7:41 pm
I have no healthcare I don’t even expect to survive much more than a year or two half my injuries aren’t even in my medical records I noticed they won’t combine my medical records in any way United Healthcare has one half VA has another half none of them are talking about what happened to me during an endoscopy that I didn’t even need 2016 before and after CT’s tell enough. I have over half a dozen torn ribs smashed out of place even severed organs and body parts that no one will talk to me about that won’t give me anything for it and tell me anything about it it just gets ignored and that’s not even my military injury or why I even went in there that’s not even in my medical records. I don’t have the ability to do this anymore.
This new online travel reimbursement is worthless. Can’t get response when you try to register online for an account. Call the number given for assistance it rings several times and you get hung up on.
Carla J. Snider, January 31, 2021 at 7:09 pm:
I get tired of feeling like I fall into a crack. Being a female, 100 percent service connected I think I see it more than men do. Dr’s don’t listen when you see them. New Primary didn’t know what meds I was on. Home Health company can’t seem to get proper paperwork or old phone numbers that are no long in service. Then when you do get ahold of a supervisor they say they have asked them to fix it they don’t. Now for over a year. Interns who have never been showed how to start an IV seem to make us their experiment. Ask a Nurse for help and they say they are not allowed to.
In August 2020, I was admitted to the Mather VA Hospital for a AFIB Heart. While in Intensive Care I kept asking for water to drink but the staff would not provide any. I was very dehydrated. The second day they jump started my heart and it return to its normal rhythm. Stop no water except for small pill container cups. I got so upset that I got up and walked out. This is not care.
I called on the 1-29-21 to schedule an appointment with my Doctor for my Annual checkup. Now in 2019 and 2020 I underwent Radiation and Chemo for Prostate Cancer. The earliest appointment was September 2021. I could have a telephone appointment for a earlier but how does a Doctor review my Rash? Is this quality Medical Treatment?
Ronald E. Chan, January 31, 2021 at 5:36 pm:
I was injured April 14, 2018, and a snow storm was going on in Minnesota, and the Ambulance couldn’t take me to our VA Hospital in the Twin Cities. I was taken to our local Hospital where I received excellent care. My wife reported it to a local VA number and was told after insurance paid, out of pocket costs will be taken care of. After a number of months the Providers told me if you don’t pay the out of pocket cost to us it will go to court. When I got that information I again contacted the VA and was told not to pay the out of pocket costs. The 6 Providers that I had again reaffirmed pay up or else, in so many words. I then paid $2792.72 to 6 Providers.
I called the VA back and was told to send the Statements to a address in Ft. Harrison, Mont for payment to me. After a number of months with no payments, I again called the VA and told me I was given the wrong information, that the Providers have to send the Statements to Minneapolis VA, then is sent to St. Cloud, Minn. VA, and they send to Ft. Harrison, Mont, which I did. After a few months with no payment to me I just gave up on it. Was told to call VA in Denver on instruction, which I did. Was told to call all 6 providers back and they should submit a message with the statement to VA Care in Tampa, Fla. which they did. That was in Oct. 2020. Since then I have talked to Denver twice with no results. What is going on with the VA?
Matt Ovaska, January 31, 2021 at 2:11 pm:
Can’t do a survey on the health care I could not get…The VA Hosp does not answer their phone. You can’t just show up. I called the president’s hot line. They answered but hung up when I asked them about Agent Orange. Just sayin.
To reiterate, these Veterans’ comments were posted electronically to the magazine named above WITHIN HOURS of the publication bragging about good health care and asking Vets for comments.
During my 2014 investigation, I learned the following: Twenty-percent of Veterans’ Affairs doctors and providers had been disciplined for everything from leaving surgery to misreading charts. But they still received a performance bonus.
A Professional Standards Board found that a radiologist failed to read mammograms and other complex images competently. The radiologist’s privileges were reduced. But that person got an $8,200 bonus anyway. A surgeon who was supervising residents left the operating room and medical center before the surgery was completed, allowing residents to continue the surgery without supervision. The surgeon was suspended without pay for 14 calendar days. But he received an $11,000 bonus anyway.
One physician refused to see assigned patients in the emergency room because the physician believed patients had not been triaged appropriately by the emergency department nurse. As a result, 15 patients waited more than 6 hours to be seen, and 9 patients left without being seen. The physician was reprimanded. But the physician received a $7,500 bonus anyway.
“I am at a loss to understand why the VA has a bonus program anyway which pays large amounts of cash. Police and firefighters don’t,” Breck Porter, a Veteran, former member of a national veterans group and former editor of The Police News told me for my first investigation into the VA. “I am amazed every time I go to the Houston VA (named after Michael E. DeBakey) to see how many employees sit around with nothing to do but trying to act like they are busy. Disgusting.”
Porter and I were discussing a GAO (Government Accountability Office) report that lambasted the VA. In the report, it was noted that one physician practiced with an expired license for 3 months until the medical center discovered the situation. The physician was reprimanded, but received a $7,600 bonus.
