“That’s Crazy!!!” – More Chronicles From The VA

Bobblehead DollThe week of 27 September 2021 started funkily and has gone downhill rapidly!  I reported Monday being refused medical service for not wearing a mask.  On Tuesday, I visibly struggled for breath, standing in the VA pulmonologist’s office in front of the pulmonologist who was holding my pulmonology function test results.  I am holding a letter showing I cannot wear a mask, wearing a face shield, and being told by the doctor, “I do NOT care, he needs to WEAR A MASK, or I AM NOT SEEING HIM” [emphasis his].  Eventually, the doctor agrees to see me, provided I remain more than 6 feet from him, and he does not have to touch me.  The doctor then proceeds to lecture me about getting the vaccine, wearing a mask, and of course, breathing through my breathing difficulties.

As they say on the Home Shopping Network, “But wait, there’s more!”  Crazy has only just begun, unfortunately!

A patient with iron-deficiency anemia died at the hands of VA Doctors at the San Juan Puerto Rico VAHCS (2017), and the VA-OIG is just completing and reporting on their death in 2021.  The patient who came in for a colonoscopy developed rectal bleeding, which required an anticoagulant, and the patient subsequently died.  A tragic set of dominoes was set up and knocked down in this patient’s case, and the VA is entirely at fault for the patient’s death.  How badly the patient’s family must feel with this report in hand and knowing they can do absolutely nothing!VA 3

100% crazy indeed; but wait, there’s more!

Justice was served cold and raw, and while I was hoping for a harsher sentence by far, I am still hoping his victims can recoup some of their losses and obtain retraining.  “Jonathan Dean Davis, the owner of Retail Ready Career Center in Texas, was sentenced for deceiving the VA of $72 million. Beginning in 2014, he offered six-week heating, ventilation, and air conditioning course, promising to prepare veterans for careers in the HVAC industry. However, upon entering the workforce, many of these veterans discovered that the course had failed to teach them many of the basic skills necessary for entry-level technician jobs. Davis was also ordered to pay $65.2 million in restitution and forfeit $72.5 million to the federal government.”

It is very hard to describe what goes into the GI Bill besides money and time in service.  It is even tougher to explain how cheated you feel when the benefit is cut by the government, stolen by school administrators, and reduced by petty rules and regulations.  To see your benefits stolen through shoddy training and see your hopes and dreams dashed, as well as your benefit, turned into useless paper, the heartbreak is incredible!  The punishment for all involved should have been greater, and some federal employees should have shared the blame for failing to do their jobs!I-Care

Hold onto your seat, folks; the insanity has not even reached its peak yet; there’s more!

The VA Office of Inspector General (OIG) inspected the VA Illiana Health Care System in Danville, Illinois, to determine the validity of allegations, specific to COVID-19 and the Community Living Center (CLC), of failure to observe infection control practices, failure to minimize the risk of exposure to COVID-19, inconsistent ongoing testing, and failure to notify residents, families, and staff of positive test results. During the inspection, the OIG identified concerns related to leaders’ post-outbreak actions.  The VA-OIG substantiated a failure to observe general infection control practices, including in the following areas:

    • Leaders failed to minimize the risk of exposure to COVID-19.
    • Leaders did not respond adequately to staff exposure.
    • Leaders did not have a plan for the transfer and isolation of residents.
    • Leaders did not implement recommended infection control measures when performing aerosol-generating procedures and continued to hold group therapies.

The VA-OIG substantiated the lack of a post-baseline testing plan and a failure to test CLC staff after potential exposure.  The OIG identified actions taken by leaders following the CLC outbreak that lacked input from frontline staff to identify corrective actions and opportunities for improvement.”  This is the politically correct way of saying that the community living center leaders are thoroughly incompetent and should not be trusted in their current positions.

Leadership failure in spades, employees, patients, families all placed at risk because of incompetence and politics of the facility leaders, and the VA-OIG does not have the teeth needed to FIRE and REPLACE the leaders who are clearly out of their depth and ability!  For months the media and political leaders have been harping and preaching how dangerous COVID as a viral infection is.  Yet, the leaders in the Illiana VAHCS seem to be operating to a different set of rules and policies.  Will any elected leader be asking why?  Insanity runs deep in Illinois!VA 3

On the topic of COVID-19, and the failures of VA providers to do their jobs, we find another dead veteran due to what in the private sector would be a classic case of malpractice!  Yet, care at the VA is protected from malpractice, and the providers are safe from responsibility and accountability for their failures.  While the following is specific to North Carolina, similar examples are found across the United States.  Insanity thy name is represented in spades at the VA!Angry Wet Chicken

The VA OIG conducted a healthcare inspection at the Fayetteville VA Coastal Health Care System in North Carolina to assess concerns related to the quality, coordination, and timeliness of care, and the impact of COVID-19 on a patient with unintentional weight loss who was later diagnosed with oral cancer and died at another VA medical center.”

    • The VA-OIG substantiated that the primary care provider and dietitians did not provide quality care to the patient.
    • The VA-OIG substantiated that dietitians conducted incomplete nutritional assessments.
    • The VA-OIG substantiated that the patient’s PACT nurse and dietitians failed to coordinate care by not communicating the family’s request for a face-to-face appointment and the patient’s declining nutritional status to the primary care provider.
    • The VA-OIG found that incorrect scheduling resulted in the patient not being seen by a dietitian for a follow-up appointment and a delay in scheduling a non-VA dental appointment.

The VA-OIG concluded that COVID-19 impacted the care provided by dietitians because of the use of telephone visits, which did not allow dietitians to visually assess the patient’s physical characteristics caused by a declining nutritional status.”

Blaming a viral disease for the failure of people to do their jobs is the height of skullduggery, showing pusillanimous disregard for the patient and a timid weak-kneed, and yellow-bellied timorous approach to medicine.  None of you deserve to be in the medical field if you cannot properly take personal protection and see patients who need to be physically seen!  Now, let’s call a spade a spade and call out your wimpy, limp-wristed, lily-livered weakling leaders who refuse to act like leaders in a hospital and prefer to act like scared amoebas in a petri dish!  There is NO EXCUSE for your paltry excuses, your shady practices, and your hiding in offices and behind the disruptive behavioral committees when your policies and procedures FAIL when YOUR training plans fall apart, and when reality bites hard enough to disrupt hospital operations and your policies are the problem endangering patients!VA 3

Crazy…  Thy name is abused in the VA, and the leaders are failing to understand sanity!  But … wait, there’s more!

There are times when I describe the insanity at the VHA, VBA, National Cemeteries, and the Department of Veterans Affairs (VA) as designed incompetence.  The following is the purest example of designed incompetence witnessed to date.  Consider with me the following:

?u=http3.bp.blogspot.com-CIl2VSm-mmgTZ0wMvH5UGIAAAAAAAAB20QA9_IiyVhYss1600showme_board3.jpg&f=1&nofb=1Blue Water Navy Outreach requirements were met, but processing and procedures remain lacking and need improvement.  The VBA was legislatively mandated to extend veteran benefits to a classification of sailors who operated in blue water conditions off Vietnam or within 12 Nautical Miles of Vietnam.  The VBA went forward and established the computers, the records, the systems, etc., to handle these claims.  The results, a complete farrago!

The VA-OIG substantiated that the VBA has not established procedures for its employees to follow when the computer search tool they use to determine ship locations during claimant service dates returns unlikely results (for example, providing an inland location in a search for an aircraft carrier). In addition, VBA employees inaccurately decided approximately 46 percent of veterans’ claims (2,100 of 4,600) from April through June 2020, which led to about $37.2 million in improper payments to veterans ($25.2 million in overpayments and $12 million in underpayments) during that period. About 95 percent of these errors resulted from VBA employees deviating from policies governing disability-rating decisions.”

Did you catch that the VBA intentionally designed a system that failed to perform the task because humans and computers were lenient to deviate?  Nobody is held accountable for the continued loss of benefits, treatment, and wasted resources of the government and the veterans involved!  Here’s the rub, this is NOT the first time this has happened!  The VBA is notorious for failures like this and never held accountable by the elected officials hired to scrutinize the government!  Name a military excursion where benefits had to be carved out by legislative order, and you will find foot-dragging, designed incompetence, inconsistencies in decision making, and piss-poor performance at every level of the VBA.  Why?LinkedIn VA Image

Let’s imagine you hold a job that has a reporting requirement to an authorizing body that can shut you down.  You arbitrarily change language in metrics and reporting, do not tell the authority but still expect the authority to license you and your efforts.  How likely do you think the governing body will look favorably upon your changes?  The VA is legislatively mandated to report to Congress on its capacity in five areas, spinal cord injuries, traumatic brain injuries, blind rehabilitation, prosthetics and sensory aids, and mental health.  But, by changing the language, metrics, and methods of talking about injuries, the VA can hide, misreport, underreport, overreport, and play reporting games with the report to Congress and the VA-OIG second look get away with the deception.  Never forget, the maskirovka comes with veteran patient abuse!Angry Grizzly Bear

The VA-OIG has reported continuously to Congress, to deaf ears and plastic lips, the following, “… VA cannot compare its current mental health capacity with its 1996 capacity because of changes in diagnosis and treatment, service provision, and data collection. For example, VA must report on the number of veterans with “serious mental illness,” but VA no longer uses that term. And non-VA care, which veterans increasingly seek, must be excluded from reports on VA’s capacity to provide care. The OIG believes that by modernizing the reporting metrics, Congress would be better positioned to assess VA’s capacity to provide care for today’s disabled veterans.”

