Northport VA Medical Center problems blamed on poor maintenance oversight

The conditions that prompted a prolonged cancellation of surgeries at the Northport VA Medical Center last year arose because of poor oversight of maintenance operations, according to reports on internal investigations commissioned by the Department of Veterans Affairs.

Of the two reports, one focused on the breakdown of cooling towers and air conditioning units responsible for ventilation in the surgical area at Long Island’s only VA hospital. Surgeries were suspended between mid-February and early June of 2016 after metal particles were found in the airflow to the operating rooms, and patients needing urgent care were forced to seek treatment at VA hospitals in Manhattan or the Bronx.

Beyond the impact on patient care, the reports also conclude that the failings of the engineering department at Northport was a significant drain on financial resources there. For instance, failure to complete maintenance projects in a timely fashion — highlighted in the second report — resulted in the loss of more than $9 million in federal funding.

The internal investigations, initiated by the VA’s regional health network director, Joan McInerney, were completed in June. Copies of the reports written by McInerney were obtained by Newsday.

The investigation into the cooling-towers failure concluded that Northport’s chief of engineering at the time “and/or subordinate staff” were negligent in responding to the deteriorating condition of the towers, which had developed a leak. The replacement system installed after the final failure of the cooling tower cost $12 million, according to the VA.

Among the other findings of the reports:

• Almost a year after the operating room closures, the engineering department remained “negligent in prioritizing a project to refurbish (air conditioning equipment) that serves the OR.”
• Northport VA has been fined after failing to comply with federal and state environmental regulations concerning its wastewater treatment plant, underground and aboveground storage tanks, and management of hazardous waste.
• “The Chief of Engineering and/or subordinate staff were negligent in failing to maintain, fix or repair” tanks in the system despite problems known to exist since 2008.
• A “deep rooted culture of mistrust” between Northport’s engineering department and contractors “has led to a breakdown of communication channels required for the successful completion of Northport construction projects.”
• Terminated projects “directly impact loss of services for the Patients at the Northport VAMC.”

“It is expected that Northport VAMC [medical center] leadership will address these conclusions with appropriate action plans to include but not limited to necessary disciplinary actions,” McInerney wrote. Both reports were dated June 19.

Ron Brattain, 50, resigned as Northport’s $132,000-per-year engineering director on Sept. 16, after heading the 70-member engineering staff since January 2012, according to the VA. He did not respond to telephone messages.

Brattain’s departure adds to a series of leadership changes that have roiled the medical center almost continuously since last year, when troubles with the facility’s operating rooms surfaced. The facility had a new director take over in late June, and Northport’s top deputy retired about the same time. Northport’s chief of staff and its head of nursing have been at least temporarily reassigned to VA duties away from the medical center.

Northport’s new director, Scott Guermonprez said the reports “highlight inexcusable failures in management and indefensible examples of waste,” that would “not be tolerated on my watch.”

“That’s why we have already started implementing the recommendations from these reports and cleaning house in our engineering department,” he said in a statement released by his office.

Philip Moschitta, Guermonprez’s predecessor as director, defended Brattain’s work at Northport, saying he was being unfairly blamed for what Moschitta described as the results of years of underfunding for needed maintenance projects.

“Over the years, with so many directors and so many engineering directors, it doesn’t come down to one person,” said Moschitta, who led Northport from 2009 until he retired in April.

Asked if he felt confident of Brattain during the five years Brattain served under him, Moschitta said, “Yes. People always want to find a scapegoat.”

News of the negative engineering reports come at a time when some indicators show improvement in medical care at Northport, even as its physical condition has been in serious decline. In an internal VA comparison of the agency’s 168 medical centers, Northport rose from a 2-star facility in 2015 to a 4-star facility now, with 5 stars being the top.

Details from McInerney’s reports depict an engineering staff that struggled to check on work totaling millions of dollars per year that contractors performed.

Communication issues between project engineering and contracting staff left the department “ineffective at mitigating extensive project delays and project terminations,” McInerney wrote.

The delays and terminations have left projects at Northport “in various stalled states of completion . . . adding additional financial burden to the Medical Center,” she added.

The same report said that Northport was required to return federal construction dollars when it could not complete maintenance projects on schedule. Northport was sometimes doubly penalized when it was forced to pay contractors for the half-finished work.

“Settlements paid to contractors as a direct resultant of failure to manage a project that results in termination is wasteful to the government,” McInerney added.

Concerns about the Northport VA have stretched all the way to Washington D.C. In a letter written in April to then-acting director Vincent Immiti, Rep. David P. Roe (R-Tenn.), chairman of the House Committee on Veterans Affairs, raised concerns about “deteriorating facilities at Northport VAMC,” referencing such issues as deteriorated roofs and mold growth in several buildings.

On Wednesday, Roe announced that he would make a short-notice visit to Northport on Thursday, during which he intends to question patients, staff and administrators about the facility’s condition.

Roe’s April letter said Northport faced a “staggering” backlog of maintenance projects among Northport’s 47 buildings, some of which date to the late 1920s — projects estimated to cost $279 million.

The letter said maintenance failures include collapsed drainage pipes, clogged underground rainwater collection systems that have not been cleaned in decades, and water-damaged plaster walls that have been painted over rather than repaired.

“The sheer number of maintenance problems, especially the litany of HVAC system breakdowns on the campus begs scrutiny of the people performing the maintenance,” Roe wrote then. “ . . . Neglect like this is inexcusable.”