“That’s Crazy!!!” – More Chronicles from the VA – Chapter 2

I-CareAs bad as the last several months have been, I hate adding more bad news; but the Department of Veterans Affairs (VA) – Office of Inspector General (VA-OIG) keeps reporting, and I keep summating.  Due to the absolute overabundance of incredible bureaucratic insanity, today’s article format will necessarily shift to report more and comment less.  Don’t worry, I will still comment on the more egregious examples, for some of these VA-OIG reports are scarier than Joe Biden dressed as a mall Santa at a Fourth of July celebration feeling up little children!

  • 2020 Pre-award reviews of contracts totaled $81 million; guess what:
      • 24 of the 31 contracts awarded contained conflicts of interest.
      • 25 of the 31 contracts had problems with overcharges for hourly rates of services rendered.
      • 6 of the 31 price gouged Medicare.
      • 25 of the 31 contracts, if they had adequately followed the contract process, would have saved taxpayers $16 Million. – Would it shock anyone to hear this is just the “tip of the VA-OIG” report iceberg?

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  • Financial Efficiency Review of the Southeast Louisiana VAHCS in New Orleans; guess what:
      • The VAHCS in New Orleans scored 75% out of 90%. The VA does not try to get a 100% because they regularly fail financial audits as a fact.
      • Actual costs are difficult to relate in dollars and cents because the leaders intentionally hid costs from the VA-OIG, then blamed the new medical center director.
      • Avoidance costs, Purchase card abuse, prime vendor program abuse, and more were employed to avoid proper fiscal practices.
      • Audit, FAILED! No accountability, no person held responsible, and the taxpayer is left holding the bill!

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  • Followup to VAHCS Ozarks Pathology Failures From Dr. Levy Scandal; guess what:
        • Levy Scandal for those who do not remember. – Intentional misdiagnosing, VA coverup, refusal to discuss with patients affected. The report is ghastly!
        • 5% of the patients have now been contacted, and the VA-OIG considers this a “success.” I sure hope you are not part of the 24.5% patient population.
        • Here’s the rub in the 76.5% notification, “an absence of a clearly defined process for clinical providers to alert the Clinical Review Team if later changes in a patient’s health required reconsideration of institutional disclosure.” Does the VA-OIG still want to cheer about that notification rate?
        • Less than 5% of the severely sick patients have been notified of the scandal and the problems created by Dr. Levy. Is this how the VA admits culpability, waiting for the patient to pass?
        • Now, here’s the real kick to the balls; “The VA-OIG determined facility processes related to disclosure of the pathology errors and amending patients electronic health records generally met Veterans Health Administration policy requirements, but opportunities for improvement existed.” – Are you KIDDING ME?

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  • Speaking of fiscal inefficiency and audit failures. The VA continues to overspend and under-deliver on prosthetic devices, especially for shoe inserts.
        • In the fiscal year 2019, such items—artificial limbs, shoes, shoe inserts, and compression garments—accounted for about $318.8 million, or about 9 percent of prosthetic spending.
        • Oversight of prosthetic spending was ineffective, resulting in medical facilities sometimes reimbursing vendors at unreasonable rates.
        • Medical facilities spent about $10 million more than reasonable rates in the six months from October 2019 through March 2020.
        • Rates and data in databases remain unreliable, no oversight, and those in charge of oversight are missing in action. Yet, the VA continues to spend pell-mell.  Does this sound like fiscal responsibility to you?

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  • VA-OIG double-speak lives, and is blatantly observable in the following report, the “Contracting Officer Warranting Program.”
        • For those unfamiliar, a simple explanation: “A warrant gives federal contracting officers the authority to obligate taxpayer dollars. VA’s contracting officers help serve our nation’s veterans by procuring the goods and services required for their care and support.”
        • Never forget – There have been long-standing concerns (Never Resolved) with VA’s contracting officer warrant program. Since 2015, the VA Office of Inspector General (VA-OIG) has issued multiple reports [describing how] warranted contracting officers exceeded their authority and made decisions that put veterans and VA facilities, resources, and information systems at risk.
        • Never forget – The VA-OIG has documented multiple times, and the VA has never resolved, that the VA’s acquisition management has been included on the Government Accountability Office’s (GAO’s) high-risk list for fiscal impropriety and poor contractual adherence.

