The former medical director of the Hollidaysburg Veterans Home has filed a whistleblower lawsuit accusing the home of substandard care, including inadequate response to a flu outbreak - allegedly resulting in up to 38 deaths.
The Department of Military and Veterans Affairs denies the allegations.
Dr. John Vasil of ADARA Healthcare Staffing in Duncansville said department management ignored his recommendations for correcting habitual deficiencies in testing and medication in order to save money, prescribed unnecessary hospice care with a company that had a connection with a home official, didn't inform Vasil immediately about the first flu patient - then fell short repeatedly in complying with his recommendations for handling the crisis.
When he learned of the first flu case, Vasil recommended immediate quarantine of the building where the patient lived and treatment of all patients and staff in that building with the preventive drug, according to the suit. But officials waited, then quarantined only the afflicted resident, while failing to order the drug, according to the suit. Then when the infection spread, the home merely extended the quarantine to the patient's floor, according to the suit. About the time the infection spread to a second building, the home authorized quarantine of the whole first building, failing to quarantine the second until next day, according to the lawsuit.
The substandard care was the result of a "bean counters" approach, said plaintiff's lawyer Neil Gregorio of Tucker Arensberg in Pittsburgh
That entire narrative is misleading, according to department spokeswoman Joan Nissley.
From the lawsuit:
"As a result of the flu outbreak, and the failure of [Hollidaysburg Veterans Home] to take the necessary precautions to prevent its spread, it is believed that multiple [veterans home] patients died."
The department's clinical staff has reviewed the allegations of substandard care and ruled the home handled those issues "in a manner that didn't threaten the health and welfare of residents," Nissley said. Moreover, the home has a full license and has passed all inspections - including those by the U.S. Department of Veterans Affairs, the state Department of Health and the state Department of Public Welfare, she said. The federal Centers for Medicare and Medicaid Services last month awarded the home its highest - five-star - rating, she said.
"We are committed to providing high-quality care," she said.
As for the flu outbreak, only one resident died from it - as a secondary cause, according to death certificates, which are executed by doctors at the home if the deaths occur there or in the emergency room and by hospital doctors if the deaths occur after patients are admitted, she said.
Only six residents contracted the flu, based on lab tests, she said.
The home administered lab tests to all residents who showed flu symptoms, she said.
The home followed standard protocol in connection with the outbreak, and the Department of Health concurred with its plan to handle it, she said.
According to the lawsuit, the home fired Vasil and nurse Laura O'Farrell, ADARA president, unjustly after the flu outbreak began, in retaliation for ADARA having contended with Commandant Deborah Nesbella over the deficiencies, and for having gone "over her head" to Dr. John Bart, director of clinical services for the Bureau of Veterans Homes, and later over his head to Deputy Adjutant General for Veterans Affairs Michael Gould, with complaints, according to the lawsuit. The firing violates the state's whistleblower law, according to the suit.
The home's gripes with ADARA included its failure to obtain a nurse practitioner, according to the lawsuit.
But ADARA had trouble complying with that contract requirement because practitioners are scarce in this area, the suit said.
The home itself compounded the practitioner problem by stonewalling ADARA's putting one in place after it found a candidate, according to the suit.
The practitioner issue was just a pretext for the firing, according to the suit.
Nissley would only say that the home fired the ADARA employees for "failure to meet contract requirements."
In response to the suit, Nesbella has taken a leave of absence and Gould has retired, according to Gregorio.
Not true, according to Nissley, who said Nesbella is still on duty and Gould's retirement had nothing to do with the suit, but rather his wish to do more with the Pennsylvania Veterans Foundation, of which he's a founder.
An insider at the home verified that all 38 deaths of home residents in January and February of this year were flu-related, according to Gregorio.
The residents are old and vulnerable, and the flu makes them susceptible to other problems, many of which they have already, he said.
The sheer volume of deaths argues for there being an exceptional cause, he added.
Nissley disputes the death toll.
There were only 28 deaths in January and February, "fairly normal," given the population of the home, she said.
There are about 400 residents overall, according to Gregorio.
The suit asks Commonwealth Court - the first venue for suits against the state - for a judgment against the department.