Healthcare Policies Expire

FAIL – Tomah VA Let 63 Key Healthcare Policies Expire

Healthcare Policies Expire

Benjamin KrauseThis year, Tomah leadership chose to let 63 key healthcare policies expire or stay expired in violation of Veterans Affairs requirements and putting more veterans’ lives at risk.

So while VA employees at Tomah VA partied, played Hungry Hippos, Ghostbusters Vaccines, and engaged in OIG whitewashes, Tomah VA leadership was too busy to do its job.

According to an Excel document containing all 300+ policies, at least 63 policies are expired – many of those policies were expired for numerous years. I forwarded that Excel document to the House Committee on Veterans Affairs for examination yesterday given the extreme nature of this dereliction of duty and the risk to veterans’ lives in real time.

Some VA employees are still at the facility who have failed to update vital health care policies that instruct clinicians in best practices during emergencies. So I hope VA takes action to update the policies.

But really, how did VA OIG miss this key failure during its numerous investigations and whitewashes? Hear no evil, see no evil?


Are you asking yourself, “Why does this matter?”

If you are wondering “why” protocols and policies matter, it is because failures to update these documents can put patients at risk of injury or death from expired medical treatment standards. For example, Tomah VA failed to create a mandated stroke protocol for years. When patients suffered a stroke, including the late Thomas Baer, Tomah VA clinicians were unaware of standard protocol for stroke treatment in rural facilities. Sadly for Baer and other veterans, they died.

Some of the Tomah VA’s expired policies a more than three years past the expiration date. Some of the key policies and procedures are:

  1. Identifying and Coding of High Risk Patients, expired since 3/26/12
  2. Rules Pertaining to Patient Privileges on Mental Health Units, expired since 5/5/12
  3. Outpatient Care Timely Access Scheduling, expired since 6/10/13
  4. Violent Behavior Protections Program, expired since 3/4/14
  5. Interim Life Safety Measures, expired since 2/5/15
  6. Patient Rights and Responsibilities, expired since 3/1/15
  7. Inter-Facility Referral and Transfer Policy, expired since 11/5/15

Does it seem like updating any policy dealing with “high risk patients” should have a high likelihood of being updated on time or at least without a couple days of expiring? What about “interim life safety measures?”

Do you think “patient rights” should matter enough to update? What about a policy telling you how and when to transfer an ill or injured patient to an emergency department?

If you answered, “Hell yes!” like practically ever other red-blooded American with a functional brain, your answer is not the same as numerous senior leaders at Tomah VA or national VHA leaders. These are people responsible for tens of thousands if not millions of American lives. Those same officials make well over six figure salaries plus bonuses.

Your “yes” answer likely makes you part of the 99% of sane Americans.

@TomahVAMC - It's time you join the sane 99% of Americans. Update policies!! Click to Tweet


To help explain the scope of this dereliction of duty, the reality is that dereliction did not occur because Tomah VA leadership was too busy with good honest work. One example really got under my skin. The day after Under Secretary Carolyn Clancy provided testimony to Congress about deaths at Tomah VA, she then attended and spoke at Tomah VA’s annual art party rather than helping investigate the ongoing scandals at the time. She attended the event alongside VA leaders and the Wisconsin Beauty Queen.

SEE IT: Tomah VA Creative Arts Festival

Here are my favorite videos from various other activities this year:




1 MH-25 3/26/09 3/26/12 Identification and Coding of High Risk Patients Identification, high-risk, code status.
2 MH-19 5/5/09 5/5/12 Rules Pertaining to Patient Privileges on Mental Health Units Privileges, absences, restrictive measures.
3 HAS-13 6/10/10 6/10/13 Outpatient Care Timely Access Scheduling priority groups, priority scheduling, Means Test, co-payments, electronic wait list, pre-registration, incarcerated veterans, fugitive
4 FS-75 11/15/10 11/15/13 Construction Management construction, project, shutdown, engineer, design, punch list, moves, activation, lessons learned
5 FS-37 12/1/10 12/1/13 Respiratory Protection Program Respirator, Asbestos, Tuberculosis
6 FS-20 12/7/10 12/7/13 Emergency Power System interruption, power outage, generator system, generator outage, generator test announcement,; EPSS, NFPA 99; NFPA 110
7 FS-40 12/20/10 12/20/13 Asbestos Control Program respirator, environment, health, friable, ACM, glovebag
8 MH-29 3/4/11 3/4/14 Violent Behavior Prevention Program Disruptive, violence, violent, PMDB, prevention, behavior, VBPC, DBC, assault(s)
9 FS-71 4/7/11 4/7/14 Green Environmental Management Systems Policy GEMS, green, pollution, waste, conserving, environmental, recycling
10 006S-09 5/16/11 5/16/14 Parking and Traffic Control vehicles, police
11 FS-43 8/9/11 8/9/14 Hazardous Waste EPA, hazardous waste, disposal, spills
12 FS-10 9/26/11 9/26/14 Operation of Government Owned Vehicles fuel, E-85, trip ticket, driving, accident, GSA vehicle, drivers license
13 FS-02 10/11/11 10/11/14 Mercury Reduction Program Hg
14 FS-08 11/4/11 11/4/14 Conservation of Energy and Natural Resources Program electrical, water, conservation
15 FS-11 12/1/11 12/1/14 Space Planning Team moves, Life Safety Code, Equipment, room request
16 FS-18 12/6/11 12/6/14 Defibrillator Testing, Inspection, and Maintenance biomedical, biomed
17 FS-72 12/13/11 12/13/14 Air Filtration Maintenance air filtration, air exchange, ventilation system, safe environment, HVAC, negative pressure, airborne
18 FS-06 12/21/11 12/21/14 Preventive Maintenance Program equipment, incident history, inventory file, personal property
19 FS-09 12/21/11 12/21/14 Equipment Inventory and Repair History File equipment changes, PM. VA Form 90-2237
20 FS-15 12/21/11 12/21/14 Equipment Maintenance By Vendor medical center equipment, leased/loaned, equipment repair
21 FS-24 12/28/11 12/28/14 Recycling Management and Pollution Prevention Policy co-mingle disposal, pollution-prevention, trash removal, sensitive data, and waste minimization
22 FS-30 12/28/11 12/28/14 Petroleum Storage Tanks Underground, tank drainage, tank spill, sewer, spills
23 FS-32 12/28/11 12/28/14 Personal Protective Equipment equipment, PPE, hazards, safeguards, MSDS, protection
24 FS-23 2/5/12 2/5/15 Interim Life Safety Measures safe environment, construction, inspections
25 11-18 3/1/12 3/1/15 Patient Rights and Responsibilities Complaints, rights
26 MS-13 3/1/12 3/1/15 Employee Health Employee, Illness, Occupational Health
27 AH-135-01 3/2/12 3/2/15 Utilization of Medical Center Golf Course recreation golf
28 FS-31 3/5/12 3/5/15 Electrical Safety hazards, safe work place, personal protective equipment, electronic equipment
29 MS-10 3/5/12 3/5/15 Routine and Emergent Procedure Emergency, routine, ambulatory care, surgical, procedures, universal protocol, invasive, dental clinic
30 FS-07 3/7/12 3/7/15 Loaned Leased Rented Equipment PM, PMI
31 FS-13 3/7/12 3/7/15 Control of Ward Television Sets TV, unit
32 FS-16 3/7/12 3/7/15 Cleaning Maintenance and Repair of Wheeled Chairs commode chair, geriatric chair, shower chair, chair washer
