Possible Hospital Mismanagement of the Veterans Administration Hospital, University Drive, Pittsburgh, Pennsylvania

Published by the Government Accountability Office on 1971-11-12.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                                         COMPTROLLER     GENERAL        QP      THE       UN
                                                       WA!SHINGTON.      D.C.         20848

                                 /J   5x59.5

            I'     Dear Senator        Schweiker:
                             Pn accordance with your request dated May 18, 1971, we                     P-
                     examined into statements         made to you by certain        employees of           7
        i          ,-,the Veterans Administration
                                        __ -.~            (VA) Hos$>-Sal, University       Drive, 44%
                 I' PittsbG$j$~       PennsyPvaniz$, concerC%%g possible         hospital   mis-         '1)_,
                                                                                                  ,t ,: *-ir .22
    i                management.                   4'
                             VA has two hospitals      in Pittsburgh,    the Leech Farm Road
                     VA Hospital      and the University      Drive VA Hospitali        The Uni-
                     versity    Drive VA Hospital      is composed of two geographically
                     separate    divisioras,   the Oakland Division      and the Aspinwall
                           As agreed with your office,        our examination      covered the
                   following    matters:    (1) inappropriate      use of purchase and
                   hire (P$H) eqgkgs~es , (2) use of VA laboratory _I_-.        facilities      for
                   nonofficial     purposes B (31 denial      of hospital    services      to a
                   -=~e!b      and (4% occupancy of VA housekeeping           quarters      by
                   former employees.
                          Our examination          included      discussions    with VA Central        Of-
                   fice officials,          University       Drive VA Hospital      officials,       a
                   field     representative        of the Federal Bureau of Investigation
                    (FBI) at Pittsburgh,           and an official        of the National       Insti-
                   tutes of Health.           We reviewed VA regulations            and examined VA
                   records at the Central              Office    and at the University         Drive VA
                          The results of our examination     into each of the four
                   matters are discussed in detail      in the following  sectians.
                           The statement was made that PGH employees,             assigned to
                   work at the VA hospital,           were working on non-VA jobs but
                   nevertheless      were paid by VA. We were furnished            with a copy
                   of a statement        made by the Maintenance       Supervisor   of the En-
                   gineering    Division,      University     Drive VA Hospital,    in which it
                   was claimed that (I) the labor costs for certain                PGH employ-
                   ees had been charged against            a project   other than the one
                   upoln which work was actually           performed   and (2) although    the
                   Maintenance      Supervisor     had been charged with keeping labor
                   job timecards       for certain      PGH employees,    he did not have su-
                   iervisory     authority     over them. - -          -

                                                  50TX ANNIVERSARY 1921- 1971
        .       .



                       P&H employees are laborers     and craftsmen  hired   on an
                hourly   basis to work on nonrecurring     major repair    and renova-
                tion projects    which have been approved by the Hospital        Direc-
                tor or by the VA Central    Office    for use of PGH employees.        VA
                Manual b!P-5, part I, chapter     532, states that:
                              "The P$H pay basis is appropriate              for the replace-
                              ment of entire       systems, building       service     equipment,
                              and structural       elements requiring        personnel      and
                              equipment not normally         available      at the station      to
                              the extent     that Federal personnel          are used as dis-
                              tinguished     from contractual        personnel.      This in-
                              cludes work necessary        to extend the useful          life
                              expectancy     of real property        such as major mainte-
                              nance to update facilities           and replacement       of build-
                              ing service      systems or major items of building
                              service    equipment."
                        For nonrecurring       major repair     and renovation      projects,       VA
                procedures     provide     for determining      whether it is' less costly
                to do the work with (1) PGH employees only,                 (2) a private         con-
                tractor    supplemented       by PGH employees (modified-contract
                method),    or (3) a private        contractor     assuming responsibility
                for the entire       project    (contract     method).    VA officials        told
                us that the purpose of using PGH employees was either                     to re-
                duce total     project     costs or to ackelerate        project    completion.
                       We discussed     the need for and use of PGH employees at
                the University      Drive VA Hospital       with the Chief,    Project     De-
                velopment    Section,     Engineering    Division,    who is responsible
                for all nonrecurring        maintenance     programs.    He informed     us
                that PGH employees were used for only nonrecurring                major main-
                tenance and renovation         projects    approved by the VA Central        Of-
                 fice.   He stated that the number of PGH employees varied with
                the work load and that such employees could be hired or re-
                leased whenever necessary.            At the time of our inquiry,        there
                were 12 PGH employees on the payroll.
                           In regard to the statement     that PeH employees were work-
                    ing on non-VA jobs, VA officials        informed   us that it was not
                    uncommon S when using' the modified-contract         method to perform
                    nonrecurring    major repair   and ienovation     work, for.PEH employ-
                    ees to work partially     under the direction      of a contractor     when
                    performing    segments of a project     not included     in the contract.
                              Under a modified-contract       arrangement,        for    example, if   a
                    private      contractor   had contractual      responsibility           for all