Congress continues NOT to push the VA to adopt 1996 language and metrics for reporting, or change the law to update the language and metrics to capture the data more accurately, thus allowing the lies and deceptions to continue.  Will anyone in the media EVER ask Congress WHY?VA 3

What kills me, the insanity discussed in this summation of VA-OIG reports does not even scrape the iceberg.  In my email inbox, I have to select between continued financial failures by leaders, veteran suicide during an inpatient residency, and the continued moral distress of employees by facility leaders.  I have twenty more VA-OIG reports sitting awaiting summation because the insanity has blossomed, and the VA-OIG is working hard to clear their reports for the end of the calendar year.  Each and every one of these reports deserve analysis, discussion, and mega-doses of sunshine disinfectant.  The sheer enormity of the insanity means that timely discussion physically cannot occur.  By overloading the system, the perpetrators of veteran abuse can escape sunshine disinfectant, and that is a sore injustice!Satire? Obama ISIS Speech Depresses Nation | Hooper's War - Peter Van Buren

Pray for the families of those who have died at the hands of the VA providers and for those currently dying under the hands of VA providers.  Congress needs to act, and we, the electorate, must hold their feet to the fire until they are consumed, or they stand and do their jobs!  There are no excuses for the insanity contained in these VA-OIG reports!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

MRSA and COVID – Pandemic Hype Indeed

Bobblehead DollMRSA is shorthand for methicillin-resistant Staphylococcus aureus, a medicine-resistant staph infection that swept America beginning in 1990 —gaining massive popularity in 2017 when it killed more than 10,000 people and hospitalized more than 300,000 in the United States alone.  Worse, of those hospitalized, many had to have large sections of their anatomy excised, limbs removed, and other surgical procedures done to cut away the infected flesh.

As for COVID’s death toll, your guess is as good as mine.  We all know the scandal of the emphasized numbers to obtain greater Federal Money and media attention.  We have all been exposed to the hype and hysteria from infection rates that do not equate to those with frank symptoms, and neither of those numbers equating to those needing hospitalization.  Worse, we all have been front-seat with the PCR testing scandal where a tampon, motor oil, and a host of other non-human samples all tested positive (falsely) for COVID.

When the intentional housing of infected patients with healthy residents in long-term care facilities is added to this COVID-drama, they shouldn’t be, for these are victims of murder, and the governors need to be held accountable for their deaths; nothing but confusion in statistics reigns.  Unfortunately, all this and more is just the tip of the iceberg regarding the statistics in the highly politicized COIVD-debacle we are living through.The Duty of Americans

One point of significant contention is the difference between an epidemic and a pandemic.  An epidemic is when a disease (bacterial or viral) spreads over a large geographical area, and many different people simultaneously take ill.  A pandemic takes an epidemic one step further and is a political decision, as the illness spreads across national borders infecting larger numbers of people.  MRSA for all the people killed, in all the different countries, and health systems, has only ever achieved epidemic status.  The Spanish Flu (1918) for all the people killed, in all the different countries infected, only achieved epidemic status.  As a point of reference, the Spanish Flu (1918) is a confusion of terms between pandemic and epidemic, and depending upon the source; you can see the media hype of the flu.  MRSA, like the annual Flu, Chicken Pox, Mumps, Measles, and Rubella, are still just as effective at killing people, and we do not shut down the globe for these viral infections.  Yet, nobody in the world’s governments wants to discuss why COVID has been given this treatment.  But, I digress; let’s get back to MRSA.?u=http3.bp.blogspot.com-CIl2VSm-mmgTZ0wMvH5UGIAAAAAAAAB20QA9_IiyVhYss1600showme_board3.jpg&f=1&nofb=1

Please note, while hospitals are on track to meet a 50% reduction in MRSA and bloodstream infection reductions, this does not mean that other places MRSA pops up will meet these same reductions.  MRSA causes outbreaks under specific conditions, typically in crowded areas with inadequate hygiene, skin-to-skin contact, and shared equipment.  Hence, MRSA is prevalent in gyms, dressing rooms, daycare facilities, and any place where human body fluids can sit on a surface shared by other humans.  Hence, before going further, I urge informed caution where MRSA is concerned.  Ask about decontamination of hard surfaces, cleaning habits, and customs, and when in doubt, ask for more information before participating.

The National Institutes of Health (NIH) in partnership with Janssen Research and Development, found some interesting results in protecting the body from MRSA by boosting the body’s immune system.  These results are interesting because until COVID came along, medicine generally wanted to stimulate the body’s immune system first, then look at vaccines and drugs.  But, since COVID came along, doctors want to revert to what created MRSA, an overabundance and reliance upon vaccines and medicines instead of boosting the body’s immune system.Vaccine

Let’s take a trip down memory lane to the 1990s.  MRSA is breaking onto the scene and scaring the living daylights out of medical professionals.  This new staph infection is resistant to every drug known to man and kills rapidly once the skin infection gets into the blood.  Sepsis deaths which had been trending down for a decade, were spiking.  People went to the hospital for a routine checkup and died of skin infections horribly a few days later.  Research quickly discovers this is a staph infection, quickly realizes it is drug-resistant, and new practices are needed in cleaning and disinfecting to prevent this from spreading.  But, the first step was to boost the body’s natural immunity.  Vitamin C, D, E, and Fish Oils, were discussed as options to be added to some diets.  Exercise, diet, and weight loss became much more important topics, and the reason why was witnessed on the evening news.  We saw patients lose limbs; a patient lost their nose; a patient went swimming in a pond and died horribly shortly thereafter.Pressure Injuries - Example

I mention MRSA because common sense, research, and boosting the body’s immune system work, as historical data supports, to protect communities from large health problems and viral outbreaks.  Masks, isolation, expensive government mandates and vaccines, do not protect communities from health problems.  Many media pundits have cited the 1918 Spanish Flu epidemic as comparative to COVID.  What’s the difference, the most significant difference between 1918s Spanish Flu and 2020 COVID, government interference, and media hyperventilation!

What’s the difference between the ongoing MRSA battle, which claims hundreds of thousands of lives annually in the United States and millions of lives globally, and COVID?  Government intrusion and media hyperventilation.  Back in the 1990s, Dr. Fauci was still relatively unknown in the pantheons of NIH and was still misinforming about AIDS/HIV.  By 2018, Dr. Fauci has reached the pinnacle of his lackluster career, and he needs a pandemic to come along to help his career into the spotlight of historical immortality.  In the 1990s, the president was a Clinton, and the media adored his every breath.  In 2016 the president was detested by the media, and a solution to his popularity needed to be generated.Apathy

MRSA has killed and maimed more people globally than COVID ever will; yet, MRSA, while being more deadly and dangerous, is relatively unknown outside medical centers, and the media hypes about COVID non-stop.  Ever stop to ask yourself why?  Common sense medicine is still the best method for preventing and healing after an MRSA infection.  It would be the same for COVID except for the political environment that shut down inexpensive and effective drugs.  Ever stop to ask yourself why?

The Center for Disease Dynamics, Economics & Policy (CDDEP) has a graph of MRSA infection rates by country reporting.  Romania is on top with the worst rates of hospitalized MRSA, Iceland has the best rates of non-infection, and the numbers appear to be current as of 2004.  Yes, that data is 17 years or so old and can be taken with a grain of salt.  However, it does provide an interesting view on MRSA infections.  Not all MRSA infections are reported equally.Plato 3

The main MRSA reported and tracked are those where the infection can be reliably proved to have originated in a hospital—leaving infections from gyms, locker rooms, sports equipment, daycare centers, schools, etc., all open for speculation and wonder.  Not good policy on something this dangerous and easily spread from person to person.  I worked in a call center that was threatened with being shut down if infectious pink eye (a staph infection) was not brought under control.  Pink-eye was spread around that call center so often, and so prevalently, the health department threatened drastic and dire measures if the business did not take action.  Yet, MRSA, another staph infection, isn’t even tracked and reported.  Ever ask yourself why?  Ever wonder why some infections and communicable diseases are reported to death and others never even get mentioned?

Knowledge Check!Please let me repeat myself, and I repeat myself only for emphasis; we live in a world of risk.  The government, any government, cannot control the risk of living.  We, the citizenry, should never expect the government to attempt to control the risks of living, for that is the road of tyranny and oppression.  The government is only a tool; the tool should be used sparingly and only in times of greatest need for the greatest good of all citizens.  When the tool of government is overused, tyranny and oppression are the only results, and the citizens will weep in frustration and anger at the governments’ largesse!  MRSA is a risk we undertake to enjoy a social activity, exercising in a gym.  MRSA is an activity we expose our children to when we send them to school, for the benefits outweigh the potential risks.  The risks of runaway government are being felt right now; what are we willing to do to fix that problem?

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

New Jersey, New York, California, Oregon, and Washington – Just Sell Them for Parts!

cropped-laughing-owlWith a nod to Bill Engvall, let’s honestly discuss three complete holes in America where suicide by legislative fiat and executive stupidity has produced catastrophic failure.  Let me be perfectly honest, if either of these states were a business, they would have been forced into receivership, broken up, sold for parts, and their leaders jailed for incompetency and felonious charges of malfeasance long ago!  The charades have ended, the rose-tinted glasses are off, and frankly, the party is over, all the taxpayers are fleeing, and the businesses are closing shop and fleeing for healthier climates.

California this week passed another job-killing piece of legislation.  The bill is targeted at Amazon and is built on hogwash, acrimony, lies, and allegations so thin you could read Apple’s User Agreement through them.  Not the first time California’s legislative body has targeted a specific business for job-killing legislation, not the first time the legislation is built on sand, and the forecast is for torrential rain, not the last time this idiocy is going to happen.  The fact that California keeps killing itself is depressing!Bird of Prey

New Jersey and California hold an interesting title, and 32 other states are 100% insolvent in their Unemployment Compensation Trust Funds.  Business owners, this fact alone should scare the living daylights out of you and every one of your workers right now!  Now, some of you get it; some are scratching your heads and going; why is this important.  For those who got it, feel free to skip the following explanation.

The unemployment trust fund is akin to the social security trust fund managed by, raided, and depleted by the Federal Government.  No money means that the debts in those trust funds cannot be paid, and all the funds being collected right now are not being used for future calamities.  For all you economists out there, yes, this is a very simplified explanation.  Insurance trust funds are expected to be the funds of last resort to ensure payments to investors; those paying premiums for coverage can receive protection.  Not having these trust funds means the state unemployment insurance fund is in deep trouble, and there is only one direction to point the blame, the legislators and executives in government.

