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Senators want a permanent director at Detroit VA hospital to move beyond ‘past troubles’

John D. Dingell VA Medical Center in Detroit (Library of Congress/Released)

Michigan’s U.S. senators are pressing the Department of Veterans Affairs secretary to install a permanent director at Detroit’s John D. Dingell VA Medical Center “as soon as possible” following revelations by an agency watchdog last year about a “crisis of care” and leadership failures at the hospital.

The Detroit VA is on its third interim medical director, Chris Cauley, since the hospital’s longtime director, Dr. Pamela Reeves, was reassigned July 1 amid ongoing internal VA investigations into misconduct. Other top hospital executives were also replaced.

In a letterThursday to VA Secretary Denis McDonough, Democratic U.S. Sens. Gary Peters of Bloomfield Township and Debbie Stabenow of Lansing said leadership and managerial failures following a “crisis of care” at the facility led to a culture of “distrust and low patient and employee morale.”

The senators said they’re grateful that a series of interim directors at the Detroit VA have begun turning things around at the hospital, but “the type of systemic, cultural change needed at the facility can only occur with long-term leadership and stability.”

They are asking McDonough to initiate “without delay” the process of appointing permanent leadership at the hospital, while still complying with agency requirements regarding ongoing investigations at the facility.

“We must ensure our nation’s veterans, including over 650,000 in Michigan, receive the support and resources they earned through the Department of Veterans Affairs after their military service,” the senators wrote.

“Only by installing permanent and qualified leadership at the Detroit VAMC can the facility fully move beyond its past troubles and return to fulfilling its duty to our veterans.”

Peters and Stabenow’s letter also was addressed to Laura Ruzick, who leads the regional network overseeing VA health facilities in Michigan, Ohio and northern Kentucky.

The reassignment of the hospital’s leadership followed an investigation by the VA’s Office of the Medical Inspector (OMI) that revealed mismanagement and “substandard” care in the hospital’s surgery practice, as first reported by The Detroit News last month.

McDonough said Thursday at the VA’s headquarters that the temporary “detail” positions are limited to a certain number of days, which is the reason for series of acting directors in Detroit. He declined to provide a timeline for the appointment of a permanent director for the facility.

“We are obviously actively looking for replacement personnel there, but we’re also making sure that we get to the bottom of what’s happened and what is going on and the bottom of making sure ― as I said last month to you ― I’ve been talking to the (inspector general) about whether we are fulfilling the 12 fixes we need to make,” McDonough said Thursday at a news conference.

“So that’s the overwhelming priority for us right now ― assuring our vets in Detroit that they can have confidence that we’ve made those improvements, that they can have confidence in their care. The personnel will closely follow that. But I can’t give you a timeline on that.

“But we’re going to make sure that historic and really important system can count on leadership that can serve them as well as the vets have served us,” McDonough added.

Ted Froats, a spokesman for Ruzick, said Wednesday that the interim director positions are required to have a “not to exceed” term limit of typically 120 days, which is why interim directors have stayed for several months in Detroit before returning to their previous roles.

“Each interim director has been a highly qualified professional from different facilities in the region. This ensures we keep the most-qualified individuals with the best understanding of veterans in the area leading this top position,” Froats said.

The OMI report, issued nearly a year ago, found failures in oversight at the Detroit VA had contributed to patient harm and death, and that former leaders at the hospital had tried to hide a pattern of “substandard” care in the surgery practice by altering external peer reviews and other data.

The OMI said one clinician had been the source of multiple investigations, tort claims and “poor veteran outcomes” for at least four years but still had been allowed to remain. Investigators also said internal processes were “manipulated at multiple points” to prevent action from being taken in response to concerns about the quality of patient care.

The VA has declined to say why Reeves and others were reassigned to other roles within the Veterans Health Administration, citing ongoing internal investigations.

But McDonough has reiterated that patient safety is a “top priority,” and stressed that the employees involved have been temporarily removed from leadership and patient-facing roles, “pending the outcome of these additional investigations.”

Peters and Stabenow in September asked VA Inspector General Michael J. Missal, who reports to Congress, to launch an investigation into the misconduct and Missal’s office is now conducting a review of how the facility has implemented fixes recommended by the OMI.

The scope of what was recommended and what has been done to correct the identified problems are not totally clear. The OMI report ― obtained by The News through a public records request ― was heavily redacted by the Veterans Health Administration, including obscuring most of the recommendations that the OMI made for the Detroit VA to address the situation.

The current investigations into leadership at the Detroit VA date back to at least 2021. The VA’s Office of Accountability and Whistleblower Protection (OAWP) launched a probe into the alleged misconduct in November 2021 in response to the OMI’s on-site investigation in Detroit, according to internal emails obtained by The News that cited concerns about data manipulation, staff bullying and a “failure of oversight leading to patient harm/death.”

Earlier this month, McDonough said he plans to hold town hall meetings for veterans and staff at the Detroit VA hospital in Midtown, though those dates and times still have not yet been set, McDonough spokesman Terrence Hayes said Wednesday.

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(c) 2023 The Detroit News

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