33 MS-03 3/7/12 3/7/15 Emergency Services Emergency, ESC, 911, Code, ACLS, BLS, CPR.
34 MS-22 3/7/12 3/7/15 Acute Coronary Syndrome (ACS) and Acute Myocardial Infarction (AMI) Ischemic, heart, disease, cardiology, coronary, and myocardial infarction.
35 MH-15 3/22/12 3/22/15 Compensated Work Therapy Program Homeless Veterans Supported Employment (HVSEP)
36 MH-22 3/23/12 3/23/15 Incentive Therapy (IT) Program Compensated Work Therapy (CWT), Incentive Therapy (IT), Vocational Assistance Employment (VAE)
37 MS-27 4/7/12 4/7/15 Influenza Vaccine Policy Statement Influenza, Vaccine, Policy
38 FS-69 4/10/12 4/10/15 Report of Accidents Using VA Automated Safety Incident Surveillance Tracking System (ASISTS) Accident reports, ASISTS, CA-1, CA-2, 2126, employee injury
39 FS-22 4/17/12 4/17/15 Fire Prevention Program fire safety, fire safety regulations, fire emergency, fire alarm, fire drills, fire extinguishers, Stryker Evacuation Chairs
40 FS-03 4/23/12 4/23/15 Equipment Management Program ASISTS. EMP, preventive, inspections, medical equipment
41 FS-44 4/23/12 4/23/15 Infectious Waste Body fluids, blood, isolation waste, sharps, biohazard, PPE, disposal, sanitary
42 FS-65 5/16/12 5/16/15 Linen Distribution Service sheets, pillow cases, towels, pads, soiled, laundry
43 MH-04 5/16/12 5/16/15 Incentive Therapy (IT) Escort Program escort, incentive therapy, compensated work therapy, safety, infection control, transport
44 11-16 6/11/12 6/11/15 Buprenorphine Naloxone (Opioid Replacement) Therapy Buprenorphone
45 MH-26 6/11/12 6/11/15 Behavioral Emergency Response Protocol (BERP) Behavioral emergency, psychiatric crises.
46 FS-01 8/7/12 8/7/15 Maintenance and Repair Work Procedure Work order, work request, personal property
47 FS-48 8/7/12 8/7/15 Electric Carts Vehicle, transportation, carts
48 HR-05-06 9/17/12 9/17/15 Employee Recognition and Awards refreshments, ceremonies, VA Form 4659
49 PCS-10 10/30/14 10/30/15 Annual Leave for Nursing Staff.docx Annual Leave, AL nursing, A/L
50 HAS-22 11/5/12 11/5/15 Inter-Facility Referral and Transfer Policy patient transfer, air transportation, transfers to non-VA, transportation, med flight transfer protocol, ambulance services
51 11-17 11/8/12 11/8/15 Tort Claims Involving Medical Issues. Medical Staff National Practitioner Data Bank, Reporting
52 MH-05 11/9/12 11/9/15 Pony Express (Incentive Therapy) Delivery System Pony Express, Incentive Therapy Workers, Delivery System
53 MH-24 11/9/12 11/9/15 Vocational Rehabilitation Treatment Team Rehabilitation assessment, therapeutic training, vocational testing, vocational development, recovery plan.
54 FS-34 11/20/12 11/20/15 Compressed Gases and Oxygen Tanks oxygen tank, gas, compressed air
55 HR-05-01 11/20/12 11/20/15 Procedures for Work-Related Injuries injury, work, related, compensation, continuation, pay
56 HR-05-05 11/20/12 11/20/15 Employee Conduct disciplinary, labor, grievance, orientation,
57 HR-05-13 11/20/12 11/20/15 Time and Attendance for Full and Part-Time Physicians, Dentists and Podiatrists duty, tour, leave, physician, schedule
58 HR-05-23 11/20/12 11/20/15 Recording the Use of Offical Time Travel, per diem, and overtime
59 MS-09 11/20/12 11/20/15 Dual Care Policy Dual, Care, Medications, Prosthetics
60 FS-35 11/28/12 11/28/15 Ergonomics employees, injuries, working environment, office, chairs, computer, keyboard, ergonomic
61 FS-49 11/28/12 11/28/15 Lead Management lead, paint, tenant, apartment, housing, quarters, painter
62 FS-51 11/28/12 11/28/15 Control of Hazardous Energy (Lockout Tagout) lockout, tagout, tags, energy isolation, equipment, electrical
63 HR-05-04 11/28/12 11/28/15 Proficienty Ratings Proficiency, rating, awards

