VA Silent on Exec Bonuses for Manipulated Data

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I find this incredibly troubling:

A year after testifying that some executives received bonuses by manipulating appointment data for veterans needing mental health care, a former Department of Veterans Affairs hospital administrator said officials have avoided the issue “like the plague.”

“They avoid it with a 10-foot pole,” Nicholas Tolentino told in a telephone interview Monday.

Last April, Tolentino, a former mental health administrator at the Manchester VA Medical Center in New Hampshire, told lawmakers that VA hospital officials across the country talked to each other to find workarounds to meet VA appointment goals. The overriding objective, “from top management on down, was to meet our numbers” and make it appear as if the VA was seeing as many veterans as possible, he said.

Meeting those goals was linked to bonuses for executive career employees, he said. This created “a perverse administrative incentive” for officials to exploit loopholes to meet manufactured goals without providing the services.

“The upshot of these all too widespread practices is that meeting a performance target, rather than meeting the needs of the veteran, becomes the overriding priority in providing care,” he testified.

Tolentino told the Senate that VA officials from across the country discussed ways to get around the system.

“That’s one of the reasons I left,” he said. “Not only because of the fraud. They were gaming the entire system and profiting off it. I left before I got a bonus. I didn’t feel right taking [one].”

Here's my related anecdote on the issue.... About 5 years ago, within weeks of getting out of the military, I woke up one day and could barely move. I knew what it was, it was herniated discs. I also knew I needed to go to the VA immediately. So, I trudged down there and signed up for VA. It took no time at all. I even got to see a doctor within 2 hours of arriving, which might not sound good, but I didn't have an appointment at all. The doctor told me "You are going to need an emergency MRI."

So a day later the VA calls to set that up. The lady told me I could not make an appointment for one yet, because "we are completely filled up for the next 30 days. But, if you call next week and make an appointment, we can schedule you 29 days from then." So, what they were doing was trying to avoid the 30 day window by putting the onus back on me to wait to schedule the appointment. That way, even though it was 36 days total, they could count it from when I called the second time.

Luckily I subsequently moved from DC to Indianapolis. Here I can virtually walk in unannounced and have an appointment that day. Sometimes I have to wait, but they don't game the system here at all. As I read this article, I couldn't help but wonder if my waiting a week to schedule something so that they could code it as under 30 days resulted in someone getting a bonus.

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You and I both know that it was.

I also know that they stopped my appointments and took me off my medicine for no other reason than to reduce their patient load. No doctor is going to take a patient off a med without a follow up. Ever.


Two young marines standing watch, as to "But Stroke" the VA director when these things happen. One to answer calls for miss treatment of our Vets and one to come down on the VA hospital director like the wrath of god. It would only take a few ass whippings and then the problem would be solved.

You are right, as I was just thinking about what would stop the mistreatment of Vets in VA system, it is not the patient advocate, not the director, not the Dr. who cares, and not any constituant liason, because they fear noone. They have it all organized. The one that speaks up is in a battle of retalliation for years to come. So VA employees have to be stripped of their own proclaimed term this is the VA. There are crimes committed against veterans even reported to congress, and directors hiding the fact, and hiding the employees involved. There system of complaints has no success. I spoke with a retired VA nurse, and she admits there is a retalliation process against anyone who speaks out. I spoke with employee who had worked at a jail before VAMC she said it is worse treatment to patients at VAMC. I spoke to another who is so uncomfortable with what she knows is going on, but didnt know what to do about it. I told to call hotline OIG, im not sure that will help, by the time they get in there some of them have contact with director then tracks are covered or excuses put into play. I have first hand experience of crimes committed against veterans. There has to be another way. Strong service organizations involved at level of complaint, not to buddy up with them to see them get special treatment. There has to be a new system to hold VA employees to accountability. They have to be stripped of the this is the VA statement, so you get what i give and better not say a word. Stop the rediculous bonuses and give bonuses according to performance. And make a statement suspend, fire whatever is appropriate. Not move them out of sight. In the long overhaul, VA would save money, save lives contribute to the well being to veterans and attract new employees with good character. They have so many titled positions and absolutely no accountability. VAMC need an outside of employee to straighten this outragious and inhumane behaviors. And trust me on this which I find so disgusting some of the employees are prior military and retired military. It wouldnt take long to smack them back in shape. Now there are some good VAMCs, and it usually is where there is a strong base of service groups, not ones to see that they get special treatment or feel they dont get there fair share of veteran benefits that some veterans get. If I speak to a service organization member and all they do is bragg up a VA that even makes headlines of innapropriate behaviors, and show me what they did for them, im appalled by it. Thats called a weak service organization who is in bed with them. Now we have a new problem since President put in order to take all insurance vet may have. These employees taking it to a level of what kind of care the veteran will get. Insurance card carrying veterans get the full service package. And entitled VA medical benefits are comprimised for the not private insured but Veterans Health Admistration are eligible are not going to receive the same care. They are so out of control who can straighten this out inhouse service organizations strong not manipulative.

Interesting approach! I was getting delays in the Eye ENT clinic (due to overbooking - unknown by me at the time) so, like a good soldier, I took up an ambush position early every morning on the VAMC SF Facebook page. When the hospital director posted a glowing report about how much things had improved at the hospital I was there with the very first comment, wondering if the VA was just waiting for me to go blind so they wouldn't have to fix my eyes. Two days later I got a phone call from the Director's personal assistant and shortly thereafter I was present in the clinic waiting room when the staff was chewed out for overbooking appointments and surgeries.

