Veterans clinic under investigation

Whistleblowers allege corruption, patient neglect

A home-based veterans clinic is currently under investigation after allegations of widespread corruption, patient neglect and a host of other violations were reported by two whistleblowers who say they were subjected to stalking and retaliation for speaking up.

Former employees Crystal Lejeune and Harvey Norris are speaking out about corruption at Veterans Affairs Home Based Primary Care Clinic (HBPC) that is based out of Jennings and is a division of the Veterans Affairs Medical Center System in Alexandria. The clinic provides care to homebound veterans. The allegations are not affiliated with the Jennings clinic on Johnson Street or the Southwest Louisiana Veterans Home.

Lejeune said she retired June 22, citing harassment by coworkers, as well as management creating a hostile working environment during her seven years working as a medical clerk with HBPC.

“I’ve been stalked, watched, ignored and harassed - they have made my life hell,” she claimed. “All I wanted was for veterans to have the healthcare they deserved and needed.”

Lejeune provided hundreds of pages of documentation to Jennings Daily News to demonstrate the allegations. No patient information was included in those documents. She claims the documents detail patient neglect, falsification of medical records, fraudulent billing, misuse of government vehicles, tampering vehicle GPS tracking systems and other practices.

“I have gone seven years looking over my shoulder in fear,” she said in a letter to VA Secretary Robert Wilke. “I have severe insomnia and have been hospitalized twice for a massive ulcer. I often wonder if everyone else sleeps in the world while I worry about the veterans that have been neglected with questionable care and the others who weren’t treated with the care they deserved and were entitled to.”

So far Lejeune said she reported her concerns to supervisors, the Office of Accountability and Whistleblower Protection (OAWP) in Washington, D.C., the Department of Veterans Affairs Central Office, Office of Resolution Management, the White House, the VA Senate Affairs Committee, along with many other federal agencies and elected officials.

The OAWP has had an ongoing investigation for over 13 months, Lejeune said.

VA Senior Strategic Communications Advisor for the Office of the Secretary and OAWP Ashleigh Barry said Friday that because it is an active investigation, no information is being released at this time.

“This investigation is ongoing and we are taking these complaints very seriously,” she said. “We are doing everything we can to ensure that if there was any wrongdoing, the correct action will be taken.”

Some of the documents detail discrepancies found in reporting through the Veterans Equitable Resource Allocation (VERA) system. Lejeune said that when she tried to report the discrepancies to her most recent supervisor, she was told monitoring the system was outside of her job description.

“My supervisor emailed me saying not to get too wrapped up in monitoring encounters and only to report anything egregious,” she said.

Lejeune said she believed her findings were egregious and that she was getting nowhere when reporting them to management. After reporting to the new supervisor about her findings, Lejeune said she received new documentation of job duties and expectations.

“She conveniently omitted the VERA report duty,” Lejeune said.

The inaccuracies and misreporting not only led to patient neglect, but a loss of funds, according to a letter from retired HBPC coordinator John McBride. McBride submitted the email as part of a factfinding investigation in June 2016 on Lejeune’s behalf. McBride stated that it was not unusual for Lejeune to review the VERA reports for inaccuracies. He said miscoding or refusal to admit affected the agency’s VERA funding.

“It should be noted that Mrs. Lejeune’s check on the VERA reporting helped to show that a doctor in our program and the caregiver staff were often using the incorrect coding for their visit,” he stated. “In the year 2015, refusal to admit resulted in our VERA funding being projected at a $998,000 loss. This was a reflection of our program and on Mrs. Lejeune as it was her responsibility to help ensure that our program maintained and earned VERA funding.”

HBPC staff are supposed to visit each veteran at least every 30 days, however, Lejeune said some were not seen for up to 136 days. Based on VERA reports she provided, one patient was seen in June 2016, but not in July, August or September. While October through November showed monthly visits to the patient, the notes for those months were not entered into the system until after the patient was deceased, in January 2017.

According to Lejeune, a note is not visible in the system until it is signed by the author, which can cause staff to miss vital information if it is not completed in timely manner.

“I was unable to get the whereabouts of my coworkers addressed and it was affecting patient care,” Lejeune said in an email to her supervisor and upper management. “The email went ignored, as did numerous others.”