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  1. BEN:
    We need to do an ARTICLE 99!!!

    A group of doctors in a veteran’s hospital must contend with their hopeless situation: too many patients and not enough beds. The main cause of their problems is bureaucratic belt-tightening by the hospital administrators. The doctors are determined to give the best service they can, even if that means defying the orders of management and performing unauthorized operations.

  2. Letting the VA get away with screwing the veterans and getting away with unethical behavior is no one’s fault but the Veterans themselves. We as veterans have enormous power and that power needs to be displayed right away. All veterans need to organize in the millions and march mainly on Washington, DC and for those who cannot travel march onto their local VA Medical Centers and VA Affair Departments. In the millions, we can close down DC for weeks. March in front of the White House, Congress, and the Veterans Department. Tell the President, Congress and Secretary McDonald (the green berate who served in Nam and O’Bama’s yes man) to immediately fix the VA to perform its functions in favor of veterans. Fire unethical bureaucrats immediately, fire leave with pay bureaucrats who have been on paid leave for an unexplained extended time, fire bureaucrats who have retaliated against whistleblowers, make good on whistleblowers, no pensions for bureaucrats who have resigned but had unethical issues, fire those bureaucrats who have plead the fifth in front of Congress or at the minimum put them on leave without pay and reduction in benefits and many other actions against the VA to numerous to mention. If the President, Congress and the VA Secretary do not enforce the changes, we should give them 16 hours to get out of town or million of veterans will physically throw them out. If the police or federal agents get in our way, they will also be thrown out. Enough of this B***S***.

  3. 12/02/2015

    Dear Benjamin Krause,

    Xylene Dream

    Failed Management has been around us for many years—some saw it very early on but the majority of the people in the World thought those individuals were “special” and dealt with them accordingly [Example: Karlheinz A. Halter/Precision Components/Slide-Matic Corporation/Puch International]. But a young kid from Ohio saw through the shit and called it Treason—-1998 Cox Report.

    Many died of Heart Attacks and Car Accidents.

    Later some smashed into Mountains.

    Failed Management has been with the Human Race for Centuries.

    And the VA is no accident.

    The VA intends to behave this way for a long time.

    They have not moved much since May of 2014 and it will be 2016 in days.

    What direction are you moving in?


    Don Karg

  4. Hey y’all, Google
    “VAWatchdog dot org”.
    Why? Because it’s got many new articles concerning fubars by VHA’s & VBA’s coming out.
    Here’s two examples.

    1.) “Washington Examiner: VA finding new ways to make life tough for vets”
    Nov. 27, 2015

    In this article, VA has actually spent millions sending out info to have veterans get enrolled through the
    “Failing Obamacare”! Can you believe that?

    2.) “VA Patient’s Family Wants Answers”
    by Brandon Scott
    Nov. 30, 2015
    First broadcasted on WOWT
    NBC OMAHA hd 6.
    This is a tear jerker and in where I believe criminal charges should be brought against specific individuals at a VHA in Omaha!

    Like I said, this is just two out of a lot more.

    1. @crazyelf- That’s the terrible Catch-22 a Veteran may find themselves in if say they have absolutely no official Service Connection %, AND if they were of these last 14+ years of “War On Terror”, they are *only* allowed I *think* a max of so many months to use the VA then because they have no coverage and do not qualify for VA Healthcare, they are mandated to use the Obamacare Insurance Exchanges…which is yet another Catch-22 because The Affordable Care Act (Obamacare) requires a person to FIRST use the VA Healthcare if you are a Veteran but if you do not qualify for VA Healthcare, you have to then jump through more hoops and I hope those Vets know that it is then when they can possibly get healthcare via their State’s Medicaid if they have little or no income.
      I know this because a Veteran friend of mine from the current wars fell through that crack because the Indy VA used-up almost 9 months of his 2 years allowed after service in JUST waiting for a damn consult/intake/appointment and now is on his own via State Medicaid. Such a FUBAR mess.

      EVERY VET, regardless of when they served, SHOULD be qualified to use the VAMC’s…but we actually have Pres. George W. Bush to thank for this rather abbreviated time frame of care after they get out or back…and then it’s even more of a mess if a person happened to be Activated Guard or Reserves because they made THAT so you MUST serve Active Duty/Activated for no less than 24 months to even qualify to use the damn VA…and guess what? MANY of the Activated Guard and Reserves were effectively pulled-back and shipped back to USA as much as a WEEK before they would have qualified for VA Healthcare Benefits. BasTURDS!

