VA home based clinic under investigation

<div class="Content"><p class="indent">JENNINGS — A federal investigation into allegations of patient neglect, fraudulent billing, falsification of medical records, misuse of government vehicles and other mismanagement practices is underway for the Veterans Affairs Home Based Primary Care Clinic based in Jennings.

<p class="indent">Andrew David, press secretary for Rep. Clay Higgins, said the office has been made aware of the allegations of corruption through media reports and has voiced concerns.

<p class="indent">“Congressman Higgins spoke directly with the VA Inspector General’s office to voice concerns about potential waste, fraud and abuse within the VA,” David said in an email to the <em>American Press</em>.

<p class="indent">David said the office was unable to offer comment on specific allegations since it is an ongoing investigation.

<p class="indent">“Congressman Higgins strongly supports whistleblower protections within the VA, and he is working with the House Veterans Affairs Committee to ensure greater accountability at VA facilities across the country,” he said.

<p class="indent">The allegations were made by Crystal LeJeune and Harvey Norris, two former employees of the Home Based Primary Care facility in Jennings. The clinic is part of the VA Medical Center in Alexandria and provides home-based primary care to veterans.

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The Office of Accountability and Whistleblower Protection in Washington, D.C., is reviewing the information and working with the South Central VA Health Care Network to look into the matter, according to an Aug. 13 letter to LeJeune from Executive Director Kirk Nicholas.

</div></div><p class="indent">LeJeune is also awaiting an administrative hearing date based on a nearly 700-page Office of Resolution Management investigation.

<p class="indent">The <em>American Press</em> was provided with dozens of pages of emails and documents concerning allegations of potential for waste, fraud and abuse within the system by employees, along with other lack of accountability and mismanagement practices, many which led to delays in patient care and expired supplies, including medication.

<p class="indent">LeJeune, who took medical retirement in June, and Norris, who resigned in January to take another job, raised concerns of alleged neglect and improper care of veterans and fraudulent record keeping with management prior to leaving employment. The Department of Veterans Affairs Central Office, Office of Resolution Management, Office of Accountability and Whistleblower Protection, the White House, the VA Senate Affairs Committee, along with various other federal agencies and elected officials have been made aware of the complaints. Incidents have been reported dating back years.

<p class="indent">“There is possibly hundreds of thousands of dollars worth of fraud and abuse here and no one cares,” Norris said, adding the paper trail is easy to follow.

<p class="indent">Norris, a former suicide prevention coordinator and former acting HBPC program coordinator, said the wrongdoings were allowed to continue for too long, then it was too late for anyone to admit they knew about it and didn’t do anything.

<p class="indent">The two contend they suffered harassment and retaliation from co-workers after disclosing information and met resistance when trying to report issues. LeJeune alone filed 12 complaints including claims to the U.S. Equal Employment Opportunity Commission. She also filed with her immediate supervisors, the Joint Commission, the Office of Accountability and Whistleblower and sent numerous letters to VA Secretary Robert Wilke.

<p class="indent">“They actually told me Crystal was crazy and conspiracy-minded,” Norris said. “I actually believed them at first, but after two weeks I told her if she had proof I can verify myself, then give it to me. The next day she had several hundreds of pages for me to go through.”

<p class="indent">“My initial thought was ‘This is not good.’ The next day she showed up with even more pages.”

<p class="indent">LeJeune, who worked as a medical clerk, said she documented many issues she has seen with her own eyes. She said many of the inaccuracies and discrepancies were found while reviewing the Veterans Equitable Resource Allocation reports, which was part of her job duties until the supervisor told her to not report anything unless it was “egregious.” Her supervisor emailed her to “please don’t” get wrapped up in monitoring encounters, this is not your job duties … of course if it is something egregious, then please let me know so it can be addressed.”

<p class="indent">It was at this point LeJeune said she questioned what pertaining to veteran health care would be “egregious.” She said she felt she was doing her job according to her job description and it appeared management wasn’t satisfied with her findings.

<p class="indent">A Quality Management and Improvement Inspection was done on April 5, 2017. Expired supplies and medicine, along with other serious problems were documented in photographs taken by LeJeune. Pneumovax vaccine, blood specimen tubes, vacutainer needle holders, accucheck strips and collection containers for stool specimens were found to be expired, some dating back to 2011-2012.

<p class="indent">Other problems were unsecured medications, an unlocked supply room door and mold on the door stripping on the refrigerator that held medicine and supplies. The fire extinguisher had not been checked for two years and clean and dirty storage areas were also noted.

<p class="indent">LeJeune said it was all documented in the inspection report and the expired supplies were laid out on the conference table and pictures were taken for documentation.

<p class="indent">LeJeune also found employees coded 1800-plus encounters as a “non-covered item or service” which meant the VA wasn’t getting paid for the service and the HBPC wasn’t getting credit for some of the services. She said that raised a red flag to her because no one else appeared to be using that code.

<p class="indent">HBPC patients were supposed to be seen every 30 days. One patient was seen in June, not seen in July, August or September and his visits for October, November and December were documented and signed by the employee in January, after the patient had died. The condolence call made to the spouse after the patient died, was billed as a visit. The note stated there was no answer.

<p class="indent">LeJeune contends this was not the only patient not seen in a timely manner within guidelines. The same patient had a visit that was not billed as a visit and a December medical note was not signed by the health care provider until February, over a month after he passed away.