The November appointment was not billed as a visit, but as a “noncovered” item. It was not signed until Jan. 5, 2017. The patient died before the notes were signed, she said.

A report also showed charges for a 15-minute visit for a condolence call on Jan. 4 to the same deceased veteran’s family that was never answered.

Lejeune described other instances of misreporting, saying a veteran was billed for a visit when a nurse discovered the veteran deceased in the residence. Other veterans were allegedly visited and not billed.

Lejeune also claims to have discovered excessive hours of over-billing, even billing for more than 24 hours in one day. Other allegations include excessive billing for vaccinations, encountering visits as phone calls, as well as phone calls as visits.

Lejeune also reported a claim that while the nurse practitioner was ordering tests or documenting information for the registered nurse, it did not appear the RN was reading the information in a timely manner.

At one point a 24-hour urine test was ordered in August, but it was not addressed by the RN until November, almost 94 days later,” she said. “Still the actions of the employees continued. I have submitted evidence of employees documenting eleven home visits and 440-plus miles traveled in six hours while the car log shows the car never moved, which is not humanly possible. There was also a similar situation where there is evidence documenting home visits for nine patients in five hours while traveling 260-plus miles, and the car log showed the car never moved.”

Another claim included admittance of serviceconnected patients being delayed for the convenience of the RNs based on geographic location. One patient was reported to management as being on the waiting list for 518 days.

“Patients who are not fully service-connected were being seen before some that are 100 percent just because the location is more convenient,” Lejeune said.

Lejeune also reported that HBPC Clergy was reviewing the patients’ nursing care plans and advising the staff of what issues needed to be addressed.

“He didn’t have a medical license, but that didn’t seem to bother management,” Lejeune said. “To maintain compliance with the Joint Commission, the clergy was completing documentation of the Nursing Care plans because the employees were doing them.”

An inspection was completed on Jennings HBPC for Quality Management in 2017, which found instances of stained ceiling tiles, expired wipes, unsecured medications, mold on the refrigerator door stripping where medications were stored, out-of-date fire extinguishers and expired supply items. Also, the keys to the refrigerator where medicine was stored were left in the door, and the door to the room left unlocked, according to a corrective action plan. There is also documentation of expired supplies including blood specimen tubes, vacutainer needle holders, Pneumovax vaccine, accucheck strips and collection containers.

A Report of Contact was also submitted at one point to management documenting that a HBPC physician and coordinator discovered 2,000 expired Tylenol pills in a homebound patient’s bag.

“The Tylenol was found in the patient’s bag despite the fact that an employee should be documenting a monthly medicine reconciliation. That appears to be a false standard of care and should have raised concerns after the Report of Contact was submitted,” Lejeune claimed.

Lejeune also found employees coded 1,800-plus encounters as a “noncovered item or service,” which meant the VA wasn’t getting paid for the service or the HBPC wasn’t getting credit for some of the services. She said that raised a red flag because no one else appeared to be using that code.

According the documentation, staff used government vehicles for uses other than seeing patients and also brought the vehicles to their residences, which Lejeune said was in direct violation of facility policy. She said that once she started noticing inaccuracies, she reported them to management. The coordinator had informed the staff in writing to give Lejeune their patient schedules for years, but she said she never received them.

“I was not given employee schedules, contrary to that being listed as part of my duties in the national handbook, because the staff didn’t want me to know what was happening,” she said. “I was removed from group emails, not alerted on patient care when I had a need-to-know and frankly just ignored and not allowed to do my job.”

Lejeune said the retaliation and hostile work environment she experienced started many years ago.

“The more I reported, the worse the retaliation became,” she said.

In 2012, a supervisor’s fact-finding form response stated an employee was questioning Lejeune’s religion and that she was also afraid the employee would physically harm her.

“No one ever questioned that response,” Lejeune said. “She was taking notes on my comings and goings since I first started with HBPC. She would report everything to my supervisor at the time. I requested to change my desk to somewhere that provided more privacy. The atmosphere was getting intimidating and the stress was taking a toll on me.”

According to an email written by a supervisor, the same employee made reference to her religion in a meeting with her coworkers and a supervisor present, saying she needed to “find God and make him a part of her life.” She said that same employee was known to send emails to staff with quotes from the Bible, which was not approved to be sent out on VA computers.