BUT…

        • The VA-OIG found that while VA’s contracting officer warrant program complied with Federal Acquisition Regulation requirements, opportunities exist to strengthen the program and that the VA lacked assurance that all contracting officer warrants were justified and necessary. – Essentially, this is bureaucrat double-speak for, continue to lie, cheat, steal. We like our job and want to continue, and since Congress doesn’t care, neither do we!

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  • The VHA continues to suffer from employee shortages. I have written about this shortage until I am blue in the face and my fingers ache.  I am fed up telling the VHA how to fix this problem.  If they want answers, call me!

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  • Nurse Bethann Kierczak of Southgate, Michigan, was charged with theft of government property and theft or embezzlement related to a healthcare benefit program. She allegedly stole authentic COVID-19 vaccination record cards from a VA hospital—along with vaccine lot numbers necessary to make the cards appear legitimate—and then resold those cards and information to individuals within the metro Detroit community. – Frankly, with the way the Federal Government is acting, this theft is almost understandable and acceptable.
          • No! I am not condoning an illegal action!  I am simply stating that Pelosi and her ilk do 10-times worse hourly by Congressional standards and get away with those crimes!

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  • Donald Peter Auzine of Baton Rouge, Louisiana, pleaded guilty to conspiracy to commit health care fraud. Bonnie Jean Lawless Diaz of Slidell, Louisiana, pleaded guilty to misprision (or knowing concealment) of the commission of a felony. From March 2014 through October 2016, Auzine, the marketing manager at Prime Pharmacy Solutions, defrauded TRICARE and other benefit programs. Diaz concealed the fraud by knowingly submitting compounded medications for which there was no medical necessity. Both will be sentenced on January 4, 2022.

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  • Amanda Dawn Rains of Fayetteville, Arkansas, pleaded guilty to conspiracy to commit mail, wire, and healthcare fraud, obtaining federal employees’ compensation fraudulently, and paying kickbacks. Rains, a former executive with a Rogers medical supply and billing company, participated in 2013 to 2017, defrauding the US government and private insurance companies.

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  • Robert Seifert of Utica, New York, was sentenced to two years in prison for making telephonic threats to Albany Stratton VA Medical Center employees. He admitted that on January 14, 2021, he made successive calls to three separate employees and left each of them threatening voicemails in which he used demeaning and offensive language. Seifert’s threats caused the employees to fear for their safety and property. He will also serve one year of post-imprisonment supervised release.

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  • Patsy Truglia of Parkland, Florida, pleaded guilty to two counts of conspiracy to commit healthcare fraud and one count of making a false statement in a matter involving a healthcare benefit program. From January 2018 through April 2019, Truglia and other conspirators generated medically unnecessary physicians’ orders via their telemarketing operation for orthotic devices like knee, back, and wrist braces. Truglia, co-defendant Ruth Bianca Fernandez, and other conspirators caused approximately $25 million in fraudulent durable medical equipment claims to be submitted to Medicare, resulting in approximately $12 million in payments.

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  • Larry Ray Bon, 62, was sentenced to over 16 years in prison for shooting a firearm inside the West Palm Beach VA Medical Center in Florida. Bon brought the firearm to the emergency room, and after becoming frustrated with medical staff, he retrieved it from his wheelchair and fired several shots. In March 2020, he pleaded guilty to three counts of assaulting, resisting, or impeding federal employees and one count of possession of a firearm in a federal facility with the intent to commit a crime. At that time, Bon was committed to the custody of the US Attorney General for 25 years of mental health care and treatment at a suitable medical facility. However, Bon was determined to no longer need psychiatric hospitalization and was recently sentenced accordingly.