Bobblehead DollNow, some are claiming these funds were only depleted due to the COVID pandemic.  Do not believe the hype.  These funds were in trouble long before COVID hit, and the fact that there are funds to replenish these trust funds and government leaders are refusing to invest money in the trust funds should be major red flags for everyone in the state!  State and local governments are spending money like it’s Christmas, and the New Year will never come with the bills from the holidays.  Think drunken-sailor on 7-day liberty here if you prefer that analogy.  Either way, financial troubles are brewing above and beyond the current inflation woes, and the media is deftly NOT reporting this crisis.  Does anyone want to venture why this topic is not being discussed?

The Article from the Tax Foundation lays out the data nicely, and you are left to draw your own conclusions from the data.  But tell me, what happens when you call GEICO, Farmers, All-State, etc., with a claim and the claim is denied because the insurance company has no money?  Now multiply that by every wage-earner and business in your state and tell me if maybe, just maybe, the unemployment insurance trust fund being insolvent should be a more significant issue of discussion.Tax Burden

If your state is insolvent, and your next paycheck is a LOT lighter, remember this tidbit about unemployment tax insurance trust funds.

Unemployment insurance tax rates on businesses rise automatically when trust fund balances are low.”

Do you see the trouble now?  First, the government maliciously raids and spends the funds, then a hidden tax kicks in, depleting your paycheck, and the government does not have to tell you why your paycheck is lighter.  Especially since those in legislative bodies traditionally exempt themselves from having to pay these taxes.  Now add in the other hidden taxes; inflation goes up because when taxes climb, inflation climbs, prices go up to cover the hidden taxes of higher costs to operating a business, and wages stagnate, which crimps your budget even further.Government Largess

The states mentioned are not the states that did not need Federal Intervention, and they are not counted among the states spending money wisely, as discussed by Governing.com.  Please tell me that nobody is surprised by this revelation.  I find it alarming that Governing.com, in their analysis, was able to conclude the following:

Despite predictions that COVID-19 would crush state tax revenues, most of them didn’t need mega-billions in pandemic aid to balance their budgets. But for the most part, they seem to be spending the money wisely.”

Leading me to ask, why did the Federal Government invest our tax dollars, venture into such incredible debts, and shut down a booming economy?  COVID has proven NOT to be worthy of the title “Pandemic.”  Yet, COVID remains an excuse for emergency measures, emergency spending, and emergency police actions.  Will any media representative ask a politician why?  I didn’t like the book, but I read Albert Camus’ book “The Plague” for light reading.  That is a book about a public health crisis, a pandemic worthy of the title pandemic, and several times in world history, the title pandemic has been warranted when survivors are burning corpses in the street.  COVID fits none of the definitions or situations for a Pandemic, except for the politically connected to laugh at the politically abused populations.Angry Wet Chicken

Look at Washington, New York, New Jersey, California, and Oregon across the COVID-19 political mania.  Tell me why COVID is not an exercise in malicious government and politics gone horribly wrong.  Sure, we can add New Mexico, Minnesota, Michigan, and a couple of other states into the mix for fun.  These core states are where politicians made vast sums of money on COVID-Hysteria, and I would like to keep the focus small for the current article.

The House Ways and Means Subcommittee is reporting 32 states are intentionally withholding money from rural governments as a political move.  When you take the top 20 receivers of COVID-Relief money and the 32 states withholding COVID-Relief money, you find some lines of congruence with states with the harshest COVID restrictions, ridiculous COVID mandates, and no correlating data to infection risk avoidance.  Now, why isn’t COVID reported as a political and social experiment gone horribly wrong?  Worse, why was the money borrowed by the Federal Government at extortionate rates and given pell-mell to the states when the majority of those states do not need the money and the states that did need the money have sufficient if their politicians reigned in spending?Angry Grizzly Bear

The five states mentioned are not poor states by any stretch.  They have resources, both human and natural; they have riches galore, they have potential, they used to have favorable business climates, they are committing suicide.  Why should the rest of America bail them out?  Why not break them up into parts, sell assets to cover debts, place them into receivership, and force them on a diet of sanity and logic until the bills are paid?

I close with a word of warning.  Texas, you’re headed to California status faster than you would like to admit!  Your COVID restrictions are particularly heinous and represent the infection found in Austin spreading like fast-moving cancer to steal your state and liberty.  Arizona, Idaho, Wisconsin, Iowa, you are all on a similar track, the speed might not be as noticeable right now, but the infection is there and growing.  Utah, Colorado, Wyoming, Montana, both Dakotas, you are all at various places in being terminally sick with the same cancer.  If soft words and political expediency can conquer the Western US, the entire United States is lost.  New Mexico has been lost since it was given statehood in a political move that robbed Arizona and Texas of land!

Image - Eagle & FlagThe time to awake and arise is now!  The fight for liberty and freedom will be fought and won or lost in the American West.  Sure, the coasts of America are well and truly infected.  But, the fight for independence is not on the shores; it is right outside your doors.  The media and politicians like to hyperventilate about the coasts, but the rural communities in the “Fly-Over” states are more important to liberty and freedom surviving than any other local in America.  Awake and Arise!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

If Everyone Cared – More Detestable VA Stories (Chapter 2)

?u=http3.bp.blogspot.com-CIl2VSm-mmgTZ0wMvH5UGIAAAAAAAAB20QA9_IiyVhYss1600showme_board3.jpg&f=1&nofb=1For the last two weeks, I have been a little remiss in writing.  My cousin passed from diabetes, two of my grandkids got sick with COVID (they are recovering), and I was diagnosed with asthma.  The last two weeks have been a roller-coaster of ups and downs, so imagine my surprise as I went to catalog more of the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) reports, Nickelback’s song, “If Everyone Cared,” was playing.  Pandora certainly appears to have a sense of humor and an innate sense of déjà vu.  I cannot think of a better title to proclaim the need for raising awareness and what is needed to fix the VA.  Until everyone is aware and the scab hiding the infection of the VA are ripped away to be exposed to the sunlight disinfectant, nothing will change, and taxpayers will continue to pay for the abuse of veterans who deserve so much more.  Thus, as we celebrate US Constitution Day, let us remember the veterans who have helped protect and defend the US Constitution and improve the government response!

The VA-OIG reports begin in Kansas City, Missouri, with a $335 Million Fraud Conspiracy, which included $615,000 in tax violations.

By pleading guilty today, Patrick Michael Dingle, 50, admitted that he conspired with Matthew C. McPherson, 45, of Olathe, Kansas, to fraudulently obtain contracts set aside by the federal government for award to small businesses owned and controlled by veterans, service-disabled veterans, and certified minorities.”VA 3

A sentencing hearing will determine if any prison time and what if any, restitution is required in this plea deal.  Frankly, the fact that the fraud existed from 2009-2018 is nothing short of a blatant and utter slap in the face for the taxpayer.  How many federal employees had to have seen the documents, failed to perform due diligence, refused to do their jobs, and were not named as co-conspirators or, at a minimum, facilitators of the crimes?  Is aiding and abetting a criminal operation not a charge that can be brought against the federal employees who empowered this fraud?  Thus, I demand all these people explain why and how an investigation can occur and not include the facilitators, those federal employees, who did not do their jobs!

Assistant US Attorney Paul S. Becker is prosecuting the case. The following agencies assisted in the investigation: the Department of Veterans Affairs, Office of Inspector General; the Department of Defense Criminal Investigative Service; the US General Services Administration, Office of Inspector General; the U.S. Small Business Administration, Office of Inspector General; the Army Criminal Investigation Command, Major Procurement Fraud Unit; the Department of Agriculture, Office of Inspector General; IRS-Criminal Investigation; the US Secret Service; the Air Force Office of Special Investigations, Procurement Fraud; the Naval Criminal Investigative Service; the Defense Contract Audit Agency – Operations Investigative Support (OIS); the US Department of Labor, Office of Inspector General; and the Department of Labor, Employee Benefits Security Administration (EBSA).VA 3

File the following under false imprisonment, and will someone please tell me why those employees involved are not in prison now!  A patient in the inpatient mental health unit and community living center at the Tuscaloosa VAMC in Alabama was falsely imprisoned and kept against their will for more than 2-years.  Was denied access to a patient advocate, which should be a red flag that something is disastrously wrong right there.  Plus, official mail to an elected official was improperly handled by staff to prevent elected officials from knowing about the veteran’s plight.

Here is what the VA-OIG investigation substantiated in their investigation:

    • Staff did not adequately assess the patient’s admission status as voluntary or involuntary and did not follow commitment requirements during the first two of the patient’s three Inpatient Mental Health Unit admissions.
    • Staff did not properly manage a letter from the patient that was intended for a public official.
    • Staff did not correctly identify a surrogate decision-maker and did not address ethical concerns regarding the appropriateness of the patient’s surrogate decision-maker.
    • Staff did not comply with requirements when the patient requested an against medical advice discharge.
    • staff at the facility denied a patient’s discharge requests and did not ensure the patient’s access to a patient advocate.
    • Staff failed to follow informed consent procedures.
    • Staff denied the patient’s discharge requests.
    • Staff did not conduct a sufficient or timely decision-making capacity evaluation and documented unsupported, conflicting decision-making capacity information in the patient’s electronic health record.VA 3

These are serious crimes, not bad administrative practices, felonious crimes.  Yet, the employees skate, the patient was held against their will, and nobody will be responsible for this disaster.  Where are the elected officials?  Where are those hired to scrutinize the government?  In this situation, any other medical organization would be facing lawyers armed with righteous indignation and seeing dollars signs in their dreams.  Yet, because this is the VA, the patient can be harmed, and no one will ever care, and that is a crime the elected officials are guilty of and need to be held to task for!

Moving to Biloxi, Mississippi, we found another VA employee who had sticky fingers and a long time to steal from the government (2009-2020).

