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View Full Version : Vets die, waiting for treatment. Yet another failure at a VA hospice



garhkal
05-01-2014, 07:14 PM
I wonder if cause of the Feres doctrine, these docs and the others at the VA will be held accountable/get sued..

http://www.cnn.com/2014/04/23/health/veterans-dying-health-care-delays/index.html

Stalwart
05-01-2014, 08:01 PM
Feres states: "... the United States is not liable under the Federal Tort Claims Act for injuries to members of the armed forces sustained while on active duty and not on furlough and resulting from the negligence of others in the armed forces."

The Department of Veterans Affairs is not part of the DoD / Armed Forces ... I am not a lawyer, but my guess would be be that the survivors may have grounds to sue.

EDIT: A quick Google seach shows many instances where people have successfully sued the VA.

garhkal
05-01-2014, 09:03 PM
AH. I was thinking that Feres would protect these putzes like it does AD doctors.

Stalwart
05-15-2014, 04:50 PM
Va Secretary Shinseki testified before the Senate Veteran's Affairs Committee today, I watched part of it and it did seem that both Republicans and Democrats were very critical of the VA.

What is troubling me about the further developments in this case, is that the "secret waiting list" seems to have been used (in a very similar format & fashion) at more than one VA medical center; this makes me think that either more that one person in the system has a good idea on how to do a bad thing, or there was some sort of collusion about how to hide the fact that patients were not being served appropriately and within the standing policies.

Measure Man
05-15-2014, 05:07 PM
I watched part of it and it did seem that both Republicans and Democrats were very critical of the VA.

Another fine example of the bold leadership displayed by men of great character :rolleyes::jaded:


What is troubling me about the further developments in this case, is that the "secret waiting list" seems to have been used (in a very similar format & fashion) at more than one VA medical center; this makes me think that either more that one person in the system has a good idea on how to do a bad thing, or there was some sort of collusion about how to hide the fact that patients were not being served appropriately and within the standing policies.

Manipulate the stats to make the numbers look better so everyone gets their bonus.

That's what this was all about.

garhkal
05-15-2014, 08:12 PM
Manipulate the stats to make the numbers look better so everyone gets their bonus.

That's what this was all about.

That does look like what it was. Govt bigwigs put 'goals' on them, so they cook the books rather than bust their butts to hit those goals.

Stalwart
05-15-2014, 08:34 PM
That does look like what it was. Govt bigwigs put 'goals' on them, so they cook the books rather than bust their butts to hit those goals.

+1

It makes me think of two scenarios:

1. Policies (goals) were set that required the staffs to work harder, overtime, or hiring additional personnel than they had in the past; however, the status quo level of effort or manning was maintained and a way to game the system was developed.

2. Policies (goals) were set that were not realistic and the management was unwilling to report that fact to the Department and a way to game the system was developed to avoid confrontation with their bosses.

hustonj
05-15-2014, 08:58 PM
Go for simple and incompetent over compicated and/or malicious when looking for likely explanations.

The reported waiting times at various centers were outrageuous, so beauracrats higher in the food chain directed improving the reported times. Some lower-level beauracrat figured out how to maipulate the data (instituting a "ghost" waiting list) to improve the reported times without actually having to change anythign about hwo service was provided. Other locations got flack abotu not improving their numbers, checked with the team who first cooked the books and copied the procedure in order to quiet complaints from above.

Typical bad human behavior that implements this bad policy (and propogates it through the VA), and it doesn't require any true maliciousness beyond simple laziness.

Chief_KO
05-15-2014, 10:21 PM
+1

It makes me think of two scenarios:

1. Policies (goals) were set that required the staffs to work harder, overtime, or hiring additional personnel than they had in the past; however, the status quo level of effort or manning was maintained and a way to game the system was developed.

2. Policies (goals) were set that were not realistic and the management was unwilling to report that fact to the Department and a way to game the system was developed to avoid confrontation with their bosses.

I'd say 65% for #2 and 35% for #1 (with a 3% margin for error).

waveshaper2
05-15-2014, 11:43 PM
This reminds me of the USAF Nuclear cheating scandal but somewhat modified. Policies/goals set to high by management and those impacted by these, impossible to reach expectations, found a work around.

ChiefB
05-16-2014, 06:25 AM
Go for simple and incompetent over compicated and/or malicious when looking for likely explanations.