My ambush worked and didn't require taking two Marines away from more important duties. Perhaps all that is needed is Marine and/or Army vets willing to perform adjustment services; at least, until such time as the VA, nationwide, gets it's collective head out of its anal canal.

Robert Ireland (PUFL)

In the past year and a half the VAMC SF has fixed a herniated disc (XLIF surgery) in my lower back that had me confined to a VA provided mobility scooter, replaced two lenses in my eyes allowing me to see clearly once again (Cataract surgeries) and is replacing my upper teeth with false teeth (Oral surgery and complete upper plate). The only delays were caused by the Eye ENT clinic overbooking patients. I was present, in the waiting room, when the clinic staff was castigated for not paying attention to the needs of the veterans visiting the hospital.

When I read of the way vets seem to be treated in other jurisdictions I’m almost ashamed of the care I’ve received; almost. It is a disgrace to read about the VA failing so many veterans. It is even worse reading about VA personnel that deliberately scheme the system to receive job bonuses for work they not only didn’t do but used fraud to give the impression they had, successfully, completed the tasks assigned. From where I’m sitting this only exposes the fallacy of providing bonuses for doing the actual work one was hired to do in the first place. When hired for a job the employee should be expected to do the job they were hired for at the wages they agreed to without any additional bonus for performing to standard. Bonuses, if given, should be for performance of duty far above the expected level of the job’s description and should be awarded to the Employee of the Year (not week or month) at the individual VA facilities.

Robert Ireland (PUFL)

As a Viet Nam era vet of the Marine Corps. I made the mistake of going to the VA in Omaha NE with an open mind and believing that some of the horror stories I had heard from friends on mine that had applied for their benefits might have been stretched a little bit.

After filling out the paperwork on 3 different ocassions, only to be told repeatedly that my paperwork had been lost (3 times). I gave up on the benefits that I was told were in place for me if needed, when I entered the Marine Corps in 1961.

Now, with the bonuses, manipulated data, lost records and on and on. Is it any wonder that vets are not getting proper care and administrators are getting rich on our backs. The real problem, no one, and I mean no one, in a position of authority will take any corrective actions. No one will come forward as a "whistle blower" and let the cat out of the bag.

We need an indepth investigation by a panel made up of vets who know the right questions to ask and the right buttons to push. But, the bottom line is that nothing is going to get done to address the problems, no ones head will roll.

There will be editorials, comments, lies and cover-ups. The smoke will clear and nothing will have been corrected. I firmly believe that the VA has adopted a position of "delay, deny and allow the vet to die". The country that we served has become overrun with crooks in Washington DC at all levels
who are more concerned with their paycheck than doing the job that they are responsible for. There should be no bonuses for doing your job right, they are getting overpaid as it is. The higher-ups should impliment a policy that sets pay guidelines that allow those employees to get paid when all of the people on their caseload get their benefits paid. Then you would hear the whir of a well oiled machine getting things done in a timely fashion. Dock their pay for any delays or mistakes on a claim. Once everyone has vented, service will remain the same.......

I can not speak what happen back then but today it is the standard of Excellence in all types of care. As a 100% veteran, I have been going there since I retired in 1993. I know of over $60,000 just in dental work has been done and the staff is super. The clinic I am assigned to has had me seeing the same DR, not PA for over twenty years. I say that importance improvements that are made, people should be rewarded for those tasks.

The problem with benefit papers getting lost, delayed or denied is that so many of our politicians have never served in the armed services. These guys make a quarter million dollars a year and can't realize what maybe a thousand a month could mean to a Veteran. I say if a candidate hasn't served this country in the armed services, don't vote for them

Having just DBS Surgery for Parkinson's at Ft Miley VA HOSP S.F., i cannot say enough about the quality of doctors and care there. It is wonderful. Also Reno VA is top notch. As a matter of fact, all my VA health care has been great. The people that do the work are the best. I have been declared agent orange contaminated non service related. Huh, doh! In the Marines 68-71 traveling throughout Southeast Asia and South Pacific I somehow got contaminated not related to the service.
What does that mean? Lost medical records, lost transfer and travel orders, lost all possesssions ( never arrived stateside) including photos proof of Vietnam service as they somehow lost all records except punative administrative ones. Somehow my service in 2/9/2 and 3/9/3 and III MAF, 5th Brigade have never surfaced. I served as armed guard mail delivery boy with top secrets clearance and discovered how we were lied to during the war. I lost motivation as they say in the Marines, was discharged, refusing less than honorable for General courts martial. 4 charges of improper equipment while riding a motorcycle and a possession of marijuana charge. All sound trumped up or what? Now to hear about the top guys at VA getting bonus money for getting our suffering and
dying then and now. It hurts. My brothers died there for an ideal. Now they die here for bonus money. Preposterous, aye. Are these guys ghouls and vultures running the system to protect us who served? We all must one day explain to The Lord. Their time will come and it will not be pretty. He'll is operated by Marine Drill Sergeants, I hope. Life is brief, eternity goes on and on.

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News from the World of Military and Veterans Issues. Iraq and A-Stan in parenthesis reflects that the author is currently deployed to that theater.