Chad Paul Jacob of Saucier, Mississippi, pleaded guilty to stealing personal protective equipment, electronics, and medical equipment while working as the assistant chief of supply chain management for the Gulf Coast Veterans Health Care System in Biloxi. From 2009 through December 2020, Jacob stole and resold VA property at local pawn stores and on his personal eBay account.”VA 3

For eleven years, they were working as the assistant chief of supply.  The employee had how many reporting employees and superiors have had to sit through how many records audits.  In all these eleven years, I cannot believe that nobody ever suspected problems.  Who did the thief learn how to steal from the government from?  How many employees churned, and did any of these employees churn because they tried to report irregularities, and the boss ensured they were disposed of to silence them?  The VA has been taken to several congressional hearings to eliminate the whistle-blower rather than fixing the problems at the VA.  Thus, it is not in any way, shape or form, out of line to be suspicious about employee churn and fraudulent actions taken by a supervisor to eradicate and protect their schemes!  Why are these questions never asked in the VA-OIG investigations where schemes are uncovered by ranking and supervisory personnel?

Remaining in the south and moving next door to Slidell, Lousiana, a doctor, has been indicted for illegally dispensing opioids in a health care fraud scheme.

Adrian Dexter Talbot of Slidell, Louisiana, was charged for his role in distributing Schedule II controlled substances, including oxycodone and morphine, outside the scope of professional practice and for maintaining his clinic to distribute controlled substances illegally. He was also charged with defrauding health care benefit programs of more than $5.1 million, given that the opioid prescriptions were filled using health insurance benefits.”VA 3

Remember, an indictment is not a finding of guilt, and the defendant remains innocent until proven guilty in a court of law by a jury of his peers.  There is a very compelling point made by our founding fathers that need to be repeated here and declared more often in American Society.

“… Should the People of America, once become capable of that deep simulation towards one another and towards foreign nations, which assumes the language of justice and moderation while practicing iniquity and extravagance, and displays the charming pictures in the most captivating manner of candour, frankness, and sincerity.  At the same time, it is rioting in rapine and insolence; this country will be the most miserable habitation in the world.  Because we have no government armed with power capable of contending with human passion unbridled by morality and religionOur Constitution (the US Constitution) was made only for a moral and religious people.  It is wholly inadequate to the government of any other.” – President John Adams

The drug war and the opioid crisis stem from the same problem, a lack of morality and religion.  The duplicity of showing candor, frankness, and sincerity, while at heart there is nothing but ravening appetites and the minds of wolves, is the problem.  Sure, drugs create a social and medical issue out of the unbridled appetites and passions.  The core is the lack of self-restraint from being disconnected to religion and morality and from social duty, responsibility, and accountability.  Thus, making people miserable and looking for a cure.Knowledge Check!

The case above expresses this point clearly; the doctors involved were filling an appetite.  As long as there is an appetite, there will be people willing to risk everything to fill the appetites of others; moral and social disconnection, and the US Constitution cannot govern these people except to their destruction!

Moving to Fort Lauderdale, Florida, we find another series of indictments for more fraud, reflecting the same social disconnection.

Kingsley R. Chin of Fort Lauderdale, Florida, the chief executive officer of SpineFrontier Inc., and Aditya Humad of Cambridge, Massachusetts, the company’s chief financial officer, was indicted on one count of conspiracy to violate the Anti-Kickback Statute, six counts of violations of the Anti-Kickback Statute, and one count of conspiracy to commit money laundering. Chin and Humad allegedly bribed surgeons to use SpineFrontier’s products, and in turn, the company received millions of dollars in revenue from surgeries the surgeons performed.”VA 3

Traveling north to Bedford, Massachusetts, we find another dead veteran and culpability so thick it should be used as a board to apply corrective discipline for all parties involved!  From the report, we see the scope of the investigation for the VA-OIG:

Mr. Timothy White was a resident of the Bedford Veterans Quarters (BVQ), an independent living facility operated by Caritas Communities, Inc. (Caritas), in space leased to it through VA’s enhanced-use lease program. A month after Mr. White was reported missing, his body was found in the emergency exit stairwell of the building that houses the BVQ. This stairwell down the hall from his room was VA property and not leased to Caritas.”VA 3

The VA-OIG found the following as facts in the investigation:

    1. The VA police department’s failure to locate Mr. White resulted in part from the police and others at VA not considering the veteran an at-risk missing patient, which would have required a stairwell search.
    2. The Veterans Health Administration and the Office of Security and Law Enforcement lacked clear guidance regarding the obligations of VA police to search for nonpatients reported missing on VA property.
    3. VA police also did not discover Mr. White in the stairwell because of an improper order by the then-police chief to cease patrols of the building in which Mr. White was found.
    4. The OIG found that the VA police chief exceeded his authority as VA policy, and the lease required VA police to patrol VA property.
    5. Medical center staff mistakenly believed the emergency exit stairwells were not VA space; they did not clean them.
    6. The confusion among medical center leaders and staff regarding the lease scope and VA’s obligations stemmed from a lack of clear guidance from the Office of Asset and Enterprise Management.
    7. Routine police patrols and stairwell cleanings likely would have led to Mr. White being found earlier.

Angry Grizzly BearNow, as logical thinking adults, do you buy the load of excuses being sold here to pass off the blame for a dead veteran?  I know I am certainly NOT buying this load of bull!  Having worked and spoken in-depth to leaders of VA Police Departments, the excuses to not do stairwell checks and camera checks for missing patients are beyond inexcusable!  I know of a situation where a patient was lost on VA property.  Every police officer and staff member, even those on off-shifts, were called in, issued out in teams, and every square inch of the property was investigated until the patient was found.  Yet, somehow this patient was able to DIE unnoticed in a stairwell!  Are you kidding me?!?!?!

Regardless of whether this veteran died of malnourishment, dehydration, exposure, or lack of medication, he died horribly!  The veteran died at the hands of responsible parties, and those parties need to be held accountable for his untimely and atrocious death!  There is NO EXCUSE for this veteran to have died.  SHAME on the administration!  SHAME on the VA Police!  SHAME on the third-party contractor.  SHAME on the leaders of government who have allowed this abuse and refused to act!

Moving west to Chalfont, Pennsylvania, we find more stolen valor and theft of government benefits.

Richard Meleski of Chalfont, Pennsylvania, was sentenced to three years and four months in prison, three years of supervised release, and ordered to pay $302,121 in restitution for stealing VA benefits by pretending to be a veteran who the enemy had captured during combat. In July 2020, Meleski pleaded guilty to one count of healthcare fraud, two counts of mail fraud, one count of stolen valor, two counts of fraudulent military papers, as well as two counts of aiding and abetting straw purchases, and one count of making false statements in connection with receiving Social Security Administration disability benefits.”VA 3

While there are many more VA-OIG reports needing sunshine disinfectant, let us remember Mr. White, who has passed, and the feloniously falsely imprisoned unnamed veteran from today’s VA-OIG recap.  These two veterans especially deserve respect, dignity, and remembrance.  Their families and friends deserve praise and prayers.  America deserves answers, and federal employees need to be held accountable for failing to do the job they are paid tax dollars to perform!

I-Care© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

ZERO COVID – The Insanity Continues: Beware the Dangerous Water Ahead!

Angry Wet ChickenNews headlines with Fauci included this gem, “We will not let up until COVID is no longer a viral infection.”  Seriously?!?!?!  If that is the goal, why has that not been the case with Chickenpox, Ebola, Swine Flu, Bird Flu, Spanish Flu, ZIKA, and the list of viral diseases goes on and on!

Here are a few more gems on COVID:

      • On Monday, Biden pressed private industry to mandate vaccination, stating, “Do what I did last month, require your employees to get vaccinated or face strict requirements.”
      • Anthony Fauci told CNN’s Anderson Cooper, “I respect people’s freedom, but when you’re talking about a public health crisis … the time has come, enough is enough. We’ve just got to get people vaccinated.”
      • Anthony Fauci announced on MSNBC that everyone should mask, vaccinated or unvaccinated: “Instead of worrying what kind of mask, just wear a mask. Wear a surgical mask, a cloth mask … We need to wear masks.” Biden went further, extending his push for masks to small children: “You have the tools to keep your child safer … make sure that your child is masked when they leave home.”

How hard is it to keep a child in a mask; almost near impossible!  The science is in; take any mask; if you can fog your glasses, then the mask is ineffective at stopping the micron level of COVID. The most straightforward test I know to see if a mask might or might not protect you against COVID.  If the mask doesn’t protect you, guess what?  Wearing that mask is only making problems worse, not better.

Now, let’s talk Delta-Variant, Science, and COVID recent infections.  A friend of mine works in a hospital in Ohio.  Out of 100 patients seen who had contracted COVID in the first couple weeks of August, 99 had been vaccinated, wore a mask religiously, and followed every one of the CDC guidelines for social distancing and COVID living.  The one exception caught the flu, and the flu became COVID through exposure.  I mention this not to paint the entire globe with the same brush but to reflect a truth science has been screaming.  When you vaccinate against viral diseases, those vaccinated become a target for mutant strains, and the vaccine might or might not help prevent the mutant strains from making a person sick.Gravy Train

Straight science found in every viral disease paper I have read and researched.  Take a moment, read, and then compare the hysteria of COVID to every other viral infection on the planet and ask questions.  Polio is considered “eradicated,” polio as a virus is still alive and well; we just have really superior vaccines against polio infections.  Chickenpox, mumps, measles, and rubella are common viral diseases children get vaccinated against; the diseases are not dead; we have developed vaccines and spent decades researching the daylights of these diseases and their mutant strains to understand the diseases and improve the vaccines.