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Finally, if you want a really good reading, you can visit the VA-OIG page and see the lowlights of the VA-OIG’s reports for yourself by visiting the page here.  Excluded from this list are the usual reports of malfeasance and misfeasance captured in the comprehensive healthcare inspection (CHIp) reports, where we find the exact carbon-copied hits from report to report.  We find moral distress, problems in staffing, continued refusals by leadership to train staff, and the ever-present refusal to attend disruptive committee meetings.  Also omitted from this summation were the inspection of veteran centers and the myriad of failures, bureaucratic ineptitudes, and abysmal behaviors.  Frankly, I could not stand being depressed more by writing and analyzing another moment’s detestable and criminal behavior.Angry Grizzly Bear

What curdles the food in my stomach, this is just the VA.  What about all the other official and unofficial government agencies in the alphabet of the executive, legislative and judicial branches of what we collectively call “the government.”  To all the freedom-loving people in America, please awake and arise; we need you!

© 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.

 

Do You Feel Represented? – Your Government In Action!

Detective 4I have received feedback that I write about the Department of Veterans Affairs (VA) too much.  Please allow me to explain why.  As a veteran, I am duty-bound to help my fellow brothers and sisters in arms.  As the son of veterans, mother (USN), and father (USN, USARNG), I know the hardships of being dependents of active duty, reserve, and National Guard members of the military.  The enlistment contract doesn’t end when the contract says so for the military member; the families and spouses contract is forever.

The final two reasons I write about the VA are most critical; NO body should be treated like the VA treats the veterans; the actions of the bureaucrats in the VA are not representing me and what I stand for in a representative government.  As I can easily have the Department of Veterans Affairs – Office of Inspector General Reports (VA-OIG) delivered to my inbox, it makes writing about the VA much easier, benchmarking how the government has insulated themselves and forgotten who holds the reigns of power in a representative government.  While not a reason to write about the VA, this final explanation should help you judge whether your representative government appropriately represents you and what you stand for.Why

The VA-OIG reports today begin with behavior that is intolerable and worthy of public shaming.  While the defendant remains innocent until proven guilty, the criminal complaint represents behavior inexcusable!  “Daniel Devaty of Elyria, Ohio, was charged with influencing a federal official by threatening a family member. Devaty allegedly sent a text message to the cell phone of a VA social worker threatening to kill his daughters.”

Angry Grizzly BearAnytime anyone threatens the family members, their behavior is beyond the pale and deserves public shaming and the harshest of criminal penalties.  I do not care if the perpetrator is a politician, a judge, the media, or a private citizen.  Leave the families out of any business dealings!  Hollywood, take note, I am sick to death of you threatening family members in movies, TV shows, or simply as private citizens/influencers.  For too long, you have shirked your public responsibility, and families are OFF LIMITS!  Learn this lesson well!

On the topic of conduct reprehensible, the following VA-OIG report leaves me running out of adjectives to describe the behavior of this VA Employee.  “Robert Sampson of Gulf Breeze, Florida, pleaded guilty to charges of video voyeurism and disorderly conduct. Sampson secretly recorded eight fellow VA employees using a hidden camera, disguised to look like a cell phone charger power adapter, that he placed in a restroom at the VA Joint Ambulatory Care Center in Pensacola on multiple occasions from August 2019 to June 2020.”  May the judge throw the book at him and his punishment be creative and sentence well earned!

