Jackson Free Press

JACKSON, Miss. (AP) — The new director of the veterans' hospital in Jackson is struggling to change perceptions of the institution as members of Congress and a government oversight office pursue investigations into misconduct.

Joe Battle stepped into a public relations nightmare when he arrived at G.V. (Sonny) Montgomery Medical Center in early 2012. Whistleblower complaints were piling up as employees and patients began to lose faith in the hospital.

Then, a year into his tenure, the Office of Special Counsel sent a letter to President Barack Obama detailing previous and ongoing investigations into whistleblower complaints in Jackson, and the inadequate response of the Department of Veterans Affairs.

In the letter, the agency described a range of wrongdoing at the Mississippi hospital including improperly sterilized instruments and missed diagnoses of fatal illnesses. Battle says the negative headlines are no longer deserved, that the medical center delivers quality care and has resolved its past troubles.

VA health care generally is good or better than care delivered by private providers, according to RAND, which conducts research on a range of social and economic issues. Veterans groups also hold the medical care in high regard and describe the biggest problem as access. But the department is the second largest in the federal government with more than 300,000 employees, and pockets of serious problems have surfaced in recent months at some of the nation's 152 VA medical centers.

— Faulty maintenance and poor management at two Pittsburgh VA hospitals may have contributed to the deaths of five patients from a deadly strain of Legionnaires disease, according to testimony at a Congressional hearing in February.

— Eighteen veterans tested positive for hepatitis after the VA hospital where they'd been treated may have improperly used insulin pens on multiple patients.

— And three deaths occurred in the past two years under the watch of the Atlanta VA Medical Center after authorities say it lost track of mental health patients it referred to a contractor and failed to keep a close enough eye on those under its own care.

Battle acknowledges there were problems to confront when he arrived at the hospital, which employs more than 2,000 people and has an annual budget of more than $300 million.

"Clearly, there needed to be a better relationship between management and our labor partners within the medical center. That was a key focus of mine coming to the facility, was to build trust and leadership, and let people know that they had a leader that listens and pays attention to what's going on," Battle told The Associated Press.

Battle has shaken up the management ranks — a new assistant director was hired in November 2012 and a new associate director started May 6. Battle says he's recruiting a new chief of staff and nurse executive.

"Anybody who had issues with prior administration, those issues are not going to be here anymore because it's a whole new leadership team," Battle said.

Physician Phyllis Hollenbeck, who worked in primary care for four years, still works at the hospital and is one of several whistleblowers to draw attention to problems there.

According to the Office of Special Counsel, Hollenbeck charges that nurse practitioners prescribe narcotics even though they are not licensed to do so and that there is a dangerous shortage of physicians in primary care, among other allegations.

Hollenbeck says the hospital remains dysfunctional, with management problems that imperil patient health.

"Emails come out and show that the veterans are not able to get appointments, that there's hours and hours of waiting, that the lack of physicians is the same," Hollenbeck said. "No one seems to have a reality-based credible plan for making a real difference. My feeling is that everyone in primary care feels the same and it's not just a few disgruntled employees."

In January, whistleblower Dr. Charles Sherwood alleged that thousands of radiology images went unread or were improperly read.

The medical center in Jackson isn't the only VA facility to come under fire, though Rep. Jeff Miller, R-Fla., chair of the House Committee on Veterans Affairs, says the allegations levied by Jackson whistleblowers in particular are "deathly serious."

"In recent weeks and months, VA's own inspector general has linked several veteran patient deaths to serious mismanagement problems at multiple VA health care facilities around the country, including three deaths in Atlanta and at least five in Pittsburgh," Miller said in a statement. "In light of these tragic events, it's quite puzzling the department has not done more to examine the alleged problems at the Jackson VAMC. It's time for VA to put its employees on notice that it will aggressively investigate every allegation of mismanagement and hold fully accountable anyone who compromises patient safety."

In 2009, a whistleblower alleged that staff failed to properly sterilize medical instruments like bone cutters and scalpels. In 2011, Gloria Kelley, who worked in the Jackson department that sterilized reusable instruments, said she witnessed employees improperly wearing their protective garments, and did not follow other department guidelines. She hoped to correct the problems internally by telling her supervisor.

"I took it to them first," Kelley said, telling her superiors, "let's make these changes; let's get this done."

Instead, Kelley said her complaints were ignored.

Kelley was never interviewed during the VA investigation of her complaint, a requirement when the whistleblower discloses his or her name, as Kelley did.

Battle said that department has a new supervisor, has provided additional training for staff, and a million dollars in new equipment.

"I work from a philosophy of whatever it is, we'll see it, we'll own it, we'll fix it and we'll move on," he said.

Veterans gathered at a town hall meeting in April led by Battle and Veterans Affairs Undersecretary Dr. Robert Petzel. One veteran, speaking from the audience, called one of the hospital's primary care clinics, "garbage."

Battle said that only a fraction of the 45,000 people treated there annually attended the meeting, and that most patients approach him with compliments.

Army veteran John Brinson, who served in Korea, was being treated by Nurse Practitioner Rebecca Clanton at the medical center on a recent day.

"I'm completely satisfied with the service here," Brinson said. "You will always find people who complain about anything and everything, regardless."

But AP interviews with veterans in the Jackson area show it's easy to find people who are not satisfied, some of whom have abandoned the hospital altogether.

Chuck Carter, former vice president of the 4th Battalion 42nd Field Artillery Association, said he was diagnosed with Post Traumatic Stress Disorder but went a year and a half without counseling when his counselor was reassigned to a different area of the hospital. He sought treatment elsewhere in 2012.

"It was really tragic to me," Carter said. "A lot of people won't go. They run you like you're in an assembly line."

Carter, who is 64 and served in Vietnam, said his health has improved since he sought treatment elsewhere.

Veterans also say scheduling at the hospital has been poorly managed. Battle said improving scheduling is an ongoing project, and he reviews hospital intake data daily to ensure veterans are seeing doctors and don't spend egregious amounts of time waiting.

Because whistleblower complaints emerge after the alleged misconduct, it's difficult to know what concerns are brewing that could be exposed years from now. Battle said he hopes to stem problems by addressing them quickly. Still, the move by the Office of Special Council to alert the president to even open investigations shows that issues at the hospital are not a thing of the past, and that results of previous investigations, deemed "unreasonable" by that office, do not inspire confidence.

There is only one other VA medical facility that's had more than one referral from the Office of Special Council in the past five fiscal years, according to a spokesman.

"The pattern of disclosures from physicians and other whistleblowers at the Jackson Medical Center is troubling," said Ann O'Hanlon, spokeswoman for the Office of Special Council said in a statement. "The whistleblowers' concerns were echoed by veterans during a recent town hall meeting. We believe the VA is taking these concerns seriously and await the results of the VA's investigations into these issues."