phases of a construction          project     except plumbing     installation,
VA could assign       PGH employees       to work on the project         to in-
stall   the plumbing,        In such cases PFH employees          technically
are under the direct         supervision      of VA supervisors;       however,
the PGH employees       receive     their   instructions     from the con-
tractor    to provide     for effective       coordination     of the project.
       Therefore     the fact that P&H employees were paid by VA
while    working    on VA projects    under the direction        of a private
contractor       did not necessarily      constitute    improper   use of PGH
employees,        Our review   of hospital      records   showed no evidence
that PfaH employees        had been paid for time that they did not
work on VA projects,
       With regard to the Maintenance          Supervisor*s     statement
that labor     costs for P&H employees       were being charged to proj-
ects other than those to which the employees                were assigned,
we were unable to determine       whether      this had taken place and,
if so, the extent       to which labor costs had been improperly
charged,      The only records   available       that document the work
performed     by the P&H employees     are the labor        job timecards,
and these show only the projects           charged.      Thus we could not
verify     the accuracy   of the data provided        by the labor job
       The Maintenance     Supervisor    stated    that he prepared     the
labor job timecards      on the basis of information           supplied   to
him by his superior,       the General     Foremm,     rather   than on the
basis of personal      observation    since he did not have supervi-
sory authority     over the P6H employees.           He advised    us, how-
ever,    that he had no complaints       about the quality        of the work
perforaged    by PEH employees     or about the purposes        for which
they were hired,
        We believe     that good management practice      requires    the
individual      responsible     for signing  the labor job timecards         to
be aware of the facts         to which be is certifying.        We brought
this    matter    to the attention     of the Assistant   Hospital    Direc-
tor who stated       that he would determine      the type of procedural
changes that might be required.

       We were furnished      with written     statements      by two VA hos-
pital   laboratory    stenographers    o in regard     to the claimed      use
of VA facilities      for nonofficial      purposes,     that a certain
doctor    had performed    laboratory     diagnostic     tests   for private


physicians        and tha% these   physicians     might   have paid   him   $10 a
test for       these services.
      Our review      showed that this doctor        served as Chief of
Laboratory     Services     from October     1954 un%il December 1956 and
served intermitten%fy          in various   capaci%ies     in Labora%ory  Ser-
vices   a% the University          Drive VA Hospital    from December 1956
un%il September       1970.      In September   1970 this doc%or received
an appoin%men% from the hospi%al             as a paid consultant     and
curren%ly    is employed as such,
        The Hospi%al   Director       told us that the FBI has investi-
gated %his doctor’s       activities       a% the VA hospi%al.       The U.S.
Attorney’s     office,  Pi%%sburgh,        in Jlaaae 1971 declined    to con-
sider prosecutive      action      based on facts     developed    by %he FBI
        The Investigation      and Securi%y     Services   VA, stareed    an
investiga%ion       in Augus% 1971, of the statements           made concern-
ing %his particular         doc%or,    Because of the investigation        by
VAgs Investigaeion         and Securi%y   Service,     we believed   it inap-
propriate     at this time to more fully          examine into this ma%%er.
We have, however,         made arrangements     to obtain    a copy of the
repor% ,when VA’s inveseigation          has been compfe%ed.
      Our review       indicated    %hat the    s%a%emen% that the VA hos-
pi%a% s%aff had refused           to %rea% a    hospital     patient   for his
diabe%ic    condition       was no% accurate,        According     %s,%he pa-
%iea%‘s hospital         records o he was a     patient     a% %he hospi%al    and
was receiving       care for his diabetic        condition      a% the %ime that
he was supposedly          denied admission     on Yanuary 12) 1971.
      Hospital    records also showed that %he veteran     had a toe
amputation     on October 29, 1970, and a below-the-knee      amputa-
tion on December 29, 1970.        We was gran%ed several   periods
of home leave in April      1971.   We no%ed tha% he was readmitted
on May 9, 1971, and was s%ill       a pa%ien% in %he hospital      at the
%ime of our fieldwork.