VA 3In another VA-OIG report, we have more leadership missing problems, where a fraud scheme existed for 11 years without discovery.  “Erik Santos of Georgia was sentenced to over 11 years in federal prison for defrauding Tricare of approximately $12 million through a compounding pharmacy fraud scheme. In January 2021, Santos pleaded guilty to one count of conspiring to commit healthcare fraud and wire fraud.”  While the US Attorney beats his chest and proclaims they will catch everyone involved in the fraud, how many managers and supervisors inside Federal Government employ will lose their jobs, pensions, and freedom over allowing this fraud to occur?  What processes and procedures will be changed to protect against another fraud scheme?  Who is personally accountable for contracting that permitted this scheme to bloom for more than a decade?

VA 3The following VA-OIG report details how clowns and asylum patients run the IT program for the VA and not professionals!  The VA was tasked explicitly by legislation to meet several IT deadlines on a program for family caregivers as part of the VA MISSION Act of 2018. Unfortunately, not only did the VA fail to get the IT program up and running on time, missed mandatory reporting deadlines, and delivered a software solution 2-years past due, but the “VA did not establish the appropriate security risk category and fully assessed the system’s privacy vulnerabilities.”  Amazing, with all the IT problems the VA suffers from, with all the IS problems the VA suffers from, one would think that, where new technology was concerned, the VA would be practicing better security and using the lessons learned previously.

VA 3Would someone please tell me why private industries would be sued to the Nth degree criminally and civilly for these IT failures, but the government can evade accountability and responsibility; why?  In a representative government, the citizens can, and should, hold the elected representatives and their minions accountable for failing to uphold basic security protocols. So how did the government vote themselves a “Get out of Jail Free” card?

While writing this article, three additional VA-OIG reports have been delivered to my inbox.  The newest VA-OIG report discusses a topic that the VA continues to struggle with, namely transparency.  Apparently, the goblins in Goblin Town still cannot stomach sunlight and prefer to keep their nefarious deeds hidden.  Unfortunately, the lack of transparency in hiring practices leads to more VA-OIG investigations into employee wrongdoing, cost the taxpayers phenomenal fees to rid the government of poor hiring decisions, and all this before the union becomes involved.  From the report, we find the following:

“… VHA delegated much of its data reconciliation to its local facilities, which introduced variability in the process and did not allow for consistent creation, maintenance, and verification of information. VHA also had inadequate business processes to ensure quality data were available to support effective medical facility staffing oversight. Without consistent methods and reliable source documents for managing information, VHA cannot be sure HR Smart data accurately reflect VA’s budget and workload requirements.”VA 3

Did you catch that local facilities were given authority, which increased risks in hiring, all while management cannot perform their functions properly?  I remain convinced that the VA built designed incompetence into every action to protect themselves from ever being forced to take action. But, unfortunately, like always, the news only gets worse!Plato 2

A little background is needed to appreciate the problem in the following VA-OIG report fully.  Coronavirus Aid, Relief and Economic Security (CARES) Act required the VA to report to the OMB how they spent money appropriated for America’s Veterans and the VA during the pandemic.  The following is what the VA-OIG found:

VA met monthly reporting requirements to OMB and Congress on supplemental fund obligations and expenditures. VA also submitted required weekly obligations and expenditures from supplemental funding to OMB by program activity. Of approximately $17.3 billion in medical care supplemental funds, VA reported it had obligated about $7.11 billion and had spent about $5.67 billion by December 29, 2020. The VA-OIG team noted three concerns where VA’s reporting was not complete and accurate: • Obligations were at risk of not being included in VA’s reports. • VA initially delayed the reporting of reimbursable obligated amounts for two months. • VA’s reports contained negative dollar amounts in data fields that should have only positive amounts, which misstated VA’s overall reported obligations. Those concerns indicate weaknesses in how VA and VHA internal controls are structured to meet reporting requirements. Despite the risks identified, VA performed only a limited review at the summary fund level of its COVID-19 obligations and expenditures before reporting. A review of summary funds is not detailed enough to identify potential anomalies and ensure the reliability of externally reported information” [emphasis mine].VA 3