<p class="indent">Veterans were on waiting lists for more than 500 days, including those that were service-connected while registered nurses refused at times to admit patients or they were screening veterans for admission based on the home location, she said. The reports also showed patients were not being seen on a regular bias and patient records were not being updated in a timely manner. There were times nursing care plans were also not updated with up-to-date information including patient vitals, she said.

<p class="indent">In many instances, the HBPC clergy, who has no medical license, was completing the care plans, LeJeune said. At one point LeJeune questioned management in writing why 100 percent service-connected veterans were still on the waiting list, one after 418 days, while a nonservice connected veteran had been screened before them.

<p class="indent">One HBPC nurse documented an impossible number of patient visits and work hours, LeJeune said. The nurse documented 13 home visits and it appears she traveled over 440 miles in six hours while the car log showed the car never moved. Another documented nine home visits in less than six hours with 260-plus miles. Again the car log showed the car never moved, she said.

<p class="indent">One nurse regularly documented a large amount of overbilling, billing more than 24 hours in one day and others not going to work on a regular basis, but were still on the time clock, she said.

<p class="indent">“That is impossible,” LeJeune said. “One nurse even billed a visit for a patient she found deceased. I don’t think that is right.”

<p class="indent">LeJeune notified management in writing that she was concerned she did not know where employees were and it was affecting patient care. When critical labs were called in or other patient needs were noted, she could not locate medical staff. Her concerns were not responded to by management.

<p class="indent">LeJeune and Norris also accused HBPC employees of using government vehicles outside of work, tampering with vehicle tracking devices and falsifying documents after information from the vehicle logs did not match GPS tracking data.

<p class="indent">“There were instances where the government vehicles were brought to the employee residences or other locations during work hours,” LeJeune said. “One RN was leaving her home to travel to and from work while on the timeclock.”

<p class="indent">Norris said for two years he knew where everyone was and was able to match the visits, but the information did not match the GPS logs. At times the progress note, the billing code, the GPS and the car log did not match.

<p class="indent">“There were days nurses made numerous stops and only one would be to a veteran, but they filed paperwork saying they were visiting patients,” he said.

<p class="indent">Norris said he was written up for misuse of a federal vehicle for taking a vehicle from a training near Lafayette to Jennings to meet after hours with a doctor concerning a suicidal veteran, but the charge was dismissed to conduct unbecoming an employee after he filed an appeal.

<p class="indent">LeJeune was also at the meeting, but left when two HBPC employees, who were on the VA timeclock, and in a VA vehicle after work hours, came into the restaurant after taking pictures (of the meeting) from the parking lot.

<p class="indent">A HBPC RN, who did not witness the incident on Feb. 1, 2017, notified management in writing that the two employees had met that day. She did not mention a third employee who was present with LeJeune and Norse, but made it a point to mention that LeJeune was a whistleblower and she wanted her removed from her position. She continued by noting LeJeune’s movements when she worked at the VA Hospital, 100 miles away and also noted that pictures were taken of LeJuene and Norris on that day. LeJeune was not on the time clock that day. She has requested the pictures through the Freedom of Information Act, but the VA has not produced them.

<p class="indent">“They sent me home for two weeks without pay because they said I didn’t have permission to re-route the trip to Jennings, then every time I turned around there was a criticism or some type of unsatisfactory job performance,” Norris said.

<p class="indent">He was also written up for not completing a training although he had finished all requirements and handed all paperwork in on time. Those responsible for approving the training did not do it in a timely manner, but he was at fault, he said.

<p class="indent">“That’s when I turned in my resignation and they actually wrote me up, but I didn’t even look at it because I didn’t care at that point,” Norris said.

<p class="indent">Norris said he is under investigation for the unauthorized release of client information when an online story appeared on The Daily Caller about whistleblowers at the VA HBPC Program in Jennings. The information has since been removed from the Internet, he said.

<p class="indent">Before leaving, Norris found three employees had formed their own home-based care and partnered with another company. The company is listed under the name of one of the RN’s husbands and is based in Lake Charles, he said.

<p class="indent">“They were seeing the patients that they were suppose to be seeing on VA time, but possibly billing home health and that is illegal,” Norris said. “It’s a federal crime.”

<p class="indent">Norris gave information he and Lejeune had uncovered to the Office of Inspector General and was allegedly told “that was more information than they knew what to do with.” Officials told him they would try to figure it out, but the investigation was sidelined and never completed, he said.

<p class="indent">“Everyone in upper management knew what was going on, but didn’t do anything about it,” he said. “Veterans are not receiving care, employees are stealing from the government and the VA doesn’t do anything about it.”

<p class="indent">In February 2017, Norris was issued a direct cease-anddesist order from Rick Taylor, chief of social work for the Department of Veterans Affairs, instructing him to refrain from “any and all forms of communications, interaction and contact, either in person, by phone, via email, etc., with any member of the Jennings Home Based Primary Care team.” He was also instructed to stop reviewing any HBPC data or information related to provision of care, vehicle utilization, or other without notifying Taylor.

<p class="indent">The memorandum indicated the order was issued as “a direct result of continued unresolved conflict between you and the team that is perceived as a hostile work environment.”

<p class="indent">Local HBPC employees are now allowed to work from home.

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All patient and personal information was redacted from documents viewed by the <em>American Press</em>.

<strong>The clinic is part of the VA Medical Center in Alexandria and provides home-based primary care to veterans.</strong>

<div class="float"><div class="Lead"><strong>‘There is possibly hundreds of thousands of dollars worth of fraud and abuse here and no one cares.’</strong><br />Harvey Norris<br />Former employee of VA Home Based Primary Care Clinic</div></div>

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