From the CDC, we find the following:

      • “The best way to prevent chickenpox is to get the chickenpox vaccine. Chickenpox used to be very common in the United States.  In the early 1990s, an average of 4 million people got chickenpox, 10,500 to 13,000 were hospitalized, and 100 to 150 died each year.  Chickenpox vaccine became available in the United States in 1995.”Question 2
      • “Hilleman’s mumps vaccine was then used in the combination measles-mumps-rubella (MMR) vaccine, which was licensed in 1971. The rubella component of the vaccine was changed in 1979, but in the United States, the mumps and measles vaccine viruses have remained the same since 1971.”… “Reported cases decreased by more than 99% after both the mumps vaccination program started in the US in 1967 and children regularly received two doses of MMR vaccine.”Question 3
      • No vaccine, and since 2019, no confirmed cases of Zika Virus have been reported in the US or its territories. Remember back in 2014 through 2016, all the pandemic emergencies, the executive actions, the mandates issued by President Obama to “flatten the curve” and “protect our hospital infrastructure” over Zika related viral infections.  Neither do I; in fact, Obama could not even stop playing golf to be bothered to discuss Zika.

Mosquito

      • “The (H1N1)pdm09 virus (Swine Flu – 2009) was very different from H1N1 viruses that were circulating at the time of the pandemic. Few young people had any existing immunity (as detected by antibody response) to the (H1N1)pdm09 virus. Nearly one-third of people over 60 years old had antibodies against this virus, likely from exposure to an older H1N1 virus earlier in their lives.”  Swine flu has a vaccine, but that pandemic did not require mask mandates or include fear for hospital infrastructure and a refusal to practice common sense medicine.  The swine flu virus, H1N1, may have killed 15 times the number of people counted by the World Health Organization.  The H1N1 pandemic struck down primarily young people, many living in Africa and Southeast Asia.  Beginning in 2009, the virus swept the globe and the WHO counted 18,500 swine flu deaths that laboratory tests had confirmed. But according to new estimates from researchers at the U.S. Centers for Disease Control and Prevention, the virus probably killed between 105,700 and 400,000 people around the world in its first year alone, and an additional 46,000 to 179,000 people likely died of cardiovascular complications from the virus.”

Vaccine

Motivation and COVID

Tom Clancy uses the acronym MICE or Money, Ideology, Coercion, and Ego, as the reasons to describe why people become spies.  Except, this acronym also applies to why people act in an anathema manner to common sense, good social order, and proper discipline.  A friend and I discussed COVID and the government tyranny; the political models do not fit since President Trump was defeated.  Economic models do not match actions and reasons for taking more steps.  Social and psychological models do not include the activities of the actors driving the COVID mandates and hysteria.  Science has been utterly rejected, twisted, and destroyed.  Medicine is being twisted and destroyed.Lemmings 1

It wasn’t until MICE came along in the conversation as primary motivating forces that logic started to appear; now, I am not fully cognizant of what was seen in that brief flash, but what I saw, I will describe.

      • Money – There are TONS of cash involved in COVID-Mandates, masking mandates, vaccination mandates, and so forth. Literally, you could take the money and count it by weighing the money by the ton!  Thus money’s influence and motivation cannot be discounted, and following the money is critical to understanding why the COVID virus has to be eradicated before the pandemic can end.
      • Ideology – Unless the ideology is to wipe out populations, such as the elderly and infirm, then I do not think ideology can be a motivating influence or at least a primary motivating force in COVID and the government and media actions.
      • Coercion – Tyrants have always wanted to coerce large populations. As a primary motivating force, coercion cannot be discounted nor eliminated.  Worse, When viewed through the lens of coercion to force people to do as told for personal power and enjoyment, coercion has plenty of solid arguments as a primary force for motivating governments and political leaders to act as they have and continue the pandemic “emergency” as long as possible.
      • Ego – Of all the primary motivating forces, ego fits the best after coercion and before money. Why; because of Fauci!  Here is a practical nobody vaulted into the public limelight and only remains popular as long as the pandemic kills people.  How many other research scientists have been treated similarly, throwing out the first pitch of a baseball season, actively sought for TV interviews, on speed dial by the politically connected and powerful elite.  Oh yes, ego has a role in motivating the pandemic to continue as long as possible!

Lemmings 5Motivation is the reason why people act.  Logic is the reasoning and is generally fully understood after the action was taken; but the motivation to act, the impulses that drive us to our feet giving us the energy to act in a specific direction, exerting our will, minds, hearts, and souls towards a goal, can generally be deduced through MICE.  Therein lay both the power and the tragedy of human relations.  Therein also lay the pattern for understanding why people act one way, and a person will act differently.  The influence of groupthink is too strong for individual voices to counter, and people go along with stuff they would typically abhor personally but accept as a group.

Are there people involved in COVID who are the sons of Mary; probably.  Are there those involved in COVID purely for the perceived health emergency and nothing else; this is also statistically probable.  Yet, for all these potential anomalies, the vast majority of those pushing the COVID pandemic and health emergency are in it for the money, the ideology, because they have always wanted to play “Storm Trooper” and force people to accept their rule, or simply because of the pleasure of having their egos stroked.

Knowledge Check!One thing every citizen of a representative government should know by now, tyranny has many faces, multiple names, but only one result.  The death of liberty too often in world history has been accompanied, not by the crash and thunder of conquering armies, but the applause of the deceived masses.  Well, COVID and this “health emergency,” “pandemic,” “global crisis,” is but one of tyranny’s names, and liberty is dying a slow and horrible death.

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Chronicling the VA – May We Remember the “Pobrecito!”

I-CareA Spanish-speaking Mexican colleague taught me this term, “pobrecito,” meaning “poor little one.”  As I chronicle the VA ineptitudes, failures, criminal behaviors, and abusive actions, I am always conscious of the pobrecito, the poor little one, the poor victim who got harmed.  Too often, the victims never receive any compensation, acknowledgment, or retribution, nothing for having become a victim of the VA.  Too often, the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) investigates long after the abuse has occurred, and the victims are not covered in the scope of the investigation, or worse, the victim was killed, and the family is left to mourn, and nobody can help.

Angry Grizzly BearWhy chronicle the VA abuses; because the needs to be held accountable, speak the language, and have tougher skin and broader shoulders than the VA’s normal victims.  The VA is slowly learning they can harm me, but they cannot shut me up!  I will not stop fighting the VA for humane treatment, honorable service, and dedicated systems.  The VA is sick because apathy and inertia were allowed to replace common sense and decency, leadership was replaced with cost accounting and bureaucratic red tape, and human kindness was eradicated and replaced with drones and robots.  I know how to make the VA better; I do not have all the answers, but I know how to launch the revolution and begin cleaning the VA, and I will not stop calling upon those responsible for fixing the mess they created!

Starting this week’s VA-OIG headlines of crimes and inspections, we find a couple in South Florida who used the system to bilk more than $20 Million in purchase order scams.

Earron Starks was sentenced to 30 months’ imprisonment, followed by three years of supervised release, and ordered to pay over $2.4 million in restitution. Carlicha Starks was sentenced to three years of supervised release, including one year of home confinement, and ordered to pay $501,000 in restitution. They paid kickbacks to VA employees as part of a large-scale bribery scheme, which enabled the Starks couple and other corrupt vendors to receive over $20 million in purchase orders from VA medical centers in West Palm Beach and Miami. Fourteen additional defendants were charged for their roles in this scheme.”VA 3

Who’s the pobrecito in this case; the taxpayers, the veterans, and the United States.  Federal Employees had to not only know the crimes occurring but be complicit in the crimes.  Will they lose their retirement benefits, have to repay their wages, and face criminal charges and jail time for their culpability?  Fourteen additional defendants, how many were supervisors in the know and on the payroll who were promoted during this scheme whose supervisors failed to do their jobs and scrutinize the work of their underlings?  The shadiest part of this entire scheme is encapsulated in the following sentence:

All VA Employees were either terminated or resigned.”

Name me one private-sector employer who could get away with a massive scheme and enjoy similar benefits!Survived the VA

We find another VA employee embroiled in theft of equipment which sold the stolen goods in Ohio.

Kevin Rumph, Jr., of Fairburn, Georgia, pleaded guilty to stealing more than $1.9 million in medical products while employed at a VA community-based outpatient clinic in Atlanta. Between 2013 and 2021, Rumph made hundreds of unauthorized purchases of equipment used to treat obstructive sleep apnea. He then stole and sold the equipment to a vendor in Ohio. Sentencing is scheduled for November 17, 2021.”

I have worked in purchasing in both the US Military and in the private sector.  If I went to my bosses with “hundreds of purchase orders for supplies,” they would naturally be curious.  Repetition of hundreds of similar requests would raise red flags and demand audits of my records and proof of need.  Why did this not occur at the VA?VA 3

In the US Navy, I was in charge of ordering stock and saw requests for certain o-rings spike, as I knew the Chief Engineer would spot this and ask why, I asked why, went to the equipment records, dug up the maintenance reports, and asked questions of the mechanics and technicians.  In doing so, we discovered an unreported problem with machinery.  This is called due diligence; why was it not being practiced by the supervisor of Mr. Rumph?  You cannot tell me a seven-year trend line is something that was an anomaly and easily missed in budget reporting year-over-year!

Exclamation MarkLet’s admit a truth for certain; COVID has been a farrago of gargantuan size from day 1.  In acknowledging this, no blame is being proportioned to the front-line workers in any way, shape, or form.  But, the administrators, policymakers, politicians, and government bureaucrats have certainly proved they could unscrew the inscrutable!  Worse, the bureaucrats proved that their idiocy was highly contagious, infecting more people than COVID, spreading faster than COVID, and killing more people than COVID.  Our proof of this concept arrives from Houston and the Michael DeBakey VAMC.

The VA Office of Inspector General (VA-OIG) conducted a healthcare inspection regarding allegations of incompletely screening for COVID-19 and treatment of a patient with serious mental illness who presented for same-day care at the Michael E. DeBakey VA Medical Center (facility).”