      1. ^forgot to add the important caveat that a Veteran DOES need to have an Honorable Discharge as well to get any VA Healthcare and if they do not, they CAN appeal for this to be changed depending on the situation.

        Meanwhile, that recent Army Puke that was either selling secrets to enemy or something (Bergdahl?) had a freaking SEX CHANGE paid by tax payers while in prison. But we cannot take care of the honest vets?

      2. @namnibor.
        It wasn’t Burgdahl, it was some other puke (faggot queer) who helped that guy living in Russia over “wikileaks”!
        I don’t remember either one’s name. But they could, if rumor is true, cause great problems with the current administration. From Obamy down and Including Hitlery Clinton and family.

        namnibor, I never held prejudice within my heart before. Yet, this administration has caused my heart to turn hard and cold. It’s something I can’t explain fully. But I truly hate people who turn against these United States. Especially in the past 30 to 40 years now. It seems the corruption has gotten worse since Obamy has taken over. His ugly ass wife actually said this;
        “White people are what’s wrong with this country!”
        When she said that, and with what he’s been doing during the last seven years. If I was independently wealthy I’d take my wife and get the fuck outta dodge.

        Rant over for tonight!

      3. Thanks for correcting me and I too cannot recall his name. I am a really open-minded person and always have been but for a convicted war-crimes and sharing Secrets along with in association with Snowden, to have a sex reassignment WHILE IN FEDERAL PRISON is plain wrong in so many ways.

  5. When is enough, enough? The VA everywhere is guilty of every violation possible, including murder. By now, we should be reading in this blog that the VA takes responsibility for something. Veterans can’t talk to our psyches, because our psyches can’t tell us the truth in fear that it may, or may not have something to do with supporting a claim. We can’t talk to our Dr’s, for same reason. Seems everyone that works for VA has more rights there than any Veteran. I have to use the VA, and it sickens me every visit. I can’t remember any Dr. asking me about anything in years. I’ve moved around a lot in oast 40+ years, and can say with conviction, if any Veteran has a choice between a liscenced and accredited Dr., or whatever the VA, or whomever the VA gives us, who may or may not be a Dr., we would choose one of our choice. I know my last prescription was signed by a (Dr.) who according to United Health Care, can’t write a script in Alabama. Please, CLOSE THE VA. I really need to see a Dr. where my interests are the Dr’s concern.

  6. If JCAHO inspected them. They would be found in violation and put on probation or shut down. This kind of stuff isn’t tolerated in private practice.

  7. Wow. Some manager/Director there just decided to not do this part of their job while collecting pay to do it. One should ask what other parts of their job they decided to ignore.
    Why are these not reviewed and signed off on by the Director at least annually? Was the Director reporting to higher management that it had been done?
    One would think having an updated Infectious Waste policy in a hospital would e a good idea. Or an updated policy on Emergency Power given the number of electronic monitors in a hospital located in an area where power outages might be common from storms.
    I would bet good money that someone at this hospital certified to upper management every year that all these policies were updated. And I would also bet upper management has never bothered to check if the policies actually were updated.
    Finally, I would also bet this too is common at many other VA facilities.

  8. Why do you renew your drivers license? It is not that you can’t get in a car and drive without one, it is because if you are caught driving without one there is a costly penalty in fines which outweigh the risks of not renewing.

    Now, let’s consider this situation at Tomah. It is not they can’t keep operating the facility without updating their procedures, they do. However, unlike my example of your drivers license, the penalty to anyone within the VA is non existent. Why should they be concerned?

    There is no individual accountability for actions which are detrimental for the overall health and welfare of veterans. No one is fired. They may be transferred, put on leave with pay or retired. If this is how people within our government are permitted to act, is it any wonder we see the consequences of today’s society where there is little ownership of personal responsibility? If a government is not responsible why should the citizens be responsible.

