BONUSES FOR VA OFFICIALS
VA executives in North Carolina received bonuses as the system's hospitals in Salisbury and Asheville struggled with patient care problems. Here are details:
2006
Total paid: $56,000
Who got money: Regional VA director Daniel Hoffmann ($24,000); regional chief medical officer Dr. Mark Shelhorse ($19,000); Salisbury VA hospital director Donald Moore* ($9,000); associate director James Robinson ($4,000).
Problems: Federal investigators found a Salisbury VA nurse failed to make required visits to veterans housed in private nursing homes from October 2003 through June 2006. The nurse, who remains with the hospital, also filed inaccurate medical reports on the veterans, including listing one as "stable" 12 days after he died.
2005
Total paid: $79,500
Who got money: Hoffmann ($20,000), Shelhorse ($25,000), Moore ($12,000), Robinson ($10,000), and Dr. Sidney Steinberg ($12,500), chief of staff at the Salisbury VA hospital.
Problems: VA investigators concluded Salisbury veterans hospital provided poor care in multiple cases reviewed. Their June report detailed the deaths of two men who received poor care. One died in 2004 following surgery; the other died in 2003.
At the Asheville veterans hospital, VA investigators determined that shortages of nurses and doctors and lack of training endangered patients. Through August 2005, the hospital also remained under order not to accept some types of patients in its nursing home unit.
2004
Total paid: $64,620
Who got money: Hoffmann ($29,120), Shelhorse ($24,500), Robinson ($6,000), Steinberg ($5,000).
Problems: VA investigators received anonymous tip of more than 12 suspicious deaths at the Salisbury veterans hospital. They began what became a seven-month investigation. A chief nurse at the time has told the Observer that he proposed suspending surgery because of unexpected surgical deaths.
The VA also directed the Asheville veterans hospital to suspend admissions to its 120-bed nursing home unit after a patient died. VA investigators said workers didn't give enough pain medication to seriously ill patients.
2003
Total paid: $61,000
Who got money: Hoffmann ($26,000), Shelhorse ($15,000), and Stephen Lemons ($20,000), interim director at the Salisbury VA hospital from Nov. 1, 2003, to June 12, 2004.
Problems: First of the two deaths that prompted an investigation at the Salisbury VA hospital.
2002
Total paid: $41,000
Who got money: Hoffmann ($26,000), Shelhorse ($15,000)
2001
Total paid: $18,000
Who got money: Hoffmann ($12,000), Shelhorse ($6,000)
Problems: Private consultants' report found so many problems at Salisbury VA hospital that it would have failed to win accreditation from a premier overseer of U.S. health care quality.
2000
Total paid: $15,000
Who got money: Hoffmann
The VA paid bonuses of more than $335,000 to some of its top N.C. hospital managers during years when they received reports of poor patient care and suspicious deaths.
Executives at the Salisbury veterans hospital were rewarded with bonuses in 2004 and 2005, as VA officials investigated unexpected deaths.
Regional VA managers in Durham also received bonuses during that time. And they received bonuses as the Asheville veterans hospital struggled with staffing shortages that investigators found caused poor care. The Asheville nursing home unit also had been ordered in 2004 to suspend admissions after a patient died.
"It's stunning," said Sen. Patty Murray, a Washington Democrat who serves on the Senate Committee on Veterans' Affairs. Murray told the Observer on Monday that she will ask the VA to explain why the bonuses were awarded.
Department of Veterans Affairs officials have said both hospitals made changes and improved care.
The Observer requested bonus information for regional and Salisbury VA hospital officials for 2000 through 2006. That April 17 request came two days before a congressional hearing about the hospital's problems. The hearing followed Observer stories about multiple accounts of poor care at the Salisbury hospital, the main facility for Charlotte-area veterans.
The hospitals in Asheville and Salisbury are among the eight overseen by the VA regional office. The region serves veterans statewide and in Virginia and parts of West Virginia.
VA officials acknowledged but didn't respond to questions Monday about how bonuses are calculated, why they were paid during times the agency's investigators found problems and who authorized payments. Private companies often pay bonuses to attract, retain and reward key employees.
Daniel Hoffmann, the regional director, has said senior management bonuses are based on a "three-part evaluation process." Performance measures include quality of care.
Hoffmann received the largest bonus payments, including more than $29,000 in 2004, the year VA officials began investigating reports of deaths at the hospitals.
In 2005, bonuses tallied nearly $80,000, the largest total paid in years reviewed. That year, VA investigators concluded both hospitals provided poor care.
Dr. Sidney Steinberg is Salisbury's chief of staff, one of the hospital's top three posts. Steinberg, a surgeon, joined the hospital in 2001 and has held the chief's title since 2003.
He received a $5,000 bonus in 2004, less than two weeks before leading an executive meeting on an "unanticipated post operative death." In 2005, Steinberg's bonus was $12,500. Last year, he didn't receive a bonus, according to the VA, which gave no explanation for payment changes.
In January, he and the associate director, James Robinson, each received $5,000.
"We have made significant progress in the past few years ... " Steinberg said in an e-mail Monday, responding to a request for comment. "I intend to see that progress continue."
-- Staff writer Peter Smolowitz contributed.
-- Stella Hopkins: 704-358-5173
