Cost of Care

Department of Veterans Affairs comes down on two local officials after investigation into Cincinnati’s VA Medical Center

click to enlarge The Cincinnati VA Medical Center has been through two federal investigations in two years.
The Cincinnati VA Medical Center has been through two federal investigations in two years.

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he last few years have been turbulent for the Cincinnati Veterans Affairs Medical Center and others across the country, and a recent investigation into scandals at Cincinnati’s branch has led to the investigation of two top local officials.

Dr. Barbara Temeck, the Cincinnati clinic’s acting chief of staff, and Jack Hetrick, the director of the regional Veterans Integrated Service Network, are facing possible criminal investigations after federal review of the clinic in February found that Temeck was prescribing hydrocodone and a generic version of Vailum to Hetrick’s wife. Officials say Temeck’s license is not valid to prescribe medication privately.

On Feb. 25, the U.S. Department of Veterans Affairs’ chief executive, Dr. David Shulkin, reassigned Temeck to non-patient care and suspended her privileges until further notice. Hetrick submitted his retirement notice before the federal government could take action on a request by Sloan Gibson, the national deputy secretary of veterans affairs, to remove him from his position.

The Department of Veterans Affairs released a statement saying the decisions were made based on the preliminary results of a September review of the clinic by the VA Office of Medical Inspector and the Office of Accountability.

“We are committed to sustainable accountability,” said Gibson in a statement. “We will continue to use VA’s statutory authority to hold employees accountable where warranted by the evidence. That is simply the right thing to do for veterans and taxpayers.”

Cincinnati’s VA Medical Center is part of the national Veterans Health Administration system, which has more than 1,300 facilities. The Cincinnati VA has divisions in Cincinnati and Fort Thomas, Ky., including a 258-bed hospital and six outpatient facilities. It serves more than 40,000 Cincinnati-area veterans in 17 counties, providing programs for trauma, Post Traumatic Stress Disorder, physical therapy, women’s health and services for LGBT veterans.

The February investigation into Cincinnati’s VA center was prompted by a WCPO and Scripps News Washington Bureau investigation into whether Temeck was abusing the federal Veterans Choice Program to pad the clinic’s budget. Veterans had been claiming they saw a decrease in quality of care, and WCPO reportedly interviewed 34 whistleblowers over the course of four months.

The $10 billion Veterans Choice Program allows veterans to find their own doctors if they either live more then 40 miles away from the nearest clinic or who would have to wait more than 30 days for an appointment. A separate pool of taxpayer dollars outside the VA’s budget pays for such care.

The Veterans Choice Program was created by Congress in 2014 after a scandal erupted in the department after CNN reported that at least 40 veterans had died waiting for an appointment in the Phoenix VA health care system.

WCPO reported that the Cincinnati VA Medical Center, under Temeck’s command, cut and reduced services in some areas like neurosurgery and orthopedics in order to shift them to outside facilities under the program to pad its own budget. Veterans complained about worse care and an increase in the amount of confusing bureaucratic red tape they faced.

The preliminary results of the federal review did not find any evidence for wrongdoing on Temeck’s part for contracting out medical procedures or the quality of veterans’ care. The disciplinary action taken against Temeck and Hetrick is based on Temeck’s unlawful prescribing of medication.

The federal government has not said when it will release the full report and that it is still investigating the clinic. It has appointed Robert McDivitt as the acting network director for the region to replace Hetrick. McDivitt previously worked as the Medical Center director for the VA clinic in Ann Arbor, Mich. Dr. Ralph Panos, the chief of medicine at the Cincinnati VA medical center, will replace Temeck as acting chief of staff.

Temeck became the center’s acting chief of staff in July 2013. She previously had been the deputy chief of staff at the St. Louis VA clinic.

The VA said Temeck’s salary and benefits and Hetrick’s retirement package would remain the same. Temeck earns $331,534 a year for her role as the acting chief of staff and a cardiothoracic surgeon, according to WCPO.

The national VA system has faced scrutiny during the past two years over criticisms of long wait times and issues of short staffing at clinics that directly affect the quality of care for veterans. The Cincinnati clinic has seen its share of these problems.

The federal government investigated the Cincinnati VA Medical Center in 2014 for possibly manipulating scheduling records to make wait times appear shorter. The investigation found no evidence of this misconduct, but did find the waiting time for the clinic’s new patients was higher than required.

In January of 2015, more than 2,000 of the Cincinnati clinic’s employees held demonstrations claiming short staffing was causing them to be overworked. Nurses said poor sanitation and housekeeping services caused by the shortage were taking a toll on patients.

VA Secretary Bob McDonald testified Feb. 23 in front of the Senate Committee on Veterans Affairs, saying he would look into alleged issues brought up by the whistleblowers at the Cincinnati clinic, which he said historically has been a “five-star facility.”

“It is an important facility. It has been historically a good facility,” McDonald said. “We need to dig into this and find out whether or not these allegations are supported and then take action as quickly as possible to remediate them if they are.”

McDonald, the former CEO of Procter & Gamble Co., took the position to head the VA in July of 2014, amid the department’s wait time scandal. He has pledged to turn the system around by holding employees more accountable and told the Senate Veterans Affairs Committee last month that he has fired about 2,600 people during his 18 months in office.

Ohio Sen. Sherrod Brown in a statement commended McDonald for the action resulting from the investigation.

“Today’s action is long overdue, and I’m glad to see Secretary McDonald following through on his commitment to me to fix the problems at the Cincinnati VA and hold individuals accountable,” Brown said. “VA management has to deliver the kind of leadership that our veterans deserve — committed and transparent.”

Ohio Sen. Rob Portman called the allegations “deeply disturbing.”

“Those who have served their country in uniform are entitled to the best possible medical care,” Portman said in a statement, “and the public deserves to have confidence in the good judgment and professional integrity of those in charge of that care.” ©

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