It took years for this reporter to get an explanation of how the system of bonuses is set up. “In order to recognize high performers, agencies should allocate awards in a manner that provides meaningfully greater rewards to top performers,” the acting Office of Personnel Management Director told the Federal News Network in 2019, “Only the best should receive top recognition and honors from their agencies,” she said. At that time, President Trump had just signed an Executive Order making it easier to fire VA employees for poor care.
There have been attempts at fully describing how VA employees receive a rating of at least “fully successful” in evaluations of their work. The scale’s ratings are “Unacceptable,” “Minimally Successful,” “Fully Successful,” “Exceeds Fully Successful” and “Outstanding.” And these could be the factors that reportedly get used to justify a bonus. But no one at the VA will confirm that.
Finally, in November 2020, a federal employee named Jessica Lycos agreed to ask, on my behalf, how it all works. Her source was Sidath Viranga Panangala, Specialist in Veterans Policy of the Congressional Research Service. Panangala refused to admit to a “bonus” fund. He claimed there are both performance awards and incentive payments for Recruitment, Relocation, and Retention, and actually took me down the path of government gobbledygook by saying, “Appointments under 38 U.S.C. 7401 (physicians, nurses, dentists etc.) may be paid bonuses authorized under 5 U.S.C. 5753, extended to title 38 employees under the authority of 38 U.S.C. 7410, and are governed by regulations in 5 CFR part 575, subparts A and B, and the provisions of VA Handbook 5007.
Are your eyes glazing over yet?
“VA may pay federally insured student loans as an incentive for candidates or current employees of the agency to attract and/or retain highly qualified employees. There are specific funds for these purposes for example, the Education Debt Reduction Program (EDRP), the Employee Incentive Scholarship Program (EISP), and the Health Professional Scholarship Program (HPSP). There is no specific account or set-aside for performance awards,” said Panangala.
But being a good “fed” Panangala just had to keep going… and it’s important that you read these new guidelines since no other reporter has this…
“P.L. 113–146, title VII, §705, Aug. 7, 2014, 128 Stat. 1798 , as amended by P. L. 114–198, title IX, §951, July 22, 2016, 130 Stat. 778 ; P.L. 115–182, title III, §305, June 6, 2018, 132 Stat. 1469 , provided that:
“(a) Limitation.-The Secretary of Veterans Affairs shall ensure that the aggregate amount of awards and bonuses paid by the Secretary in a fiscal year under chapter 45 or 53 of title 5, United States Code, or any other awards or bonuses authorized under such title or title 38, United States Code, does not exceed the following amounts:
“(1) With respect to each of fiscal years 2017 through 2018, $250,000,000, of which not less than $20,000,000 shall be for recruitment, relocation, and retention bonuses.
“(2) With respect to each of fiscal years 2019 through 2021, $290,000,000, of which not less than $20,000,000 shall be for recruitment, relocation, and retention bonuses
“(3) With respect to each of fiscal years 2022 through 2024, $360,000,000.
“(b) Sense of Congress.-It is the sense of Congress that the limitation under subsection (a) should not disproportionately impact lower-wage employees and that the Department of Veterans Affairs is encouraged to use bonuses to incentivize high-performing employees in areas in which retention is challenging.
Panangala pulled a lot of his responses to me from the Mission Act of 2018 which was sold to Americans as giving Veterans greater access to health care in VA facilities and the community, but kept the bonus trough flowing by inserting the following phrase: “improve VA’s ability to recruit and retain,” which may be code for “keep the bonuses alive or lose Democrat-registered federal employee votes.”
And Panangala did point out the gravy boat was kept afloat by none other than the Coronavirus Aid, Relief, and Economic Security Act, “CARES Act” which made some exceptions to the Waiver of Pay Caps for Employees of Department Of Veterans Affairs During Public Health Emergencies. In other words, “you don’t have to give great care during a pandemic, just clock in and you’ll get a bonus.”
VA Truth Tellers
Toward the end of President Trump’s tenure, his Secretary of the VA Robert Wilkie, had some TV advertising money left over. He got the message, “use it or lose it.” That’s why the TV networks launched a series of commercials bragging about nice new facilities and a new satisfaction survey which alleged that American Vets liked their care at the VA hospitals. But it was bunkum. Ask a Vet; walk up to any Vet in front of any hospital and ask him yourselves; and ask people you trust about “survey tools.” One thing I learned during my masters degree studies is that your survey is only as good as the tool – the questionnaire – how it is worded; what the tone of voice the interviewer, or even the document has; what kind of mood the interviewee was in that day; the length and complexity of the questions; the mood of the interviewee. If you remember, the Wilkie TV commercials went away around January 6, 2021, and so did Wilkie.
Shea Wilkes, a VA whistleblower in Shreveport, Louisiana, co-founded a national employee group known as VA Truth Tellers, Dennis Wagner of the Arizona Republic newspaper recently reported. She analyzed other surveys and said survey responses verify that department leadership at all levels in the VA “is poor due to cronyism, manipulated hiring practices, lack of accountability,” and other issues.
Some employees at the beleaguered Phoenix Veterans hospital were striving for improvement, Wagner and Wilkes reported, but most believed they lack the leadership and resources necessary to carry out that mission, according to a U.S. government worker survey filled with grim data on job conditions and workplace satisfaction.