    The second area of concern is what does the VAOIG actually do? They do not, nor have ever, given a complete top to bottom investigation of a facility. Unless a whistle blower brings attention to one specific issue, they have a preset agenda when going to a VAMC. Currently they check to see if veterans are asked questions to determine if they have Alcohol Abuse Disorder, environment of care, are vets being tested for HIV and about a half dozen other areas they look at. They currently are not checking doctors bona fides, nurse training, and other policies and procedures. There are literally hundreds of areas where they should be concerned. However, they go unchecked for years. And if they do find something? No one gets prosecuted, no one gets fired, and life goes on. In any organization, be it government or private, for employees to excel they must be subject to both rewards and penalties. Rewards such as job security, increased pay, greater benefits, safe work place, etc. and penalties such as being fired, demoted, or disciplined in other manners. The VA employee only has the reward side of the equation, therefore there is no personal responsibility – and, everyone wonders why it doesn’t work.

  9. Legislative efforts should be made so that all healthcare professionals, be mandated to carry professional liability insurance. If every citizen who drives a car is mandated to carry insurance while driving, it shouldn’t be that hard to carry insurance while taking care of patients. This will save lives by sifting out the ones who have repeated claims against their skill. Then the government can back up the insurance.This will give the government cause to terminate them for unsatisfactory performance. Congress is the problem.

    1. If its like the military, you can’t sue the providers. You can only sue the government. Therefore there is no incentive for insurance.
      Your argument is also a fallacy. Being insured only gives them the peace of mind that when they make an error, they won’t lose thier house. It protects them. Thus malpractice insurance allows bad doctors to do more harm.

      1. @CorpsmanuP & Dustin,
        As was stated the “insurance” would insure, possibly, healthcare providers might be more diligent in their care of veterans.
        Because, if the government insures them, they could, if found guilty of malpractice or some other egregious act, be FIRED!
        I believe this is what CorpsmanuP was eluding to!

        As you say, it may protect them from losing their house and other belongings. But without a job. Insurance means nothing.
        Also, who would hire someone (healthcare provider) in the civilian sector who was fired from a VHA? In my opinion, very few!!

      2. The insurance doesn’t give them a piece of mind, their premium will go up if a claim is made. My comment initially cited legislation that changes the liability directly back to the provider. If they cannot maintain a license or insurance, it would be grounds for dismissal. A truck driver cannot drive if he doesn’t maintain a med cert. That is all I am saying. VA medicine is substandard to military medicine.

  10. The importanf one to remember is the Patient Event Reporting system. This is a software program where any adverse event happens to a patient, they are to enter it into the system. It would be interesting to compel the data where the healthcare providers that killed our beloved veterans there , reported these adverse events to the State as mandatory reporting requirements dictate, according to their license to practice.

    1. The data will be scewed. The cause of death is almost always blamed on the patient. They will find something call it bad, point thier finger at it and blame the patient.
      For instance. Patient found dead with OD of percocet. This was a very troubled young man that served his country with pride. He suffered catastrophic injuries and trauma and was treated with pain killers. Unfortunately this soldier took too many (often ruled suicide).
      Truth be told they are now learning “studies are 10-20years old” that there is a lifetime dose and when taken chronically some patients up and die with no explanation. How bout giving narcs to unsupervised patients in pain. Common side effect drowsy, lethargy, foggy head, and makes people confused. You get trained to take pills for pain. Before long you build a tolerance. You begin becoming too comfortable with these dangerous medications. You become complacant. Often this leads to double or triple doses, where the patient takes the med, forgets, then takes another. Dies, then gets labeled a suicide or abusive drug user.

  11. Of the 63 policies, 40 of them expired after my father (Thomas Baer) died. 52 of them expired after Jason Simcakoski died. 27 of them expired after the congressional hearing. They are not listening. They do not seem to care. We need to make them realize they are not exempted from common decency and rules.

    1. Whats even worse. If the upper leadership doesnt look at and insure the policies are up to date, how often are the staff that are using these looking at them and being kept up to date.
      Might explain why my visits remind me of childhood, the customer treatment in childhood was better of course. But the trchnology, medications, and services offered to treat diseases was oddly similar. The VA is practicing with information, like thier policies, that is outdated and no one is looking.