The reported waiting times at various centers were outrageuous, so beauracrats higher in the food chain directed improving the reported times. Some lower-level beauracrat figured out how to maipulate the data (instituting a "ghost" waiting list) to improve the reported times without actually having to change anythign about hwo service was provided. Other locations got flack abotu not improving their numbers, checked with the team who first cooked the books and copied the procedure in order to quiet complaints from above.

Typical bad human behavior that implements this bad policy (and propogates it through the VA), and it doesn't require any true maliciousness beyond simple laziness.

I agree that maliciousness may not have been a prime motivation, however the adverse effect was the result of a nefarious act that resulted in possible unforeseen consequences resulting in the death of veteran patients. The cause and effect relationship is the same whether malicious or otherwise. You are correct, again, claiming "laziness" as the base motivator of these scofflaws impersonating caring healthcare workers.

Decentralizing management and control to the regional or local level, as was done in the VA system recently, did not include adequate oversight of the now mostly autonomous area hospitals and has allowed a "second tier system" to develop that masks true performance and presents a false image of hospital compliance and competency.

The manipulation of paperwork and data regardless of detriment to patient health and life and to accept resultant bonuses is just about as low a fellow human can sink. Our fellow veterans deserve way more from their caregivers and their government they so faithfully served.

garhkal
05-16-2014, 06:37 AM
This reminds me of the USAF Nuclear cheating scandal but somewhat modified. Policies/goals set to high by management and those impacted by these, impossible to reach expectations, found a work around.

And with our political climate its going to be those lowers who DID the work arounds who get held accountable.


I agree that maliciousness may not have been a prime motivation, however the adverse effect was the result of a nefarious act that resulted in possible unforeseen consequences resulting in the death of veteran patients. The cause and effect relationship is the same whether malicious or otherwise. You are correct, again, claiming "laziness" as the base motivator of these scofflaws impersonating caring healthcare workers.

Exactly. Regardless of whether it was incompetence, negligence or laziness, the end result was IMO neglegent homicide if they DID make people wait and that contributed to their deaths

efmbman
05-16-2014, 01:07 PM
We've all seen this at one point or another in our careers. An issue is identified and a plan is put into place to correct it. How do we know if we are succeeding or failing to achieve the goal? Most likely, the means by which leadership monitors this devolves to a Powerpoint slide with "Green / Amber / Red" circles. Once the troops figure out how to make that amber or red circle a green circle, it will turn green. The means by which that circle turns green is not important. Once a metric is applied to a system, the system will be gamed to affect the metric to the desired outcome. Often, no attention is given to HOW the circle went green.

garhkal
05-16-2014, 08:27 PM
Just like statistics. Those working an 'angle' can always find a way to make the statistics "Prove" their point.

AF Comm Guy
05-19-2014, 01:45 PM
Let's have a look at this recipe for disaster...

1. 13 years of war (and counting), causing a huge increase in the number of patients relying on the VA for help.

2. A higher number of members simply getting out or retiring due to force shaping, also adding to the VA's burden.

3. A congress that has voted repeatedly over the years to either maintain current levels or cut funding for the VA. (John McCain, I'm looking at you)

4. A large amount of VA work that is outsourced to contractors which cost three times more than doing it "in house."

Mix well, adding a dash of conspiracy theory, incompetence and partisan bickering.

Put in oven at 600 degrees and cook for over a decade.

Upon completion you should have a nice hot pan of burn-out disaster.

Enjoy!

Stalwart
05-19-2014, 02:03 PM
3. A congress that has voted repeatedly over the years to either maintain current levels or cut funding for the VA. (John McCain, I'm looking at you)

This part isn't entirely correct, while overall funding for the VA was at one point reduced, appropriations for the medical care accounts was increased.

GeoDude
05-19-2014, 03:02 PM
Let's have a look at this recipe for disaster...

1. 13 years of war (and counting), causing a huge increase in the number of patients relying on the VA for help.

2. A higher number of members simply getting out or retiring due to force shaping, also adding to the VA's burden.

3. A congress that has voted repeatedly over the years to either maintain current levels or cut funding for the VA. (John McCain, I'm looking at you)

4. A large amount of VA work that is outsourced to contractors which cost three times more than doing it "in house."

Mix well, adding a dash of conspiracy theory, incompetence and partisan bickering.

Put in oven at 600 degrees and cook for over a decade.

Upon completion you should have a nice hot pan of burn-out disaster.

Enjoy!