Findings:

      • The VA-OIG substantiated that facility staff did not complete the patient’s COVID-19 temperature screening.
      • The VA-OIG substantiated that facility staff failed to manage the patient with COVID-19 symptoms medically.
      • Sent the patient to the drive-through testing area without medical evaluation, did not isolate the patient, complete a care plan, or follow the policy for transporting patients suspected to have COVID-19.
      • The vulnerable patient disappeared while in the facility’s care, was found off-site four days later experiencing a medical emergency, taken back to the facility, and died the following day [emphasis mine]!
      • The VA-OIG determined that the Mental Health Intensive Case Management team failed to address documentation discrepancies related to the patient’s surrogate and educate the family on COVID-19 visitor policy and screening processes.
      • The VA-OIG identified the facility’s noncompliance with the missing patient policy.
      • Facility leaders’ failure to report an adverse event and ensure a timely review of the patient’s episode of care.
      • The VA-OIG identified facility leaders did not timely or accurately disclose to the patient’s family the medical mismanagement that led to the patient’s adverse clinical outcome, e.g., death!
      • The VA-OIG concluded the failure to screen, isolate, and evaluate the patient resulted in potential COVID-19 exposure to staff, patients, and the public when the patient moved through facility grounds.VA 3

What was not covered in the scope of the VA-OIG investigation was whether the staff had proper training on the written policies or if training had been suspended due to the “pandemic health emergency.”  Failure of training has been a running and recurring theme for the VA before the pandemic, and the failures of training have led to thousands of “adverse clinical outcomes” at the VA, up to and even including death.  Yet, as evidenced in this example, small decisions lead to catastrophic events.  The infected patient was mentally unstable and missing for four days; how many people interacted with the patient as a superspreader event?  Who is at blame at this VAMC for this event, the leaders!  They failed their people, failed this patient, and failed this family!

Detective 4Before continuing, we must pause and take a moment to send heartfelt congratulations to two VA Health Care Systems (VAHCS) who passed their comprehensive healthcare inspections (CHIp), if not with flying colors with significant improvement, and are deserving of the highest praise.  Would the leaders of the Fort Harrison VAHCS in Montana and the Western Colorado VAHCS in Grand Junction please stand and take a bow.  Your improvements, conduct, and capacity to achieve reflect that success is possible with good leadership.  Keep up the good work; find ways to improve daily, and may continual success be ever yours!

Finally, we come to a regular topic, the failure of the VA as a whole entity to manage to pass a simple audit on financial matters and the continuing debacle where hiring is concerned during the pandemic.  Let me refresh your memories on the hiring debacle; first, the VA-OIG found that VISN leaders “were generally pleased with the “flexibility” provided during the pandemic for speedier hiring.”  What did the American people get for reduced hiring practices at the VA?  More criminal employees, more employees with shady pasts, more employees with sticky fingers, and more employees who could not find employment in public schools, now working for the federal government.VA 3

How did that relaxing of hiring practices work out for the American people and the veterans receiving care; not very well!  But, let’s all relax; the VISN leaders are “generally pleased.”  Frankly, I would be shocked if anything ruffled the VISN leaders’ feathers long enough for them to care; they are mostly at the top of their career ladders and failing a presidential appointment to Washington, know they are set for life.  So, why rock the boat?!?!

As for financial audits, the VISN leaders know that money continuously is appropriated to carry them and their poor decisions forward.  Just ask the Denver VAMC where the construction cost overruns are still costing the taxpayers, and no one was ever held liable for that boondoggle or any other crime and scheme for that matter.

Question 3Why?  Why are victims left to rot, the assaulters and victimizers promoted, and the VA as an organization left in the hands of disreputable, dishonest, unethical, and immoral people?  Why is the VA a culture of corruption, greed, envy, sloth, and disinterest when the US military is the exact opposite?  America is not what is found in the halls of the VA, why has the VA been allowed to become something anathema to the American people?

Knowledge Check!Great Britain, you find similar in your halls of government.  Your people are amazing; your government workers are just as despicable and deleterious as the American VA, IRS, and DMV.  Australia, great people, absurdly detestable government workers.  France, interesting people, but the government employee seems to have been drug from the bottom of the scum sucked from the Seine.  I have met incredible people in Italy, Greece, Germany, South Korea, etc., but the story rings true everywhere; the government does not represent you.  Pobrecito; what has happened?

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Blood is Blood – The Logic is Flawed!

Exclamation MarkLast night, during one of my frequent periods of wakefulness, a headline blew my mind, “There is no difference between blood and blood – Horowitz removes restrictions on gay men donating blood,” as reported by the Jerusalem Post.  Using this logic, then going maskless is not a problem, and being vaccinated or not vaccinated is not a problem either, for blood is blood.  Worse, consider the ramifications; the safety and integrity of the blood supply have been a critical problem from the first day humans realized we could take blood from one person and put it into another person successfully.  Mistakes in the integrity and safety of the blood and blood product supply cost people their lives!

I am not here to discuss the political aspects of this move.  The Health Minister of Israel (Horowitz) will be measured and weighed by his electorate for good or ill.  How and when the Health Minister will be measured and weighed will be up to the people in Israel, and I hope they will choose wisely.  I have no further comments on the political side and wish Israel the best of luck on this issue.

However, on the practical aspects of blood and blood product, safety and security, I have a LOT of concerns and have some authority, knowledge, and ability; thus, I will speak to this issue.  As I begin, I will state, again for the record, I do not care about your bedroom choices (hetero-, homo-, etc.), keep them to yourself and your legal age of consent consenting partner, and I could care less.  However, medical professionals should know some risks as they handle body fluids, especially when donating those fluids for others to use in an emergency.

Pin on Signs and SymbolsDuring the 1980s, both the American Red Cross and the Canada Red Cross Society suffered blood tainted scandals due to insufficient testing of, knowledge of, understanding of, and the dimensions inherent to donating blood and blood products where sexually transmitted diseases were concerned, especially AIDS/HIV.  AIDS/HIV was not the only sexually transmitted disease that crossed through blood transfusions, Herpes, Gonorrhea, and many more all had their times in the spotlights as diseases making their ways into donated blood and thence into patients without risky lifestyles, who contracted these diseases after receiving transfusions of blood or blood by-products.  The first cases were noticed in the US Military, where patients started having problems with these sexually transmitted diseases after being wounded and receiving life-saving blood or blood by-products and then catching an infectious disease.  Even Malaria has records of being passed through blood and blood by-products, so just presuming that sexually transmitted diseases are the only diseases to worry about is not acceptable.

Claiming “blood is blood” is the height of exaggerated ineptitude for a political cause.  Yes, red stuff oozing from a mammalian host can generally be typified as blood, but not all blood is the same, nor is all blood equal.  This is why monkey blood is not harvested for use in humans, why Ape blood is not transferred into elephants, and human blood has a letter classification system.  Whale blood cannot be used in dolphins, nor is it compatible with human use; thus, claiming “blood is blood” remains a thoroughly ignorant comment of the highest magnitude!

The 17th AnnualGive the Gift of Life Holiday Blood Drive | B104 WBWN-FMTake a minute, those of us who lived through the 1980s health scares and blood scandals.  By the way, that is plural for a reason; blood scandals keep happening because blood security and integrity and politics do not mix, and every time some politician thinks they can mix safely, we have another blood integrity scandal, and people die!  Do you want to take the risk of being in an auto accident, being rushed to a hospital, receiving blood or blood by-products, and coming home with a transfusion disease?  What about dialysis patients who regularly receive blood or blood by-products; do you want to add another worry to your list of health concerns when receiving care?

Sign Donation Blood Heart Donor Icon Stock Illustration - Illustration of icon, design: 79488667Now, suppose the findings on a medical record were being made public, and the patient’s rights trampled, where disclosure of lifestyle risks kept that person from donating blood and were being published. In that case, I might believe there was a “rights” concern to be vocal about.  However, this is not the case, and refusing a population with known high risks for passing multiple communicable diseases through all types of body fluids, from donating said fluids to the general population, is just sane and common sense medicine.  It is not discriminatory to exclude those who choose a higher-risk lifestyle to participate in specific activities where the health and welfare of the general population are concerned.Blood Donation Sign Wall Poster Background Material, Love, Blood, Donation Background Image for ...

Case in point.  If I travel to Thailand, whether I engage in the sex trade or not, I am refused from donating blood for a specific period after I return home, and I will have to pass a blood test before my blood is accepted at the blood bank.  Plus, because I prefer to give plasma, I will have to prove I am clean twice before I can give plasma again.  This is not discriminatory; this is a safety precaution to protect the rest of the blood and blood by-product supply from contamination.  Now, if I engaged in the sex trade in Thailand, I would be banned indefinitely from donating blood, regardless of condom usage, and the remarks would be permanent across the entire records of the Red Cross.  All because the threat is too great to risk allowing this heterosexual male access to donate blood and run the risk of contaminating it with a disease from Thailand.  I know people in South Korea, who caught unique diseases during the Korean War, who cannot return to the United States, ever.  The United States made this decision not to run the risk of contaminating America with what they caught.  Not discrimination, simple public health policy.

Knowledge Check!Now, we return to the crux of the argument.  If “Blood is blood,” then being vaccinated does not matter because blood is blood and public health and safety are not issues where communicable or infectious diseases are concerned.  If this is correct, why do we still have COVID restrictions?  If blood is not blood, why bow to political pressure on something that is definitely not a political but a medical safety issue?  Politicians and those who cling to the government for an answer to every single problem cannot have this issue both ways.  Either blood integrity and safety is a medical issue where common sense practices trump individual rights for the common good and safety of donating life-giving fluids, or life requires taking risks, and we can shut down the regulatory boards and panels, reducing the costs of medicine.  I am all for reducing the size and cost of government; while I might not argue fully for making all those cuts in medicine regulation, a choice needs to be made and then supported.  Choose wisely!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

What We Are Witnessing – What We Can Do!

Angry Grizzly BearThe US Senate passed the non-infrastructure bill, loaded with everything but infrastructure initiatives and a bloated price tag that is not paid for, which will increase inflation and the National Deficit.  The US Senate is on its way to passing a $3.5 Trillion spending spree, again no accountability, no restraints, not paid for, balloons the government, and robs freedoms and liberties from every American.  Did you know all legislation that spends money is supposed to originate in the US House of Representatives?