  12. Posting this for a friend – regarding the situation in Tomah. “I am a totally disabled veteran and I have been seriously medically mismanaged and have experienced great harm at the VA. I have screamed for help for years and it has never come. Clancy promised, Kind and Baldwin promised but nothing. All I have continued to receive is backlash, continued maltreatment, being degraded, dehumanized, etc. for telling the truth. Yet the powers that be and those in the positions of authority continue to get away with murder, literally, and my life has been stolen from me. Please tell me, where do I turn when I’ve trusted so many already and I continue to be placated or ignored. I’m so tired, so very tired…all I wanted to do was to live as happy and healthy of a life as possible and now I feel as though they have taken almost everything from me. Who can I trust? Is there anyone with any integrity left? I’m so very tired of constantly being beaten down.”

  13. I believe it goes deeper than that. I believe, from top to bottom, VA in Washington has allowed VHA’s and VBA’s across this nation to do whatever they want. The VA has shown the public and veterans they have no power to punish law breakers at any VHA or VBA. The DOJ is a joke, in my opinion.

    I also believe, our current POTUS is behind much of the egregious acts pulled on taxpayers and veterans. His distain for the military and veterans is well documented.
    Right now, 2 Dec. 2015, our government has just 9 days to come up with a spending bill. If not, on 11 Dec. @ 12 midnight the government will be shut down.
    How will Americans deal with this? Already, a majority of Americans are angry at our government (potus, congress and senate). As well they should be.
    From my understanding, VA already received the allocations for the 2015-16 fiscal year. Questions are already popping up on where all those billions of $$$$ are going! Seems Congress can’t find out. Why? Wasn’t VA required by a Congressional Mandate to report on this at regular intervals? I believe it was every 14 days! But we all know McDonald does whatever he wants. As does all the other upper echelon of VA.
    I also want to remind y’all that VA owes 89 Florida hospitals $134 MILLION. This is only in Florida. Multiple that by 49 more states, and the amount will be staggering. There’s a “difference of opinion” on this between the VA and the Florida hospitals. In the “Miami Herald” article veterans were being billed. If veterans don’t pay, it went to collections.

    As far as what’s on here today. How many other VHA’s are in noncompliance over this same issue? In the civilian sector this would not be tolerated one bit!

    Lastly, I wonder exactly what’s in store for America in the coming months? Obamy has made it clear he will send more military SOF’s to Iraq and Syria as an “advisory force”! What’s going to happen when these young men and women return as “Wounded Warriors”? How will they react to VA’s incompetent actions toward them?

    Talk about how VA convolutes the situation. How many egregious acts in the past year or two has VA been allowed to get away with?

    1. @crazyelf- I think you made an interesting suggestion and point in that I wonder if it’s “By Design” to allow all the differences of running and managing various VAMC’s in different States the way each manager chooses to interpret or ignore all regulations and rules in place entirely different from each other, even VARO’s in different States, then there’s non-networking and connectivity via BILLIONS $pent with VA to do just that and so far like 4 attempts have failed, keeping this “chaos inherent in the system”, to actually facilitate and obscure any efforts of an audit or accountability…and the VAOIG is really by design a “horse and pony show” to give the “Magical Illusion” they are doing “something, as minimal as a slap on hand with a feather can be”, and this “100 Day Plan” truly is cooked-up VA Spin Machine??

      Yes, I am insinuating that a complex web has been spun to make the systemic corruption thick as honey in Antarctica by design and perhaps long ago. Meanwhile, the VA gets free Medical Resident M.D.’s by the minions, performs pharma tests on Vets for Big Pharma, it’s an elaborate money pit. The Denver VAMC Black Hole is yet another obscured truth I believe as well…what else explains the second largest Fed. Agency’s being allowed to be so irresponsible with Tax Payer’s money that’s supposed to be going for the best care for those that have served and their survivors, but is never held accountable?
      A LOT of pink slips need to be given in Tomah and NOT paid leave for a year or two while the VAOIG does their song and dance and two-step PR Spin Machine.

      Tomah VAMC employees must have a very low collective I.Q.
      VA needs an enema with a fire hose.
      Rant over for today.

