VA Probe Confirms Long Wait List, Manipulation

By Walter F. Roche Jr.

An internal  investigation has confirmed that the Veterans Administration facility in Pittsburgh had 700 veterans waiting for appointments in 2014 and that staffers routinely manipulated data to hide the actual number of veterans facing unacceptable delays.
In a 22 page report on its probe of the allegations, the VA's Inspector General said it confirmed media reports that more than 700 veterans were on a New Enrollee Appointment Request (NEAR) list in May of 2014.
The "Administrative Summary" of the probe was made public late last week.
In addition after interviewing some 40 current and former employees and reviewing emails and other records, the IG found widespread evidence that staffers were manipulating data to hide the fact that veterans were not getting appointments within acceptable 30 day time periods.
In fact some staffers reported being told to make it appear that a veteran had no wait at all.
"Medical Support Assistant (MSA)  #1 confirmed he had been directed to schedule appointments in a manner that did not accurately reflect accurate wait times," the report states.
A former senior leader told investigators "it was her understanding that MSAs were being directed to manipulate appointment entries so that it appeared that performance standards were met when in reality standards were not being met."
According to the report some current and former staffers interviewed said they were not aware of any wait time manipulation. In some of those cases, however, investigators found emails and other evidence showing the same staffers did alter data despite the denials.
According to the report, a supervisor said "she became aware of a way to reset the 30-day time frame for scheduling appointments so that they did not exceed the 30 day requirement.
Another staffer said "she shortened wait times on her appointment only because those above her wanted her to do it.
Yet another staffer reported that she shortened wait time about 20 times from December of 2013 to March of 2014.
The cause of the lengthy delays, according to the report, were multiple and ranged from a shortage of medical professional to a logjam when a single staffer was assigned to set appointments for all veterans on the NEAR list.
The IG also looked into but did not confirm allegations that some staffers were given bonuses as a reward for manipulating data. The data showed one service chief received more than $45,000 in extra pay.

TB Case at VA Pittsburgh, PA

By Walter F. Roche Jr.

An unidentified veteran who has been a patient at Veterans Affairs facilities in the Pittsburgh area has been diagnosed with tuberculosis and is undergoing treatment.
VA Pittsburgh officials disclosed Wednesday that the patient was diagnosed Monday and is responding well to treatment. He has been a patient at the VA outpatient facility in Beaver County and the University Drive facility in Pittsburgh.
According to an announcement from the VA, no additional cases have been found but the agency is now notifying persons who may have come into contact with the ailing veteran and offering free testing. That process is expected to take several days, according to VA officials.
"While it is unlikely anyone potentially exposed will become ill, out of an abundance of caution we urge notified patients and employees to be tested, " VA Medical Director Karin McGraw said in a statement.
Tuberculosis is transmitted through the air and symptoms include coughing up blod, chest pain, fever, chills and night sweats.

Two PA Veterans Homes Cited in Sexual Assaults

By Walter F. Roche Jr.