Long ago, a couple of legislators crammed down some rules that allowed for spending bills to originate in the US Senate, as long as the US House of Representatives got the legislation, eventually, and voted for that legislation.  Generally under immense pressure from the upper house and the special interest groups lobbying for the lower house to “just go along.”  All of which is legal but unconstitutional, but allowed as legislative chicanery called “doing business in Washington.”

Tired of Politikal-Gimmickry yet?  I am!

My wife brought up an interesting question regarding the now resigned Governor of New York, Andrew Cuomo, “Will he be prosecuted?”  I do not know, and from the headlines, I cannot tell.  Worse, it is not apparent if a deal was struck to compensate the victims from the New York taxpayers and avoid accountability if Gov. Cuomo left before electioneering could begin to hinder Democratic efforts to keep the office in New York.  Tell me, how can private industry have significant penalties for even a suspicion of sexual impropriety, but government elected officials can weasel out of accountability time after time if you are in the appropriate political party?Angry Wet Chicken

Speaking of Ex-Governor Andrew Cuomo, his anti-apology/resignation speech was the worst kind of political skullduggery since Anthony Weiner was disgraced for sexual impropriety.  If Chicago is the land of pay-for-play politics, then New York must be for sexual impropriety politicians, beginning with William Jefferson and Hillary Clinton!

Tired of Politikal-Gimmickry yet?  I am!

Can someone tell me how and why YouTube, Facebook, LinkedIn, Twitter, and other Social Media companies, private companies, can block content and customers?  First, the companies take money to be news outlets and media giants, obtaining tax breaks and special benefits for being tech giants and other prime companies for the government.  Then, they squawk they have the right to silence content, isolate content providers, shame politicians, and spout political beliefs like private companies while receiving public funds.  The IRS came down hard on churches in the 2020 election cycle for having 501 C status and being mouthpieces for political speech; how is this not the same principle with social media companies?  Why aren’t social media companies forced to either maintain neutrality or stop receiving preferential treatment from the government?

Tired of Legal and Politikal-Gimmickry yet?  I am!

Exclamation MarkLet’s talk about scientific facts for a moment, and if you like, feel free to look up the corresponding research.  I am not a medical professional, epidemiologist, virologist, or chemist; however, I can read a research paper, and this is what I have found.  One of the reasons it is so difficult to vaccinate against viral infections is the ever-changing viral infection itself.  Essentially, the virus mutates a lot, and these generational mutations tend to keep a vaccine from working effectively against a virus for very long.  The only sure-fire way to protect a population against a viral infection is to allow the people to experience the viral infection and build herd immunity.

The Delta-Variant of the Sars-COV-2 (COVID-19) viral infection is essentially a fizzle.  Vaccinated people are catching this mutation, spreading it, and then complaining, “But I got vaccinated.”  However, the fizzle is that the virus has mutated into a half-life in a previous mutation, and the Delta-Variant is a half-life again of the previous half-life.  This is why the Delta-Variant will make you sick but not keep you sick, and the antibodies your body builds against Sars-COV-2 are actually beneficial in the long run.  Having said all this, do you think the media will report this information; do not bet the farm, Lucy!  Will, the government, relinquish control; hold your horses, Mack!  Totalitarianism has broken out, and reigning in these out-of-control bureaucrats and power-hungry politicians will take a lot more than the half-life deaths of Sars-COV-2.Anton Ego

I am a person of action; I do not take kindly to being told to sit down and wait or shut up and stand still!  Never have been; in fact, learning patience has been one of my biggest challenges and hardest lessons, and I still fail gloriously DAILY!  Worse, I see the danger and the emergency, and I desperately feel the need to take action immediately!  It makes me good in the trenches but not very good in the stadium.  Here are my thoughts on taking action now; agree or disagree, take action NOW!  We can talk about the problems later!

      1. Start right now, calling the US House of Representatives and DEMANDING in the strongest language possible that your elected representatives refuse the boondoggles being passed in the US Senate right now!
      2. New Yorkers, you are some of the toughest people in the world; show it! Put your backs up, put your mouths in gear, and DEMAND that Governor Cuomo be held accountable, in a court of law, for the crimes for which he is accused.  Guilty or not, these accusations need to be settled in a courtroom.  Not a pressbox, not a media-feeding frenzy, but by a jury trial!  Force the truth!
      3. America, lead the world in throwing off the totalitarianism that is killing representative government across the globe! From the mayors to the governors to the US President, it is time to end the farrago called COVID and throw the bums OUT!  Yes, this includes the MEDIA!  The politicians’ lapdog needs to be held accountable for spreading half-truths, lies, and falsehoods for personal power, and rightly so.  When discussing the media’s role in spreading and fanning the flames of COVID, we include social media and hold these tech companies responsible for their roles.  Nobody is “Too Big To Fail!”
      4. If the elected officials, including judges, refuse to listen to you, begin the recall procedures! Refuse your consent to be governed!  You own the power of and the keys to the government, and it is past time for the government to begin fearing us, the electorate!The Duty of Americans

As the politicians take the rest of August off, lets us remind them who is in charge.  Turn off your TV.  Turn off your Cable.  Turn off your social media.  Call, text, email, and visit their town halls, demand an audience with the elected officials.  Get heard!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

COVID-19 – Authoritarians, Storm Troopers, Liars, and Thieves

Angry Grizzly BearSince February 2020, the world has seen COVID-Authotirarians, Storm Troopers, Liars, and Thieves rise.  I think it is time to start naming names and being specific that we will no longer accept this detestable behavior from government, media, community, bureaucrats, and those who have constantly been aching for a chance to exert authority over someone else!  Too often, I have witnessed these ignorant savages trying to overcome common sense and legal boundaries in the name of a survivable viral disease because the atmosphere has allowed the rise of stupidity masquerading as “Health Policy!”

The Secretary of Veterans Affairs

Monday, 26 June 2021, the US Mail delivered to me a letter from the Secretary of Veterans Affairs (VA), Secretary Denis McDonough, and cosigned by Acting Under Secretary for Health, Dr. Richard A. Stone MD.  Two people who were selected by the fraudulent president Biden for their political adroitness and not for their brains, experience, intellect, or even manners, and the letter received is proof!  Imagine sending a letter to all US Veterans using an attitude of childishness and the faux superiority of the intellectual elite to compare getting the COVID-19 vaccine to serving in the US Military, “AGAIN!”

Angry Wet ChickenWhat was the desired intent of this despicable piece of self-righteous trash?  I have had three calls to date from two different VISN’s and VAMC’s requesting me to get vaccinated, neigh demanding me to get vaccinated.  Yet, the VA cannot even answer simple questions about my concerns for the vaccination, including future sterility, why vaccinated people are only catching the DELTA variant, how the vaccine interacts with medications already being taken, the neurological issues and heart issues from receiving the vaccine, and the list goes on and on!  But the VA wants to send me a letter talking down to me and my intelligence trying to promote the vaccine and claiming this is like serving in the US Military again!

Quoting Colonel Potter, M*A*S*H 4077, “Bull Feathers!”

Governors who do not understand the Separation of Powers or the Rule of Law!

Governor Michelle Lujan Grisham, governor of New Mexico, Governor Gretchen Whitmer, Governor of Michigan, Governor Gavin Newsom, Governor of California, Governor Andrew Cuomo, Governor Phil Murphy, governors of New York and New Jersey respectably, and too many more who act like tyrants, think like spoiled children and run their state’s like the Federal Government is their personal piggy bank and all the citizens are private property.  We, the citizens, are sick to death of being held captive to your ignominious and deleterious policies, stupidity, and damnable insanity!  You have disgraced your offices, demeaned the rule of law, and distanced yourselves from any political redemption.Apathy

I look forward to the day when you are held legally culpable, accountable, and individually responsible before the bar of justice for your behaviors, actions, double-dealings, and waste of taxpayer funds!  You named, and those unnamed who are cohorts in crime, have been the cause of unemployment, businesses shuttering, economic disaster, all for personal gain and individual ego, and your reigns of terror are, hopefully, soon to end in Federal Court and an Orange Jumpsuit!  You have betrayed the honest citizens in your states, and when they awake and arise, blessed change will follow, for there is nothing more dangerous than an honest man betrayed!

US Senators, US House of Representatives, and Every Legislator Elected in the United States

cropped-bird-of-prey.jpgEvery one of you should be ashamed!  Each one who has sat by and watched your governor or president be the flaccid media mouthpiece of cheap science, faux interest in public health, and have voted to create inflation, destroy businesses, livelihoods, and communities, while cheering the destruction of law and order, you also need to be held accountable for your culpability in this most disgusting and distressing event, COVID-19!  I absolutely require your retirement packages, repayment of all funds, and a dishonorable discharge from public service for every one of you!   Why have so few of you even asked the simple questions regarding COVID; for example:

      • Why is COVID different from every other viral disease in the world?
      • Why do we need to “fast track” a vaccine using untrusted, untried, and unknown technology?
      • Why is a Chinese Viral disease able to shut down economies, close businesses, close churches, and close everything but big box stores?
      • What is different about COVID, a viral disease less dangerous than any other viral disease shipped from China with a higher survivability rate, able to throw the entire world on its ear?
      • How did Fauci go from approving Hydroxychloroquine in research to being against Hydroxychloroquine for the same COVID viruses he wrote peer-reviewed research papers?
      • Why was common-sense medicine thrown away for personal suffering at home until those susceptible to COVID were dying?

You were elected to represent the best interests of ALL your electorate, not the special interests, Big-Tech, Big-Pharma, Big-Box retailers, but the common citizens, and you refused to perform your primary function!  Legislators have only two jobs, write common-sense laws that support the best for all citizens, honoring the US and State Constitutions, and scrutinizing the legislative branch!  That is your entire job, and too many of you have failed to even show up for work.