I did a workstudy at the VHA shortly after leaving active duty - there are so many people who file for frivolous disability claims its appalling - that's no doubt at least part of the reason it takes so long for people with legitimate injuries/conditions to get their claims processed - the system is bogged down with BS knee problems and sleep apnea.

sandsjames
05-19-2014, 03:10 PM
I did a workstudy at the VHA shortly after leaving active duty - there are so many people who file for frivolous disability claims its appalling - that's no doubt at least part of the reason it takes so long for people with legitimate injuries/conditions to get their claims processed - the system is bogged down with BS knee problems and sleep apnea.

As has been pointed out before it's usually the VA rep helping members fill out the forms that causes the "frivolous" claims. As told by the guy who helped me, I put down everything in my records, even if it isn't affecting me right now. Who knows what kind of condition I'll be in 20 years from now. I've already had two appointments that I knew were pointless...both having to do with my hearing (which is just fine). But it's in my records and if it gets worse in the future then I can show that it was documented.

When I submitted my form to the guy on base who helped, I had two things on the list. My back (which I've since had surgery for a herniated disc) and my shoulder (which is intermittent). The list that actually went to the VA had 9 different things on it. I wasn't going to submit for the extra 7 but was persuaded to do so because there's no telling if those things that don't bother me now will in the future.

Are there frivolous claims? Sure. But better safe than sorry if it's in the records.

GeoDude
05-19-2014, 03:15 PM
As has been pointed out before it's usually the VA rep helping members fill out the forms that causes the "frivolous" claims. As told by the guy who helped me, I put down everything in my records, even if it isn't affecting me right now. Who knows what kind of condition I'll be in 20 years from now. I've already had two appointments that I knew were pointless...both having to do with my hearing (which is just fine). But it's in my records and if it gets worse in the future then I can show that it was documented.

When I submitted my form to the guy on base who helped, I had two things on the list. My back (which I've since had surgery for a herniated disc) and my shoulder (which is intermittent). The list that actually went to the VA had 9 different things on it. I wasn't going to submit for the extra 7 but was persuaded to do so because there's no telling if those things that don't bother me now will in the future.

Are there frivolous claims? Sure. But better safe than sorry if it's in the records.

Absolutely - and also worth pointing out that many of those VA guys themselves made frivolous claims.

I picked up a whole Vet Center team from the airport one time for a conference - a few minutes of conversation revealed I was the only person in the car who didn't have a disability rating.

Stalwart
05-19-2014, 03:34 PM
When I submitted my form to the guy on base who helped, I had two things on the list. My back (which I've since had surgery for a herniated disc) and my shoulder (which is intermittent). The list that actually went to the VA had 9 different things on it. I wasn't going to submit for the extra 7 but was persuaded to do so because there's no telling if those things that don't bother me now will in the future.

Are there frivolous claims? Sure. But better safe than sorry if it's in the records.

Good point. When I was meeting with reps from the VA last year, the two biggest issues they were grappling with:

1. A HUGE influx of veterans into the VA system since 2000.

2. A jump in the number of 'complex' claims (claims with several issues.) The average Vietnam era claimant had 2 or 3 issues, the average veteran today has 8. Transitioning from a paper-based system to an electronic system has been an ongoing headache -- combined with the (shockingly odd) fact that the DoD medical system does not 'talk' to the VA medical system.

My opinion: we drain a lot of the VA resources treating something that comes with the natural process of aging that manifested during military service vice as a result of military service. I won't argue that an injury or illness can take years to really become problematic, and my exit interview with the VA is undoubtedly coming one day and it is impossible to know what will be an issue in 10 or 20 years.

waveshaper2
05-19-2014, 05:01 PM
Just a couple observations.
1. The number of Veterans is at its lowest level since the end of WW2, EVER.
2. The VA budget, when compared in todays dollars, is at its highest level, EVER.
3. The number of people claiming and receiving disability on the civilian side of the house has never been higher, EVER. The funds being spent on disabilities has never been higher, EVER.
4. The number of people receiving entitlements like SNAP, EBT, WIC, etc have never been higher, EVER. The funds being spent on entitlements has never been higher, EVER.
5. This explosion in enrollment and funding in the VA, civilian disability programs, and entitlement programs is a fairly recent confluence of events (last 5 years or so).
6. WTF is going on?

