Staff members working for the Bay Pines VA Healthcare System in Florida left the body of a deceased veteran in a shower for nine hours, violating post-mortem care procedures. The veteran passed away at Bay Pines in February after spending several months in hospice care.
An internal investigation revealed that hospice staff members “demonstrated a lack of concern, attention and respect” for veterans in their care.
The report states that hospice staff members violated proper procedure and contacted a staff member known as a “transporter” to move the body to the morgue. The transporter then told hospice employees to follow proper procedure and contact another employee known as a “dispatcher.” That request was never followed and the body was moved to a hallway and then a hospice shower room where it remained unattended for at least nine hours.
The investigation also shows that hospice staff falsely documented the incident to cover for their failures, oversights, and mistakes that led to the body being left unattended. Investigators discovered that hospice staff failed to check 24-hour nursing reports that showed whether the veteran’s death was properly reported, that they failed to update nursing service organization charts the night of the incident in an attempt to hide which staff member was in charge, and that they falsely told investigators that the incident was caused by a lack of clerical staff; a claim they later withdrew.
It is unclear whether the employees involved in this incident the alleged cover-up attempt were fired. Hospital spokesman Jason Dangel stated that “appropriate personnel action was taken,” and that the VA and hospital “view this finding as unacceptable.”
The investigation found that the hospice unit lacked a structured plan for teaching best practices before the incident. Dangle defended the hospital by saying that all hospice staff have been “recommitted” to the VA’s core values and have undergone reeducation and training. He told reporters:
“We feel that we have taken strong, appropriate and expeditious steps to strengthen and improve our existing systems and processes within the unit, It is our expectation that each veteran is transported to their final resting place in the timely, respectful and honorable manner. America’s heroes deserve nothing less.”