In 2016, Lejeune said several photos were taken purportedly of her desk with sensitive patient information unattended.

“The complaint was then anonymously shared with the privacy officer to start another investigation,” Lejeune said. “After an investigation by the privacy officer, the allegations were determined to be unfounded.”

Norris, who left HBPC as a program coordinator in January to take another job, also raised concerns of mismanagement that led to patient neglect.

“This has been allowed to continue for too long,” Norris said. “There are hundreds of thousands of dollars worth of fraud and abuse and no one cares.”

According to a letter written to U.S Congressman Ralph Abraham from Network Director Skye McDougall on May 8, 2017, Norris provided evidence of false documentation of concerns regarding nursing work performance and vehicle utilization to the HBPC nurse executive. Norris also reported the alleged activity to the Office of Inspector General (OIG), however, according to the letter, the OIG declined to investigate the matter.

In February 2017, Norris said he was reprimanded for misuse of a federal vehicle for driving from a training program near Lafayette to Jennings for an after-hours meeting with a doctor about a suicidal veteran.

Norris said that he drove to St. Martinville to do a presentation in late January 2017. After the presentation, he met with a veteran a few miles from the presentation. The veteran’s son, also a veteran, was suicidal. Norris convinced the suicidal man to visit a hospital immediately. Norris said he went to see an employee who would be handling the case at the Jennings VA, and the VA filed a complaint because his original itinerary had called for him to go to a hospital in Alexandria from the conference.

Lejeune was also at the after-hours meeting, but left when two HBPC employees, who were on the VA time clock and using a VA vehicle after work hours, came into the restaurant after taking pictures of the meeting from the parking lot, she said.

A registered nurse, who Lejeune claimed was not witness to the incident on Feb. 1, 2017, notified management in writing that the two employees had met that day. In the letter, the RN did not mention a third employee who was present with Lejeune and Norris, but made it a point to mention that Lejeune was a whistleblower, saying she wanted her removed from her position.

“They took pictures of us according to the letter,” Lejeune said. “I was not on the time clock that day and I have requested the pictures through the Freedom of Information Act, but the VA has yet to produce them.”

Norris was sent home without pay for two weeks and after an appeal, the charge was reduced to conduct unbecoming an employee.

“What we did was not against the rules,” Norris said. “If I had anything to hide, why would I log the entire trip? There is no policy that states that you cannot alter a route. Also, this was an issue directly involving suicide.”

A cease-and-desist letter was issued to Norris on Feb. 3, 2017 by Chief of Social Work Service Rick Taylor, requiring that he refrain from any contact with HBPC staff, which appears to also be outside of work hours. The letter stated that the order was issued as a result of continued unresolved conflict between Norris and the team that was perceived as a hostile work environment.

“I finally resigned because they were progressively disciplining me out the door,” Norris said.

Norris also said in 2014, three current HBPC employees started their own home-based care business, Managed Care Health Systems, LLC, which is listed with the Louisiana Secretary of State’s Office (SOS) under one of the HBPC nurse’s husband’s name. The three officers listed according to SOS’s business filings database are all currently employed with HBPC as RN’s, one being a nurse practitioner.

“It may be possible that they were taking care of their patients on the VA’s time and billing it another way,” he claimed. “It appears they could be stealing from the government and no one want’s to do anything about it.”

In an email dated Dec. 9, 2016, to VA Medical Director Peter Dancy, Norris stated, “currently our Jennings team is in chaos.” The email was also sent to other management including a nurse executive, Chief of Social Work Service, Chief of Nutrition and Food Services and the Associate Chief of Staff for Mental Health.

Dancy responded to Norris’s message asking to be excluded on any future messages on the issue.

“Harvey, I am confident that those you include on the messages regarding HBPC will address issues appropriately,” Dancy stated.

Lejeune said she believes the response is just another example of management turning a blind eye to the issues.

“It was the same action that was happening all along,” Lejeune said. “Management didn’t really want to know. Even the network director was aware of concerns, but no one contacted me about my concerns.”

Lejeune said she has spoken with a representative from Congressman Clay Higgins’ office, who told her he contacted the Office of Inspector General (OIG) to look into the matter.

Calls to Higgins’ office and OIG were not returned to Jennings Daily News as of press time Friday.