To turn around the most troubled Department of Veterans Affairs (VA) hospital in the nation, officials have selected a woman who left her last hospital in disgrace after it ranked dead-last in patient satisfaction among the agency’s 126 hospitals nationwide.
Rima Ann Nelson has been named the next leader of the Phoenix VA, The Daily Caller News Foundation has learned.
In St. Louis, Nelson oversaw a hospital that potentially exposed 1,800 patients to HIV and whose operating rooms were closed twice for serious medical safety issues. Patients and employees both gave it the worst possible marks for trustworthiness. The Democratic congressman who represented the area around the facility said mediocrity “thrives” under Nelson and he was astounded that she was still employed by the VA.
When she starts Oct. 2, she will become the seventh director in less than three years for Phoenix’s hospital — the epicenter of the national wait-time scandal that rocked the nation. She is the second consecutive boss who is known to have a bad track record even before her first day on the job.
Her appointment will likely spark new questions in Congress on whether VA is trying to turn the hospital around, or continuing to move poorly performing executives from one site to another, much like pedophile priests were formerly moved around by the Catholic Church.
“Nelson and [new chief of staff Maureen McCarthy] bring sound leadership qualities and many years of proven experience. I am certain they will be valuable assets to the organization, the staff and volunteers, the community, our health care partners, and most importantly, to the Veterans,” the hospital’s interim director wrote to employees Wednesday.
Among a complex string of horrible metrics for St. Louis during Nelson’s tenure there, a 2012 review of 27 nurses’ personnel files in St. Louis found only half had required documentation of their competency. Auditors found “a lack of effective nursing leadership.” Nelson is a nurse. Employees told a local TV station that veterans were left sitting in feces for days.
“If [the St. Louis VA] were a ship or a military unit, the commander would have already been relieved,” then-Rep. Todd Akin, a Republican, wrote in 2011.
In 2013, Nelson was whisked away from St. Louis to VA’s most out-of-the-way location: A tiny office in the Philippines — its only foreign outpost — where she continued to be paid $160,000 annually despite managing a far smaller office and country’s extremely low cost of living.
The Government Accountability Office has questioned whether the office, which once cared for Filipino vets who fought in World War II, should even still exist.
Since 2007, Nelson has worked in Salt Lake City, two hospitals in Missouri, the Philippines and now Phoenix. TheDCNF’s analysis of government personnel data found that executives who have not managed to stay in one place for long are typically problem children who the VA rotates from job to job because officials believe they can’t fire such poor performers.
Former Rep. Russ Carnahan, a Democrat who represented St. Louis in Congress under Nelson’s tenure, told TheDCNF that “when you have a system that’s too closed, this tends to happen. It’s perpetuating people that are in the system.”
“They have to address the less than good talent that’s there, and hold them accountable and weed them out.” Then “you’ve got to open up that system to allow new talent in,” he said.
The Phoenix hospital has been rudderless since it caused dozens of deaths by having veterans wait months for care, while reporting stellar wait-times so managers could get bonuses. Its then-director, Sharon Helman, is now a convicted felon.
The hospital’s troubles has been the focus of front-page articles in every major paper in the country, hearings by multiple Congressional committees, and internal government investigations.
That makes it all the more perplexing that in the months since, VA brass has repeatedly selected from an existing crew of hospital directors–and seemingly from among the bottom of that barrel.
Nelson replaces Deborah Amdur, who was brought in to stop the data manipulation, even though an inspector general report from just before she started that included extensive evidence that the same problem occurred during her previous assignment in a Vermont VA hospital.
Wait time metrics became implausibly positive the moment she arrived at the Vermont hospital. When she took over, the facility’s rate of veterans getting to see doctors the exact day they wanted to was 49 percent.
In the six months after, the reported rate rose rapidly until it was at 96 percent. Recent records show that “more than half of the total schedulers … entered the appointment date as the desired date 100 percent of the time.”
Abdur resigned abruptly after less than a year after a series of new scandals. Some of those VA bosses could have anticipated based on her track record: she refused to meet with Sen. John McCain, the Arizona Republican. Shortly before she was hired, she was caught lying to another senator to cover up misconduct.
Employees at Phoenix who tried to report corrupt management were punished during the scandal. Nurses in St. Louis said they were retaliated against for reporting problems, while bad employees went un-fired, when Nelson was there.
In a statement, VA Deputy Secretary Sloan Gibson praised Amdur, saying “in large part due to the leadership of Deb Amdur and Barbara Fallen, the Phoenix VA Health Care System has made irrefutable progress in increasing access to quality care that our Veterans have earned and deserve.”
He said the new chief of staff comes from the VA’s central office, rather than a hospital.
“Dr. Maureen McCarthy comes to Phoenix from the Veterans Health Administration in Central Office serving as the Assistant Deputy Under Secretary for Health — Patient Care Services, where she had a key role in the development of clinical care guidelines and policies.
“Nelson graduated from the University of Utah with undergraduate degrees in Nursing and Community Health Education and a graduate degree in Public Health/Health Services Administration. She has also completed the Senior Executive Fellows Program.”
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