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New Haley VA director had controversial reign at Mississippi VA hospital

Joe D. Battle is expected to take over the James A. Haley VA Medical Center in Tampa, one of the nation’s busiest veterans hospitals, within the next 40 days.
Joe D. Battle is expected to take over the James A. Haley VA Medical Center in Tampa, one of the nation’s busiest veterans hospitals, within the next 40 days.
Published Jul. 4, 2015

TAMPA — Three years ago, Department of Veterans Affairs manager Joe D. Battle got the unenviable job of turning around the Jackson, Miss., VA hospital, a facility critics called a dysfunctional mess.

The hospital didn't have enough doctors, and two patient deaths were blamed on inadequate staffing. A radiologist was accused of failing to properly read thousands of images. Veterans were assigned to "ghost clinics" without seeing doctors.

"I came here with the goal to build trust in the organization, veterans and anybody in the community to move our hospital beyond the past," Battle told the Clarion-Ledger in 2013.

But Battle, appointed last week as the new director of the James A. Haley VA Medical Center in Tampa, ended up fending off his own critics.

They included a VA doctor who accused him of pressuring physicians to permit nurse practitioners to treat patients with little supervision. This whistle-blower also said doctors were asked to sign off on narcotics prescriptions without actually seeing patients, which she said was illegal.

As the U.S. Office of Special Counsel investigated allegations in 2013, Battle called issues at the Jackson VA minor and said they "did not impact patient care."

Someone disagreed: Carolyn Lerner, appointed by President Barack Obama as chief of the OSC, an agency that investigates allegations by federal whistle-blowers.

Lerner said this in a Sept. 17, 2013, report: "Such statements fail to grasp the significance of the concerns raised by (whistle-blowers at the Jackson VA) and call into question the facility's commitment to implementing necessary reforms."

Battle, who declined an interview with the Tampa Bay Times, is expected to take over the Haley VA, one of the nation's busiest veterans hospitals, within the next 40 days. He comes to a hospital that has, itself, been in the news, most recently after internal emails showed the facility's kitchens have been infested with rats and cockroaches.

Battle, who has served more than 30 years with the VA, said in a written statement he was "humbled and privileged" to lead Haley.

"Working with my fellow employees, we will build trust and honor (to) those coming through our doors by demonstrating our commitment of caring,'' he wrote. "I look forward to meeting everyone in the Tampa area veteran community."

Battle took on a big job when he took over the Jackson VA, first as interim director in January 2012 and then as its permanent director that April. Allegations of improper patient care had been widely reported, and the Associated Press said Battle "stepped into a public relations nightmare."

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The VA has long had a difficult time recruiting doctors to Mississippi. Battle told the U.S. House Veterans Affairs Committee at a 2013 hearing, "Mississippi is a medically underserved state."

The Jackson VA in the years before Battle's arrival came to rely on nurse practitioners — nurses with advanced training — in primary-care clinics. That continued under Battle, said one Jackson VA whistle-blower, Dr. Phyllis Hollenbeck.

The OSC said in its September 2013 report that Hollenbeck reported that 85 percent of primary-care patients at the hospital received care from nurse practitioners without being seen by a doctor and that some patients did not know their nurse was not a physician.

Hollenbeck, who did not return a call seeking comment, said she was concerned that nurse practitioners could not provide the same level of care as physicians and that some veterans were, as a result, not being properly diagnosed.

"Dr. Hollenbeck emphasized that these problems persist," Lerner's report said.

In December 2012, Hollenbeck said, she attended a staff meeting with other doctors in which Battle and a regional VA director pressured them to sign "collaborative agreements" with nurse practitioners indicating the physicians were adequately supervising the nurses.

But Hollenbeck said she and others were reluctant to do so because supervision was inadequate. Battle and the second VA official, she said, threatened to withhold 55 percent of doctors' performance pay if they refused.

The doctor said after she and others balked at signing the agreements, Jackson VA nurse practitioners started obtaining licenses to practice from Iowa, where they are not required to have agreements with doctors.

Hollenbeck also alleged that nurse practitioners were improperly writing prescriptions even though they did not have Drug Enforcement Agency authorization. That practice was eventually ended, she said.

But Hollenbeck said doctors were later asked by supervisors to sign off on prescriptions without seeing the patients, which she said was illegal. She refused.

The hospital, she said, ended up assigning medical residents — physicians in training — to review narcotics prescriptions. "Leadership was telling them to break the law," Hollenbeck said. The VA disagreed.

The agency later said problems at the Jackson VA predated Battle and blamed an "institutional failure" on officials who no longer worked at the hospital.

"The facility's new leadership is taking corrective actions to remedy the past noncompliant practices and prevent them from recurring," the VA said in a Nov. 12, 2013, report to the OSC.

Hollenbeck bristled at that characterization.

"Mr. Joseph Battle in particular cannot be allowed to continue to use the phrase 'These things happened before I came' as a verbal shield," she said. "The same kind of things are still happening. And once you take over command — of a business, medical center, ship or family or any other communal entity — everything is immediately and completely on your watch."

Times researchers John Martin and Caryn Baird contributed to this report. Contact William R. Levesque at levesque@tampabay.com.

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