Two state run veterans homes have been cited by the Pennsylvania Health Department for incidents in which female residents were sexually assaulted by male patients.
The incidents, one at the Hollidaysburg Veterans Home and the second at the Gino J. Merli Veterans Center in Scranton, triggered citations for violations of state law and regulations.
The two facilities, which have been the subject of several other critical inspection reports, are part of the state Department of Military and Veterans Affairs, which operates six such facilities statewide.
A third home, the Southwestern Veterans Home in Pittsburgh, was cited recently for an incident in which a veteran was seriously injured while being transported in a wheelchair. The home's license was put on a provisional basis as a result of the inspection.
Joan Nissley, a department spokeswoman, said the incidents at the Scranton and Hollidaysburg facilities "sparked a wide-ranging, multidisciplinary review that is still ongoing."
Asked if any employees were disciplined following the  incidents, Nissley said that while she could not comment on any specific personnel matter "we can state that appropriate disciplinary actions have been taken where applicable."
Nissley said there are 28 female patients at the Scranton home and 46 at Hollidaysburg. Overall 13 percent of all state veterans home residents are female.
At the Hollidaysburg Veterans Home a male resident, who had previously assaulted a female patient, entered that same female patient's room on Aug. 21 and pulled down her pants and touched her genitals then began masturbating.
A staffer saw the male patient leaving the female's room with his pants unzipped and his genitals exposed.
According to the report the female patient was bruised and had slight bleeding. She was sent to a hospital for an examination.
The female resident, the report continues, "was scared and very upset." She said she didn't ring the call button because she was scared
The Health Department report noted that following the incident officials at the home did not interview other female residents to ask whether they had ever been sexually assaulted.
The same male resident had assaulted the same female patient in April, the report states. He squeezed her breast two times on April 22 when she was seated in her wheelchair in a hallway.
Following that incident, staffers were advised to keep the male resident away from the female, the report states, but "there was no documented evidence that following the April 22 incident, the staff monitored Resident 1 (the male) when he was around female residents."
The 15-page report also faults the Blair County home for failing "to provide sufficient detail about a resident incident to the Department of Health regarding an incident which seriously compromised a resident's safety."
In a plan of correction, Hollidaysburg officials said the male patient had been moved to an all male unit and was to undergo a psychiatric evaluation. The victim was provided supportive counseling and a psychiatric evaluation.
The plan also includes training of staff on dealing with sexual behaviors. Other residents were evaluated for any inappropriate sexual behaviors, according to the plan.
Officials at the Scranton veterans home were cited for failing to monitor a patient who had a history of inappropriate sexual behavior. The patient was supposed to have 1 to 1 monitoring during waking hours but early in the morning of July 23 the staffer assigned to watch the male patient left to attend to another patient.
The employee, the report states, did not ask another staff member to observe the male resident even though he had been observed in the hallway near the female patient's room.
"The facility failed to ensure that Resident 28 (the female) was kept safe from Resident 1's unwanted sexual behavior," the report states.
According to the report the staffer who left to attend another patient "was immediately removed from the nursing unit.
In addition the facility was cited for failing to report the incident to the state Department of Aging, as required by law.
Notification was provided however, to local police and the Area Agency on Aging.
In its plan of correction, the facility formally notified the area agency of the incident and said it would audit all abuse allegations
At the Southwestern Veterans Center in Pittsburgh a patient was injured when he fell headfirst on the floor causing a forehead gash requiring 18 stitches.
The aide had failed to apply leg rests to the wheelchair as ordered and when the wheelchair hit a threshold the patient pitched forward striking the floor.
In its corrective action plan the facility reported it re-evaluated the injured patient and the need for leg rests. The plan also includes evaluating all other wheel chair bound patients for the need for leg rests.
Nissley said the agency's "number one priority is ensuring that our veterans and their spouses receive long term care in a safe and secure and caring environment."
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QTC Loses 4 Contracts After Bid Protest

By Walter F. Roche Jr.



A company with ties to a former U.S. Veterans Affairs Secretary has lost four contracts with the veterans agency as a result of successful protest with the U.S. General Accountability Office.
In awards announced this week QTC Management a subsidiary of Lockheed Martin was stripped of awards it had previously been granted to provide disability exams for veterans in four regions of the country.
QTC, a company with ties to former VA Secretary Anthony Principi, will still have contracts in two VA regions.
With the new awards Logistics Health of LaCrosse, Wisc., also a Lockheed Martin subsidiary, gets contracts in four of seven regions.
The new awards follow a GAO review which found that the "VA made several prejudicial errors in evaluating the proposals for these contracts."
 QTC, a California based firm, was once headed by Principi. More recently the former secretary was signed on as a lobbyist for Lockheed.
He has stated that he was not involved in the recent bidding effort.
In addition to Logistics Health , contracts to conduct medical exams were awarded to Medical Support Los Angeles, Veterans Evaluation Services in Texas and VetFed Services of Virginia.
The contracts, if extensions are exercised could have a total value of $6.8 billion.
In its 23-page decision on the original awards in late March, the GAO said it agreed with the protesting firms that the VA's evaluation of prices was "unreasonable
"The agency (VA) essentially changed the evaluation criteria they used to measure price reasonableness," the decision states.
The GAO found that bidders had not been provided with the needed information to shape their bids.

GAO Details VA Bidding Issues

By Walter F. Roche Jr.

The U.S. Government Accountability Office says the Veterans Administration used unreasonable standards in evaluating the price of medical exams submitted for a contract worth up to $6.8 billion over five years.
In a 23-page decision finally issued today, the audit agency also found that the VA gave one firm more credit than it should have in evaluating its anticipated performance in performing medical exams on veterans seeking disability benefits.
That company, VetFed Services, partnered with another winning bidder, QTC Medical, for most regions of the country, but was going it alone in the district in question.
"We conclude that its assignment of a good rating to VetFed for its past performance in District 2 (Kentucky, Tennessee, Alabama, Georgia, South Carolina and Florida)was unreasonable," the GAO decision states.
As the decision noted VetFed has partnered in the past with QTC by utilizing its staff and computer capabilities.
A shortened version of the decision had been issued earlier in the week, but the final document was delayed while the GAO redacted so-called proprietary information. VA officials have indicated that while they do not plan to rebid the pact, they will address the issues raised by the GAO.
The GAO had recommended in its decision that the VA reopen negotiations with the offerors and solicit and evaluate revised proposals and then make new source selection decisions.
Two bidders, including Veterans Evaluation Services, filed protests of the contract awards after they were announced in the Spring. The awards are for one year with options for four annual renewals.
As for the price evaluation, the GAO found that the VA shifted the way it compared bids without telling the bidders about the changes.
"We agree with the protesters that the agency's evaluation of total prices was unreasonable," GAO General Counsel Susan A. Poling wrote in the decision.
She found that bidders were not provided with the required information to shape their bids.
"The agency (VA) essentially changed the evaluation criteria they used to measure price reasonableness," the decision states.
While sustaining some of the protests, the GAO found several other claims without merit, including the impending sale of QTC to a third party.
QTC, based in Diamond Bar, Calif. was once headed by former VA Secretary Anthony Principi, who now is a registered lobbyist for QTC's parent company, Lockheed Martin. The GAO said that the possible sale of QTC was not relevant.
Principi has stated he was not involved in the bidding effort.
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VA Won't Rebid Disability Exams Contract

