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 Military.com 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].”
Tolentino, who in the Navy worked in patient care as an independent duty hospital corpsman, is now studying nursing in Boston
Overall, the VA paid out about $194 million in bonuses in 2011, according to testimony during the hearing.
A VA spokeswoman said an administrative investigation board looked into Tolentino’s claims even before he gave his public testimony and made several recommendations. This included hiring more staff at the Manchester facility and implementing electronic scheduling reviews and waiting lists as part of the process, among other things.
But nothing in the VA response indicated the board looked at the issue of bonuses based on manipulated data.
The VA’s Inspector General backed Tolentino’s accusations. A VA IG report was submitted to the committee days before the hearing. While the VA claimed that 95 percent of veterans received mental health evaluations within 14 days of contacting a hospital, the IG found it was closer to 50 percent. And where the VA said 95 percent of those veterans evaluated received some treatment within 14 days, the IG found it was 64 percent.
The IG concluded the VA was failing to meet its own mandated timelines but then manipulating the system to make it appear those deadlines were met.
The offices of Sen. Patty Murray, D-Wash., then chairman of the committee, and Sen. Bernie Sanders, I-Vt., the current chairman, did not respond to Military.com’s request for comment.
Sen. Richard Burr, R-NC, the ranking Republican on the panel, also did not respond. Burr was absent the day of the hearing but was represented by then-Sen. Scott Brown, R-Mass. During the hearing last year, Brown began to ask about the bonuses but stopped when William Schoenhard, a VA deputy under secretary for the Veterans Health Administration, asked to take questions for the record.
Brown, who lost his Senate seat in November to Elizabeth Warren, did not return Military.com’s call on Monday.
The issue appears to have fallen off the committee’s radar despite Murray’s closing remarks at the hearing.
“This is not something we’re going to hold a hearing on and then leave and go do something else … I don’t want to continue to hear that anybody’s gaming this system,” she said.
Tolentino said that when he gave his testimony he believed the Senate would follow up.
“I have never heard a single whisper of a follow-up on that,” he said.