I did not find this in the VA-OIG report. Did anyone ask why the VA failed to meet the reporting for the first two months?  After the FISMA Congressional hearings, everyone knows the VA sucks at information technology and information security (IT/IS). So why was the VA given more money and told to budget it using existing failed software, processes, and procedures?  My work in the finance field is limited; however, when a company cannot handle its finances properly and meet legal obligations, a third-party accounting firm can be hired to handle this for the organization.  OMB, why are we not using this solution at the VA?  OMB, why is a third-party auditing company not conducting in-depth analysis and audits of the VA?  With all the missing taxpayer dollars at the VA and Department of Defense, it seems that you are just as negligent as the agencies you are supposed to monitor.

Theres moreAs they say on the Home Shopping Network, “But wait!  There’s more!”  Unfortunately, the same holds of the VA, just without the enthusiasm!  Each VA Medical Center in the Department of Veterans Affairs – Veterans Health Administration (VHA) is expected to have supplies, also referred to as caches, on hand at all times to handle local emergencies and national health care incidents.  For example, a pandemic!  The VA-OIG investigated these prepared caches and found that only 9 of 144 supply stockpiles were ever mobilized.  The excuses, oh these excuses, are like butt holes, everyone has one, and they stink!

      1. “Medical facility directors reporting supplies were not needed or caches lacked sufficient quantity for meeting pandemic demands.”
      2. “The Veterans Health Administration (VHA) changed the process for mobilizing caches during the pandemic, but without clearly communicating it to medical facility directors” [emphasis mine]. – We have the blind leading the blind, in a darkened room, in a London fog!
      3. The VA-OIG, not the VHA, not the local VAMC, but the inspectors “identified problems with cache maintenance and monitoring.” – Never forget, this is a job of several people, overseen by a director, who reports to facility leaders, and inspectors had to find the maintenance and monitoring problems. Just let that sink in for a minute!
      4. Most caches contained some expired or missing personal protective equipment, diminishing their ability to support pandemic preparedness.” – This is an example of how the VHA is “Defining Excellence in Healthcare!”
      5. The “VHA had incomplete documentation on cache activations, making it difficult to know which caches would need to be restocked.” – See item number 3 above.
      6. Medical facility leaders were not always able to accurately report if their facility’s cache was activated during the pandemic.” – Is the proof sufficient that the VA leadership IS the problem with the VA; yet?VA 3

In the US Navy, a significant part of my job was to maintain and monitor emergency supplies. Additionally, to use and cycle through reserves during drills and replenish those supplies quickly and efficiently not to impair the ship’s ability to protect itself 24/7.  I did my job well enough to earn three people Navy Accommodation Medals.  I took over the emergency stores, and all consumable supplies were expired or consumed.  Within 3-months, I was winning accolades and awards.  Yet, 144 caches of emergency supplies for the VHA need more procedures, more documentation, and more oversight to fulfill the mission correctly.

Knowledge Check!I beg to differ!!!  We need leadership, active, engaged, enthused, leadership!  We need the medical facility leader to stop designing incompetence and do the job they have been hired to perform.  We, the taxpayers, need the oversight instruments of the Federal Government to become a lot more effective at demanding results.  We desperately need the elected officials we have hired to scrutinize the government!  Just imagine if you hired someone to perform a mission-critical job, and in the middle of needing emergency support, the person hired reveals, “Oops, I might not have done my job properly.”  How fast would that person be fired?  Now, why can we not do the same to the government employees?

So, ask yourself, do you feel represented by your government?

© 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.

NO MORE BS: VA Administrators – Heaping More Shame

Angry Wet ChickenI believe in public shaming; I am an equal opportunity shamer.  Where the VA is concerned, well, I tend to be more motivated to pass out shame than any other government entity.  Not that I won’t pass along shame, or congratulations, when warranted, the administration of the VA deserves a few more scoops from the shame bucket today!