      1. If the fire hose was big enough to knock down all the VA’s simultaneously requiring a knee jerk reaction to authorize all vets to seek private healthcare ,AND IT ACTUALLY PAYS THE PROVIDERS FOR THE CARE RENDERED, then it would be a step in the right direction
        Don’t even get me started on who does the authorizations. I will say this much. The person responsible for my last choice appointment (urgent egd that should have been covered by my gi consult to evaluate and treat) barely spoke english and had no medical terminology. The billing coordinator at the Drs office i put on the phone with him had to spell out all the words and give him numbers, then boom I was authorized. I was supposed to wait two weeks to call back to see if they got the fax. So I was supposed to wait two weeks for someone that doesnt know medical procedures or terminology to check a box to “authorize” me for treatment I was already authorized to recieve.

  14. They need to shut Tomah down the stench is just getting to overbearing.

    Anyone connected to any VA Health Care provider is putting their health and lives at serious risk.

  15. What a List!! Here’s my take on this:

    1) The VAOIG obviously does some serious “pencil whipping”, which tells an already dysfunctional facility that these things have absolutely no priority nor even importance if NOBODY is holding them accountable for standardized patient safety procedures and policies that can and have contributed to Veteran deaths.

    2) Individual VAMC’s are interpreting VA Regulations/Policies rather than following them to the ‘T’, which in-turn contributes to the VA **not** possessing any “Standardization” from one VAMC to another and this is systemically a huge problem because when a Veteran moves to another State, as a few on here have attested to, that new VAMC and RO will then potentially not even honor a Veteran’s established ‘Plan Of Care’, doing exactly what they want, and often the effect of such leaves a Veteran Homeless or even thinking about taking their own lives when mental health and pain meds are abruptly discontinued because they choose to ignore entirely the Veteran’s conditions, even going as far as telling Veteran “there’s nothing wrong with you”…(figure8fan comes to mind on here, as a prime example).

    3) Tomah VAMC has let very important HVAC monitoring and inspections expire, which begs into question if all the various outbreaks of Legionnaires Disease at VAMC’s and Veteran Retirement Care Facilities were results of such policies allowed to expire…Tomah VAMC has been a ticking threat of such an outbreak in letting such protocols lapse.

    4) Letting asbestos monitoring and containment inspections lapse shows reckless lackadaisical management choices, again, placing Veterans AND VA Employees at serious risk…are not these basic OSHA Laws/Regulations?

    5) ^related to above: letting safety protocols lapse since 2012 on canisters of Oxygen, et al…an Industrial Accident waiting to happen.

    6) ^Infectious Waste management and disposal lapse since again, 2012??? What are they doing at Tomah? Making meatloaf with medical waste for the cafeteria? WTF?!

    7) Does this mean that any VAMC in any given State is somehow also “exempt” from State Board of Health Inspections and Federal OSHA Requirements? Sure seems like it. Especially when many of these go back 4+ years and Benjamin found these items with little effort while VA OIG’s repeated visits missed entirely.

    You get the drift. I get the strong impression that the VA OIG missing this MANY important things displays egregious incompetence and shows they are ONLY part of the VA’s PR Spin Machine to put out fires but not address ANY problems with teeth.

    Speaking of fires, it makes one wonder if it’s been 4 years or more since Tomah VAMC performed a basic Fire Drill…but damn it, they have time for their incredulously stupid and embarrassing videos, playing Hungry, Hungry, Hippos, while only the presumed Lead Paint of facility is peeling and holding the whole facility together.

    VAOIG is definitely an enabler to the VA’s many problems…esp. lack of accountability and basic discipline and work ethos of employees.
    If this were a facility in the Civilian Medical Community, all these lapsed items would have quite possibly had effect of being threatened to be closed-down until all items up to date and more.
    It would only take one or two of those items in today’s blog/list to expire and a private business, esp. a mom and pop restaurant be CLOSED DOWN by *any* State’s Health and Safety Boards. Shows the VA has gone dangerously ROGUE.

    Lastly, Tomah VAMC and other VAMC’s are literally playing violin while Rome burns around them.

      1. The feeling I get from dealing with VA staff. They are on a sinking ship and no one knows how to fix it. Long term employees stopped bailing water and the newbies get tired real fast.

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