        The statement     was made that two former employees          were
living    in VA-furnished       housekeeping    quarters     at the Aspinwall
Division.       The two employees        cited had been emp%oyed as an as-
sistant     hospitab   director     and a hospita%     pathoaogist   on a
paid-consultant       basis)    respectively.
       Our review    showed that the former Assistant                 Hospital    Di-
rector   had been transferred        to the VA Central           Office     on No-
vember 118, 31969, We were informed              that,    due to personal
reasons ) he had requested        that his fami%y be allowed                to con-
tinue   occupying    housekeeping      quarters        at the hospital.        With
the approval      of the Hospita%      Director,        he continued      to occupy
the quarters      at the VA hospitaf       and paid the rental            charge
for the use of the quarters.            The emplioyee was transferred               on
August 8, %97%, to Saginaw,          Michigan.
         The Hospital     Director    was of the view that continued
occupancy     of station     quarters    by the former Assistant   Hospital
Director    was proper because he had remained          a VA employee    and
because VA regulations          did not specifically    prohibit  occu-
pancy of a station9s         housekeeping     quarters by a VA employee
not currently      assigned     to that station.
        In a March .%97% Xnterna% Audit               Service      report     concerning
the University        Drive VA Hospitall,          VA auditors        stated    that,
“unless    otherwise       approved by Centra% Office,                housekeeping
quarters     should be assigned          only to station           emp%dyees.r9       To
comply with this         recommendation,         the Hospital         Director     re-
quested    that the Regional           Medical     Director      review     the appro-
priateness      of occupancy        of station      quarters      by the former
Assistant     Hospitalb     Director’s      family.
         Staff  in the Regional     Medical     Director’s  office     told us
that the request        had not been acted on because a decision             had
been made to transfer         the employee      to Saginaw and that there-
fore he would be moving his fami%y to the new %ocation,                     VA
officials      did not indicate     whether     occupancy  of VA housekeep-
ing quarters       at a particular     station     by a VA employee not as-
signed to that station          was proper     or whether  extenuating
circumstances       woul’d permit   such an arrangement.
       We agree with the Hospita%        Director’s      assessment     that the
VA regulations     do not specifically        prohibit    continued     occu-
pancy of station     housekeeping      quarters     by former station       em-
ployees    after they are transferred         to another     VA location.

            c           ,     *
    .           .           \_
                    .         .       >.
‘                                 .


                                                   In regard to the occupancy of station               housekeeping     quar-
                                           ters by a pathologist,          we noted that the pathologist            had been
                                           employed as a consultant           at the VA hospital        but that,    on Sep-
                                           tember 18, 1970, his employment status was changed to that of
                                           part-time     resident    physician.       Because VA regulations         permit
                                           occupancy of station        housekeeping       quarters     by certain    station
                                           employees,      the pathologist      was qualified       to occupy, at the
                                           discretion      of the Hospital      Director,     VA-furnished      housekeep-
                                           ing quarters.

                                                We trust      that the above information          will    serve   the pur-      -
                                           pose of your     inquiry.
                                                                                   Sincerely     yours,

                                                                         DeputyI   Comptroller  General
                                                                                   of the United States
                                           The Honorable     Richard    S. Schweiker
                                           United States     Senate