The Department of Veterans Affairs – Office of Inspector General (VA-OIG) passed along two issues today, and I have to weigh in on serving more shame, cold, hard, and well deserved.  Long have I maintained that the administration and administrators of the VA are the problems in the Department of Veterans Affairs (VA).  Today’s VA-OIG reports provide more justification for demanding cleaning of the house for administration officials at all levels in the VA.

      • Rita Copeland, 59, of Portsmouth, Virginia, pleaded guilty today to wire fraud and aggravated identity theft in connection with a scheme to defraud veterans. Copeland operated an entity known as Veteran Services of the Commonwealth and purported to provide various services to veterans from 2016 through 2020. She caused a number of victims to apply for VA home improvement grants and then used a portion of the grant payments to her own benefit instead of performing the promised work.”
      • Sophia J. Quill, 60, was charged with defrauding the VA and the Michigan Department of Treasury out of $470,000. Quill and her co-conspirator Melissa Flores, who was arraigned last year, allegedly created aliases and obtained or created fraudulent documents to make it appear that they were heirs to various individuals who died.”

VA 3If this is VA Excellence in action, we all need to be concerned!  Do you notice anything missing from these reports?  Let me help; where are the approving officials expected to do due diligence in being held culpable for allowing the fraud to thrive?  I fully admit I have limited experience being a document reviewer and approving authority.  I cannot help but ask about these approving officials who have been trained and gathered experience for their employment role.

ApathyI submit documents to the VA all the time, and every time I have to submit anything, the intake “officer” has to certify the document’s validity.  Heck, the VA had my NGB Form 22 and both DD 214’s, and I still had to submit valid copies to ensure I was not defrauding the government.  Forget innocent until proven guilty; submit forms to the VA, and you are guilty until they begrudgingly claim you are innocent.  Submit documents to Social Security for a claim, same thing, same process, same everything.  Yet, somehow three different people were able to defraud the government, stealing money, and are now hosts of the government.

Detective 4Now, returning to the VA-OIG reports, who authorized accepting the fraudulent documents?  Where were the inspectors?  How many veterans had to complain they were being cheated before anyone took notice of Copeland’s crimes?  How many congressional members were contacted for help that never arrived?  How many letters to administrators were written that were never answered?  How long did veterans suffer before the VA took action, especially in Copeland’s case?  How many evidence intake specialists lost their jobs in either case?  Were any held accountable for failing to do their jobs?

Congress, you have two straightforward jobs, write laws that are constitutional and scrutinize the legislative branch to protect the citizen from runaway government.  After the last two weeks, I have to ask, where are you in performing either role?  Passing District of Columbia Statehood for the “umpteenth time” is unconstitutional!  Overlooking the scrutinizing of the legislative branch is unconstitutional and criminal negligence of your sworn duties.

The administration of the Department of Veterans Affairs is rotten to the core!  Yet, even when directly responsible for fraud, negligence, and dead veterans, the administrators are given a “Get out of Jail Free Card.”  Wasn’t Speaker Pelosi pretty upset with CEOs and “Golden Parachutes?”  Yet, the VA Administration has precisely this and more, and the veterans and taxpayers cannot even get your attention for a second of work!  Where is the corporate media taking the politicians and the VA administration to task for criminal negligence and failure to protect the citizen?  It seems to me we can add a culpable third party to the needs a dish of shame, the media, who are also criminally negligent in performing their duties.The Duty of Americans

Where are the lawyers?  Copeland’s case undoubtedly deserves a Class-Action Lawsuit to help those defrauded get the money they need.  Where are the lawyers, hungry to see change and willing to risk becoming known for taking on the VA and winning?  The actions of the VA Administrators need to be corrected.  If Congress refuses to scrutinize appropriately, the lawyers need to begin processes in all 50-states and US Territories and Districts to demand the VA get fixed!

Bird of PreyThe time for kid-glove treatment and soft-shoe approaches is past and dead; more positive and forceful measures are required.  Where are the lawyers?

© 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.