One of the most alarming survey results involved a question of accountability. When workers were asked if VA leaders take appropriate action to deal with “poor performers,” negative responses were more than double the positive ones. Barely one-quarter said pay raises are based on job performance.
The results suggest that Phoenix VA employees are doubtful that administrators have the ethics and management skills to lead them.
“The majority of VA employees know what was reported by whistleblowers was true,” Wilkes said, “yet over and over their leaders have denied any wrongdoing.” Ironically, the year before the Phoenix VA chief of staff Dr. Deering was ousted, VA employees in Phoenix went to Congress and the media exposing mismanagement and delayed care for veterans, some of whom died awaiting appointments. As stated above, Deering and others got their bonuses anyway.
The controversy spread across America as investigators verified that VA hospitals were falsifying appointment data while administrators collected bonuses for efficiency. The scandal led to then-VA Secretary Eric Shinseki’s resignation and passage of a $15 billion VA reform bill. But the VA reform bill did not improve quality of care; it did obtain more equipment, bonuses and salary money for staff.
Shinseki greased the revolving door for Wilkie who greased the hinges for President Biden’s Secretary – Denis McDonough. It doesn’t matter who is in charge, not president nor secretary – because bad care, misuse of funds and abuse persist. One employee at VA Prescott told me, “Changing the VA is like making an aircraft carrier do a U-turn.”
A collection of bad care, abuse, fraud and waste articles are on the website v.a. care sux and the VA Truth Tellers site.
“Whether it’s shuffling problem employees from one location to another instead of disciplining them or repeatedly paying out bonuses with reckless abandon, VA’s habit of coddling those who can’t or won’t do their jobs is as well documented as it is disgraceful,” said Rep. Jeff Miller, R-Fla., chairman of the House Veterans’ Affairs Committee to another national newspaper.
As concerns continued to be raised about the performance review process used to evaluate workers, the number of VA employees receiving bonuses jumped by more than 20% and the total amount paid out increased by 24%. Rep. Miller said the fact that the bonuses have continued throughout a period of major scandals, including one involving veterans facing long waits to receive treatment, shows that the agency “cannot be trusted to fix this problem on its own.”
Even the staff in VA’s Office of Construction and Facilities Management is under scrutiny for lying to conceal cost overruns.
At a House Veterans Affairs Committee hearing, Rep. Miller described an “outlandish bonus culture” at the VA. All 470 senior VA executives were scored as fully successful or higher in their performance in 2013, according to committee testimony; in fact, going back four years, no executive had been scored in the lower two categories.
On Memorial Day, I celebrated the lives and deaths of my family members who served in the military, including my Dad, who lived his last five years in Las Vegas. He was eaten up by skin cancer and all the Las Vegas VA would do was keep carving on him. By accident one day when touring Nellis AFB, in Nevada, a Colonel-surgeon noticed his skin and inquired. Later the Colonel said, “Come to me (on base); don’t go to the VA hospital.” He may not have cured cancer but he put my Dad into a comfort zone the VA staff never would have figured out in Dad’s last days.
In the interest of full disclosure, this reporter is a Veteran who receives (bad) care at the Prescott VA. One request for my medical chart resulted in me receiving a retired Navy officer’s chart who lived 15 miles from me. That act by the VA employee could be a violation of the Health Insurance Portability and Accountability Act.
On numerous occasions I drove up to 90 miles to get copies of my medical charts from outside providers who were hired under the Community Care program because the VA was not communicating with them or the VA had lost their printed diagnoses.
Bad care, bad attitudes and condescending conversations experienced by this Vet/news reporter resulted in numerous complaint letters that were never answered so I now address my complaints to the Prescott hospital Director and copy the Secretary of the VA in Washington and U.S. Senator Kyrsten Sinema.
One nurse told me she was not prepared to talk about so many health issues in one conversation and hung up the phone on me. Her team’s CMA (certified medical assistant) called me to set up an appointment with the doctor and when I asked if he would convey a message to the doctor, he refused. Another nurse refused to send me my laboratory test results, so my three-prong letter went out and he eventually supplied it to me.
One of my VA doctors said she could get me into a special trial for people with my eye condition. I checked back a month later and she apologized saying that she forgot to mail in the application by deadline time. When I developed back problems, the VA prepared a CT Scan of my head for a spine surgeon. I had to round up my back x-rays and spinal MRIs from outside providers and hand-carry them to the spine surgeon.
For years we Vets were able to direct dial our doctors or nurses but the Prescott VA took that option away a couple years ago, opting for a new process. For a while, we had to go through a call center, usually employed by flunkies who can’t spell medical terms and often get the message wrong. I had to spell ‘retina’ to the call center employee during one conversation. So what we ended up with was a call center person in Los Angeles who decided whether we could get a message to our Arizona doctor. He then would email a Triage Nurse who might call us back and make more determinations such as hospitalization, or if we could have the pleasure of speaking directly to our care team.
Members of the American Legion Posts and the VFW clubs in the Prescott area were afforded an opportunity to comment for this article and declined; voice them now, in our comment section!