Yes; you who have sat around and done nothing to protect citizens from run-away government are guilty, culpable, responsible, and need to be held accountable in front of a judge for your lack of job performance!  Justice demands you to be held responsible.  You will be held liable and accountable.  I long to see you in distinctive clothing, carrying sandwich boards advertising your crimes, picking up trash, pulling weeds, feeding the hungry, and doing other public services until all the funds you have squandered, and the pain you have inflicted has been paid off!Plato 2

Neighbors and Bureaucrats

America has always come together in difficult times, relying upon our neighbors and communities for strength and support.  But those who have used COVID as a means to exercise dominion, creating rules and policies at a whim, demanding obeisance, and using fear of a public health emergency instead of logic and calm-headed reasoning should be utterly ashamed of yourselves!  I have watched neighbors, friends, families torn apart by COVID Storm Troopers who have used faux science, media talking heads, and the most abysmal behavior exercising control, and this behavior must cease immediately!  When government fails, bureaucrats lose their voice.  Well, the government has failed, the bureaucrats have lost, and it is time for a reckoning with the citizens who have been cheated, defrauded, and penalized!quote-mans-inhumanity-2

Neighbors and Citizens

Do you realize that you have had money stolen from your pockets through inflation, taxes, and a run-away government?  Do you understand that through media talking heads, faux science, and out-of-control legislative branches of government, your liberties, rights, and freedoms have been stolen and replaced with socialized government?  In fact, the socialization of the government began before COVID, and this was done to directly penalize you for crimes you have never committed and enlarge the pockets of career politicians!  Are you aware of how close the US Constitution has come to being irrelevant, overtaken by a socialized/communist government?  How concerned are you that your heritage, your legacy, and your family are about to be wiped out through government actions taken in capitals and applied on main streets, and the bureaucrats are laughing all the way to the bank!

VaccineCOVID is the virus with the highest survivability of ALL the Chinese viral diseases unleashed since the early 1990s; yet, COVID is the only virus to impact the world, as we have witnessed since Jan//Feb 2020.  Why is that?  Why is COVID powerful enough to change governments to demand green/health passports to enjoy food and drink in an outdoor café?  Businesses owners, why was COVID allowed to close your businesses?  None of the other Chinese Viral diseases were allowed to close you down; why was COVID allowed?  The Ebola outbreak in the last years of Pres. Obama was insufficient to close schools, businesses or demand health checks, and health passports; why was COVID given this honor?

What is Politics?

Knowledge Check!Politics is too often a word with so much baggage; people become confused and stop listening after hearing the word politics.  According to Webster:

As a Noun, “the activities associated with the governance of a country or other area, especially the debate or conflict among individuals or parties having or hoping to achieve power.”

  • The activities of governments concerning the political relations between countries.”
  • The academic study of government and the state.”
  • Activities within an organization that is aimed at improving someone’s status or position and are typically considered to be devious or divisive.”
  • A particular set of political beliefs or principles.”
  • The assumptions or principles relating to or inherent in a sphere, theory, or thing, especially when concerned with power and status in a society.”

As a Verb, politic/s is derogatory and is defined as “engaging in political activities.”

From Old French Politique “political,” Latin from Greek Politikos, and Politẽs “citizen” and Polis “city.”  Thus, we have described the term politics in all its glory and inhumanity.  Is the term more understood?  Politics is a descriptive tool used to identify certain human activities where power is sought, and devious means and divisive gestures are employed to obtain that power.  Every action tied to securing power through devious means and divisive gestures is politics or political, meaning derogatory.  For those needing more, derogatory is “showing a critical or disrespectful attitude.”quote-mans-inhumanity

COVID has only EVER been about POLITICS!  Meaning that those exercising political leadership positions have a derogatory view of you; the common citizen, those of us who elected them to power.  The politicians are in the “political game” to demean, abuse, and destroy you.  Mad yet?  Feeling betrayed?  We, the citizens, need to restrict our consent to be governed, recalling all the politicians and demanding they be held accountable for creating the mess America is in!  I am not talking about being violent, I do not condone any violence, but I demand the Rule of Law be applied to those who have abused the law, usurped power, and exercised dominion!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.

Sometimes, You Have to – More Repugnant VA Chronicles

Angry Wet ChickenIn looking back, it has been a long time since I wrote two scathing chronicles about the Department of Veterans Affairs (VA) in a single week.  But, I could not allow these Department of Veterans Affairs – Office of Inspector General (VA-OIG) reports to age any longer in my inbox.  With the Fourth of July fast approaching, as you celebrate, please keep in mind what the VA is purposefully doing to the Veterans, Dependents, and Spouses under their care.  America would not be here without her military, and military service produces veterans.  But, the VA is producing bodies and bureaucracy instead of helping veterans as they are paid and legally charged to do!

When I first left the US Army, I found myself employed in a telemarketing call center and was never paid the correct amount.  18-months later, I was employed with an Internet Service Provider, who bounced multiple paychecks before going bankrupt underneath the employees.  When the VA-OIG reports part-time physicians not being appropriately paid, I can understand the issues this causes.

I-CareThe VA-OIG randomly selected 134 salary agreements for part-time physicians on adjustable work schedules and found 44% of the physicians were either over or underpaid.  One might ask how and why these pay errors occurred.  The answer is extreme designed incompetence, not that the physicians will feel any better that they were either overpaid and owe back monies or underpaid and are now owed a considerable check.

From the VA-OIG report, we find the following as causes for the discrepancies:

This occurred because key management controls were missing or not working. Officials did not make certain that medical facilities complied with policies and procedures. Consequently, the OIG estimated VHA medical facilities had about $8.3 million in questioned costs that year (2019) and an additional $8.3 million in 2020. VHA medical facilities also may have violated the prohibition against voluntary services, and potentially the Antideficiency Act, by not correcting underpayments or by having physicians working above the 1,820-hour cap because their agreements were not properly reconciled” [emphasis mine].VA 3

The government officials’ neglect, malfeasance, and misfeasance might be illegal, as they failed to do their jobs properly.  Yet, the VA-OIG only issued recommendations.  There is potentially $16.6 Million in over or underpayments at stake, plus illegal actions, and people have not been fired or perp-walked into custody.  How can government employees get away with behavior that would have seen class-action lawsuits, criminal investigations, media reporting feeding frenzies if similar had occurred anywhere in the private sector?

IronyYet, the marketing materials produced by the Department of Veterans Affairs – Veterans Health Administration, a division of the VA, claims this is “Defining Excellence in Healthcare in the 21st Century.”  If you believe that, then you must believe that buffalo wings come from flying buffaloes.  Unfortunately, the problems only continue to worsen.

The VA-OIG reports that a doctor had accumulated more than 4000 alerts from the electronic health record (EHR) system.  This means that the computer system notified the doctor that patients needed care, appointments, were seen in the ER, required treatment, pharmacy prescription renewals, and much more.  The alerts, called views, are a built-in measure to help patients not get lost or have “adverse clinical outcomes” while receiving care at the VHA.  The VA-OIG found that the entire medical facility at the Charlie Norwood VAMC in Agusta, Georgia had similar issues.  The doctors were not viewing the patient EHR views as indicated.VA 3

What’s worse, the VA-OIG could not tell if “adverse clinical outcomes” had occurred because once the EHR views are settled, there is no record of the patient or why the view was required.  Talk about accountability, responsibility, and transparency in the patient-aligned care team (PACT).  In reading this VA-OIG report, it looks like when the facility leadership was alerted the VA-OIG was coming, the leadership team did a massive clean-up of the records, knowing they would never get caught and held responsible for any “adverse clinical outcomes.”  As a side note, the VA-OIG report claims the doctor with 4000 views is no longer providing care at this VA facility.  Heaven help his patients wherever this doctor is now!PACT 1

So far in 2020, I have had two different primary care providers assigned, and since moving out of Arizona, I will shortly have a third assigned to me.  My first primary care provider retired, but before doing so, he set up many EHR problems for his replacement to handle.  Including refusing to renew prescriptions, some of which were mine, which caused weeks of not receiving the proper medications.  Upon learning of my impending move, my second primary care provider essentially wiped her hands of my care, leaving me without medications and a clinic to contact for help.  Great job if you can get it; get hired to treat patients, and then not treat patients.  Before you ask, no, knowing I am not alone in this ordeal does not help!

PACT 3Finally, the VA-OIG has completed a full VISN wide comprehensive healthcare inspection (CHIp) for VISN 10.  VISN 10 covering Ohio, Indiana, Michigan and is located in Cincinnati, Ohio.  For all intents and purposes, the CHIp went well; the leaders are competent and knowledgeable.  Thus, I issue my sincerest congratulations to VISN 10 for their success.  The VA-OIG inspected the VISN’s ability to respond to the COVID pandemic appropriately, and the VISN performed well.

VA 3Except, this opens a few questions needing address.  At two VISN 22 and two VISN 17 facilities, I have experienced four utterly different responses to the COVID policy and masking mandates.  None of the facilities have written guidelines that are geographically specific to the patients and weather patterns in those areas.  None of the facilities have documented processes for veterans who cannot wear masks, with an approved policy supported, written statement for accommodating these veterans.  One facility insists that the veterans who cannot wear masks be arrested, cited, and fined.  One facility insists that if you have a letter from your doctor, you are okay.  One facility vacillates wildly from day-to-day and person-to-person, and the fourth facility doesn’t have a clue but is still very helpful, with supervisor approval.Question

Yet, somehow, VISN 10 has all their VAMC’s and VAHCS’ operating to the same sheet of music and behaving similarly.  How is this possible VA-OIG?  Better still, how does this spread out to other VISN’s and facilities?  May I hazard a guess, based solely upon the perceptions of veterans in VISN 10, the masking policy from COVID remains haphazard and improperly applied because Washington, DC, never issued proper guidance in the first place, the VISN leaders never issued written guidance.  The policy process on the local level is a quagmire of egos, bureaucracy, unions, all set into a cesspit of inaction and designed incompetence!  If COVID has taught any lessons, the number one lesson has to be that the leadership at the VISN and local levels remains inadequate to the task they were hired to perform!

© 2021 M. Dave Salisbury
All Rights Reserved
The images used herein were obtained in the public domain; this author holds no copyright to the images displayed.