GeoDude
05-19-2014, 05:11 PM
Just a couple observations.
1. The number of Veterans is at its lowest level since the end of WW2, EVER.
2. The VA budget, when compared in todays dollars, is at its highest level, EVER.
3. The number of people claiming and receiving disability on the civilian side of the house has never been higher, EVER. The funds being spent on disabilities has never been higher, EVER.
4. The number of people receiving entitlements like SNAP, EBT, WIC, etc have never been higher, EVER. The funds being spent on entitlements has never been higher, EVER.
5. This explosion in enrollment and funding in the VA, civilian disability programs, and entitlement programs is a fairly recent confluence of events (last 5 years or so).
6. WTF is going on?

I don't think its true that the number of vets is at an all time post-WWII low. We've got vets from GWOT, Desert Storm/Shield, Vietnam, Korea, WWII, and all the little conflicts in between. We've got around 2-3 million service members at any one time, our vet levels must be massive.

It always annoys me when I see pompous a-holes on Facebook pages like Uncle Sam's Misguided Children going "only 1% of all Americans serve in the military" - BS, it is much higher than that. In fact pretty much every person I know on the civilian side has at least one family member in or previously in the military.

DocBones
05-19-2014, 05:27 PM
Not sure about the Feres deal extending into the VA Hospitals, but if any service member enters a VA hospital and has no next of kin, they are deemed to be 'Wards of the Gov't'. Being a 'Ward of the Gov't' opens up the chance of becoming an experimental patient, either in treatment, or in medications, while staying in a VA hospital.

I imagine that if a 'W of the G' is of a clear state of mind, that patient could refuse any experimental treatment or drugs, on the spot.

However, I myself have seen 'W of the Gs' being treated to death. Just because they can't clearly be with the rest of the world doesn't mean that those patients should be so cavalierly treated.

Gals and guys, make sure that you put down somebodie's name in the Next of Kin space. Please! For your own sake!

TomTom093
05-26-2014, 10:43 PM
I'm not too familiar with the VA system, so forgive me if I'm making the wrong assumptions on this.

Would it not be easier for every veteran using VA facilities to instead go to a private hospital, and the government just pays for the cost of their care? That way, they get the care they deserve, and we don't have to (directly) pay for the cost of the facilities and the staff.

sandsjames
05-27-2014, 04:03 PM
I'm not too familiar with the VA system, so forgive me if I'm making the wrong assumptions on this.

Would it not be easier for every veteran using VA facilities to instead go to a private hospital, and the government just pays for the cost of their care? That way, they get the care they deserve, and we don't have to (directly) pay for the cost of the facilities and the staff.

With Obamacare, this could become an option. The private industry, however, doesn't have the availability of the long term care, bed stays, etc.

I imagine if they were able to get all of the systems linked together (private, government, and VA) as far as history/medical records go then it could be possible.

Even with all of the issues within the VA, I still believe it's the best way to go for veteran care. In the short time I've been dealing with it it's been pretty good.

waveshaper2
05-30-2014, 07:05 PM
The morale in the VA must be at an all time low now that Shinseki has resigned. The VA should fallow the morale building example recently implemented by Global Strike Command and shower the ranks with incentive pay, promotions for VA Senior Executives, and possibly some kind of medal. Maybe they could name this new award/decoration the Veteran Care Deterrence Service Medal.

The new medal would be awarded to all employees assigned directly to the Veteran Care Enterprise. At this time I'm not sure what the medal or cluster/s (maybe a bronze/silver casket device would do) for subsequent awards of this medal should look like. One thing is for sure, the Deterring going on at the Phoenix VA was "literally" of the charts and you can bet there are a few Senior Executives at that location that should be receiving the maximum number of medals/clusters. I imagine these folks, when decked out with all their medals, will look like some highly decorated North Korean General.

Stalwart
06-28-2014, 01:16 AM
This was a pretty good commentary on the VA issues now that the scheduling issue is getting more light shed on it:

CNN: http://www.cnn.com/2014/06/27/politics/va-report-white-house/index.html?hpt=hp_t1

As more information on this has come to light, I am not lawyer ( RS6405 ) but it would seem if VA administrators were purposefully gaming the reports they sent to Washington on meeting the 14-day appointment scheduling guideline so they could keep a bonus ... that is fraud against the federal government. I imagine it would take some good documentation to directly link the lack of an appointment to a patient's death, so I don't know if patient deaths could ultimately be deemed criminal either.