By Walter F. Roche Jr.

Veterans Administration officials say the do not plan to rebid medical examination contracts valued at up to $6.8 billion, but they do plan to address concerns about the massive procurement raised by the U.S. Government Accountability Office.
"The VA does not have plans to reissue this solicitation," said VA spokesman Henry Huntley, adding "we are working on reconciling issues raised by GAO in the protest."
The statement follows the disclosure of a GAO review of the contracting process in the award of contracts to conduct medical exams on thousands of veterans seeking disability assistance.
The GAO, acting on protests filed by two of the bidders on the contract, found that the VA made "prejudicial errors" in its review of the bids.
The GAO had recommended that the VA reopen negotiations with the offerors and solicit and evaluate revised proposals and then make new source selection decisions.
Scott Orr of VES Services, which filed one of the protests said, "We look forward to the VA addressing the issues raised and the recommendations made by the GAO in its decision."
Under the protested contracts awarded by the VA, the bulk of the work would go to QTC Medical, a subsidiary of Lockheed Martin.
The California firm was formerly headed by Anthony Principi, who served as VA Secretary. Principi is now registered as a lobbyist for Lockheed, but he said in response to questions that he was not involved in preparing a bid.
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Prejudicial Action Found in VA Contract Award

By Walter F. Roche Jr.

Concluding that the U.S. Department of Veterans Affairs made several prejudicial errors, the U.S. Government Accountability Office has sustained the protests of competing firms for contracts valued at up to $6.8 billion.
In a decision issued to interested parties last week, the GAO recommended that the VA reopen bidding for the contract to conduct thousands of medical exams per year on veterans applying for disability payments.
The protest centered on the award of the largest chunk of the $6.8 billion to QTC Medical Services,  a firm once headed by former VA Secretary Anthony Principi. The company was sold to Lockheed Martin, but Principi now serves as a lobbyist for the firm.
In a summary of its decision GAO said, "VA made several prejudicial errors in evaluating the proposals for these contracts."
In addition the  GAO found that "the VA misled two of the protesters during the conduct of discussions or negotiations. These errors led the VA to make source selection decisions that GAO found were unreasonable because they were based on erroneous conclusions in support of the contracts awarded."
 Among those protesting the awards were Veterans Evaluation Services of Houston, Tex., Logistics Health of La Crosse, Wisc. and Medical Support Los Angeles of Pasadena, Calif.
The decision was issued under a protective order because the  full decision contains confidential proprietary information, according to a GAO announcement.
The actual ruling will be issued later after the confidential information is redacted, according to the July 13 notice.
Principi, who left QTC to become VA Secretary only to return to the company later, said in response to questions that he was not involved in QTC's bid effort. He said he was not a founder of QTC but joined the company after its founding by Dr. Lay Kay. The sale to Lockheed Martin occurred in 2011

 "I never read any of the (bid) documents," he wrote in response to questions. 

 "I’m confident that the process will lead to a result that serves the best interests of veterans.  The integrity of the government’s procurement process should be above reproach and free of outside influences," he added, when asked to comment on the GAO action.

Congressional lobbying records show Principi's firm, The Principi Group, registered as the lobbyist for Lockheed Martin in 2014.
 "Determine the benefits and medical affairs requirements of the Department of Veterans Affairs," the lobbying firm listed as its assignment.

The GAO action comes as several members of Congress questioned the award. In addition the U.S. House Veterans Affairs Committee has initiated an investigation of the way QTC conducted exams of veterans claiming injuries from exposure to Agent Orange. 

The inquiry came in response to charges in a court suit by a former QTC employee that the exams of veterans claiming exposure were rushed and not properly completed. QTC performed the exams under a prior contract.

The whistleblower suit filed by David Vatan was dismissed on a technicality, but an appeal is pending.
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