VA officials look toward Cincy facility's future

Posted at 7:38 PM, Feb 29, 2016

CINCINNATI — Top officials at the Cincinnati Veterans Affairs Medical Center said Monday that despite controversy this month the facility provides quality care for veterans.

Robert McDivitt, now-acting network director for this region, and Dr. Ralph Panos, now-acting chief of staff at the medical center, along with Cincinnati VA Director John Gennaro, said efforts are under way to hire more doctors for programs that are understaffed such as neurosurgery and orthopedics.

VA officials appointed McDivitt and Dr. Panos last week after then-regional director Jack Hetrick and former Acting Chief of Staff Dr. Barbara Temeck — both at the center of an investigation by WCPO and Scripps News Washington Bureau that revealed possible conflicts of interest and unethical behavior — vacated their respective positions.

The WCPO/Scripps investigation looked into cost-cutting practices and other allegations brought forward by more than 30 current and former VA medical staffers. The WCPO/Scripps findings sparked two federal probes.

Hetrick submitted his retirement after receiving notice of his pending removal, and Temeck was reassigned to non-patient-care duties. VA Undersecretary for Health, Dr. David Shulkin, also suspended Dr. Temeck’s medical privileges. Documents WCPO/Scripps uncovered showed she prescribed medication to Hetrick's wife when she did not have a license to prescribe controlled substances privately.

One of the specific issues uncovered by WCPO/Scripps’ investigation was that cost-cutting tactics might have left the facility short-staffed, particularly when it comes to complex joint surgery specialists and neurosurgeons. VA officials have acknowledged previously that they no longer have any specialists on staff to perform total joint surgeries such as hip, shoulder or knee replacements.

“We’re still working to recruit and identify with our affiliate a joint surgeon,” Gennaro said, adding that the Cincinnati VA has hired two general joint surgeons over the last several months.

Currently, patients needing specialized joint surgery are referred to doctors outside the VA in the community.

Panos called the recruitment process for doctors a “difficult endeavor, but it’s an ongoing and active recruitment, not only in orthopedics but other departments, as well.”

Read the full WCPO/Scripps News Washington Bureau investigation here.

McDivitt, formerly the VA's medical center director in Ann Arbor, Michigan, also pointed during Monday's roundtable to the facility’s close relationship with the University of Cincinnati College of Medicine.

“I’m very pleased to be part of this…high quality, safe, accessible care to veterans and promoting a culture where employees and veterans tell us we’re doing well…and also where we can improve," McDivitt said.

“I’m also pleased to be part of the tremendously important mission we have of educating the next generation of medical professionals.”

Dr. Panos added that, thanks to a program run out of the VA’s Cincinnati facility, methicillin-resistant Staphylococcus aureus, or MRSA, infections have seen a five- to six-fold reduction across the country.

But the Scripps/WCPO investigation showed that under Dr. Temeck's tenure at the Cincinnati VA the rate of MRSA infections increased substantially. The highly contagious, drug-resistant infection is commonly associated with surgeries. According to the most recent publicly available data, Cincinnati has one of the highest rates of MRSA infections for VA hospitals nationally.

Source: U.S. Department of Veterans Affairs

The VA's internal investigation team initially did not find any impropriety with respect to referrals through the Veterans Choice program or quality of care for veterans at the Cincinnati location, VA officials announced last week. However, the team did substantiate misconduct by both Hetrick and Temeck related to Temeck’s provision of prescriptions and other medical care to members of Hetrick’s family. VA OIG has accepted VA’s referral of the substantiated allegations for potential criminal investigation.

The team's final report is still forthcoming.

WCPO's Dan Monk and Scripps News Washington Bureau's Mark Greenblatt and Aaron Kessler contributed to this report.