St. Louis Veterans Home probe to cost about $45k

The newest investigation into the Missouri Veterans Commission's operations of the St. Louis Veterans Home likely will cost "$45,000, plus expenses," Public Safety Department spokesman Mike O'Connell said last week.

"Obviously, that could be adjusted if warranted, based on how things proceed," he said in an email.

Harmony Healthcare International, or HHI - a health care consulting firm whose work includes nursing home audits, compliance reviews and patient care monitoring - is DPS' contractor for the investigation, which was ordered by Gov. Eric Greitens on Oct. 31 and began Nov. 16.

It's the second time the department has been directly involved in an investigation of the home since some residents, their family members and the home's staff complained about problems earlier this year.

Greitens asked Drew Juden, the department's director, to look into the home's operations after the governor received complaints in July and directed the Veterans Commission staff to investigate those complaints.

"The majority of the violations that were listed were basically the result of miscommunications or did not occur," Juden said Sept. 7 in a two-page letter to Greitens.

Juden said his investigation earlier this year included a review of "all documentation that you submitted to my office concerning these allegations and (I) have determined that the majority of the allegations are without merit."

He told Greitens many of the allegations "were serious and very concerning. However, they are all unsubstantiated."

That finding seems to contradict the information contained in a separate, Oct. 19, nine-page report on the home's operations by William "Bill" Bellomy, Lt. Gov. Mike Parson's Veterans Affairs director.

"All issues have been verified by either a very qualified, competent medical opinion or dual sourced (such as, by) a family member and staff member," he wrote.

Bellomy also reported other issues that had been raised were not covered in the report "because they could not be verified by the above standard."

The governor's office has said it first was contacted in July.

The Bellomy report said the lieutenant governor's investigation began Feb. 21 after Parson's office was approached by a "medical professional" with concerns about the St. Louis Veterans Home in Bellefontaine Neighbors.

Bellomy's report also noted the St. Louis home is one of seven the Veterans Commission operates, but the other six "have not reported the type of issues covered in this investigation."

Juden's Sept. 7 report to Greitens said the "most concerning issue I have uncovered deals with issues relating to staffing that have been occurring in the home for a long time."

He said state law requires a minimum staffing level, finding the problem is numerous last minute call-ins requesting sick time or some other type of leave, creating a significant hardship on the staff members who are already at work, because they are forced to work additional hours when no one is available to relieve them.

"They are compensated at an overtime rate," Juden told the governor, "but it is still a major disruption to their lives and regularly interrupts important plans and commitments they may have made."

The lieutenant governor's report noted required overtime is called "mandation."

"If a member of the nursing staff refuses two mandation shifts they are terminated," Bellomy reported, citing one case where a certified nursing assistant's son was taken to the emergency room and she was told she could leave.

"But, upon returning for her next shift," Bellomy wrote, "she was informed that she had been written up for refusing mandation and would be placed on administrative leave for a day."

Juden told Greitens the St. Louis home's administrator, Rolando Carter, is looking at the scheduling issues and working on a solution.

Bellomy's report to Parson said many of the home's staff said Carter's style "is to threaten and degrade staff in front of staff and veterans. This has led to experienced staff leaving."

Both reports also cited communication problems.

Juden's report to Greitens said Veterans Commission Director Larry Kay and his staff "have committed to making sure they have a better network to communicate with guest services, as well as staff and caregivers that are responsible to the veterans."

However, Bellomy's report told Parson "every issue discovered through this investigation" had been given to Carter, Kay and other Veterans Commission leaders "numerous times, and the perception of the veterans and their families is that nothing has changed."

Juden expects the new, HHI investigation to be finished "by the end of the year."