I have met a lot of people who work at the VA and many are veterans themselves. Many seemed like they really wanted to do a good job but were part of a system bigger than them or their decision making authority. At some point, accountability is key and Secretary Shinseki's resignation last month was the first step but in the long run a decimation (to use the Roman definition) may be what is needed to send a message to anyone currently or in the future employed by the VA or federal government -- you need not be a superstar to keep your job, but if you are truly a poor performer and not up to the task then you will need to find employment elsewhere.

RS6405
08-03-2014, 10:01 AM
~read lightly as I'm just into my 1st cup for the morning~

Without looking anything up and thinking out loud ....
I've mention somewhere here about the Feres Doctrine & the exceptions to that doctrine involoving those who are no longer serving in active duty. (If it survived the cuts that is...)

On the flip side to suing the government, I am wondering what would it take to sue the individuals at the VA who make the decisions to fraudulently produce documents that show the are performing their jobs when in fact they are not. And, these documents allow those who have served not to be timely served medically, which leads to greater injury and death.

Granted the US Gov. has the deep pockets, but to exact change in such behavior then personal accountability would be the means to do so. Meaning, let those who created the fraud defend themselves personally in a lawsuit whereas they would (or could) lose their savings, second home, weekend toys, and etc.

It would be nice for the government to charge them with fraud, but until then, a lawsuit directed to them personally might be the only way to achieve justice.

garhkal
08-03-2014, 07:12 PM
Granted the US Gov. has the deep pockets, but to exact change in such behavior then personal accountability would be the means to do so.

Since the govt just raises taxes when they need more money, they don't really have deep pockets.
BUT you could go after those administrators OWN bank accounts, rather than the state/fed.

Stalwart
08-03-2014, 10:30 PM
Granted the US Gov. has the deep pockets, but to exact change in such behavior then personal accountability would be the means to do so. Meaning, let those who created the fraud defend themselves personally in a lawsuit whereas they would (or could) lose their savings, second home, weekend toys, and etc.[\quote]

Welcome back. I think you are hitting the nail on the head. An employee made a mistake, and if the employer is the one who pays for it, without either firing or attempting to fire the employee, there is no accountability.

As far as Feres goes, there are several cases of people successfully suing the VA -- not a lawyer but from what I know it is because VA is not part of DoD and the people suing at the time were no longer active duty.

[QUOTE=RS6405;345715]It would be nice for the government to charge them with fraud, but until then, a lawsuit directed to them personally might be the only way to achieve justice.

It would be nice, but as you said, without them being forced to come to task with their actions I think little will be learned.

BT BT

This could actually spawn a whole conversation that a few other threads have hit recently: accountability of government civilians.

RS6405
08-07-2014, 07:55 AM
Since the govt just raises taxes when they need more money, they don't really have deep pockets.
BUT you could go after those administrators OWN bank accounts, rather than the state/fed.

I think that is what my convoluted statement was going trying to go without coffee that could have made it coherent.

(Oh look I'm up at 3:30 am during my vacation thanks to having my son's phone alarm go off. If I had a different 16 year old for a son, I would really question why he would have that alarm set during summer vacation.)

RS6405
08-07-2014, 08:12 AM
[QUOTE=RS6405;345715]Granted the US Gov. has the deep pockets, but to exact change in such behavior then personal accountability would be the means to do so. Meaning, let those who created the fraud defend themselves personally in a lawsuit whereas they would (or could) lose their savings, second home, weekend toys, and etc.[\quote]

Welcome back. I think you are hitting the nail on the head. An employee made a mistake, and if the employer is the one who pays for it, without either firing or attempting to fire the employee, there is no accountability.

As far as Feres goes, there are several cases of people successfully suing the VA -- not a lawyer but from what I know it is because VA is not part of DoD and the people suing at the time were no longer active duty.



It would be nice, but as you said, without them being forced to come to task with their actions I think little will be learned.

BT BT

This could actually spawn a whole conversation that a few other threads have hit recently: accountability of government civilians.

Thanks! The board has changed quite a bit since I was a regular, with the focus on more serious military core issues, which greatly limits (out of my respect to those who have serve,) where I could share my opinion on a topic.
(If that statement makes sense at 3 something in the morning).

Mjölnir
08-09-2014, 08:36 AM
Thanks! The board has changed quite a bit since I was a regular, with the focus on more serious military core issues, which greatly limits (out of my respect to those who have serve,) where I could share my opinion on a topic.
(If that statement makes sense at 3 something in the morning).

In the News, Religion, and Politics and Government are by far the most active sections of the Forums. Hardly core military issues. Your opinions are always welcome.