I-Team In-Depth

VA Connecticut Hiring Practices Under Investigation

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The U.S. Office of Special Counsel is investigating allegations of illegal employment practices at VA Connecticut Healthcare System connected to the hiring of seven employees­­—some in top management positions­—who are all former co-workers of the system’s director. A separate complaint filed by a whistleblower to the Office of Inspector General of the U.S. Department of Veterans Affairs alleges “gross misconduct” in the hiring of staff from the Manchester (New Hampshire) VA Medical Center. It says that “all management positions were pre-selected.”

“VA Connecticut is in turmoil,” wrote the whistleblower in an anonymous complaint filed in August and obtained by C-HIT. The complaints have put a spotlight on the management of Alfred A. Montoya Jr., who has been head of the West Haven VA for almost a year. Montoya was brought in from the Manchester (New Hampshire) VA Medical Center after years of upheaval in the delivery of health care at the West Haven VA, where surgeries were outsourced to Yale New Haven Hospital after deficiencies were found in sterile procedures.

Fines & Sanctions

New Report Highlights Problems Of Hospital ‘Observation’ Stays

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Medicare patients had more than 600,000 hospital stays in 2012 that lasted three nights or more but did not qualify them for follow-up nursing home care, according to a new report by the U.S. Department of Health and Human Services’ Office of Inspector General (OIG). Although the report does not include historical data, it indicates that hospitals in the U.S. increasingly are designating multi-day stays as outpatient or “observation status” visits, rather than inpatient admissions. In all, Medicare beneficiaries had 1.5 million hospital stays in 2012 that were classified as observation visits, with more than a third of them lasting two nights or more. The “observation status” designation – which often deprives Medicare recipients of coverage for follow-up nursing home care – is being challenged in a lawsuit in U.S. District Court in Hartford and in legislation proposed by Democrat U.S. Rep. Joe Courtney, who represents the 2nd Congressional District. Many Medicare beneficiaries who come to hospitals in emergencies are classified as observation patients, even though the care they receive may be indistinguishable from the care received by patients classified as inpatients. Under current rules, Medicare will not pay for a stay in a skilled nursing facility after hospitalization unless the beneficiary has been classified as an inpatient for at least three consecutive days.