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Health Care

St. Catherine Chief Nursing Officer Mary Jane Finnegan gives a flu shot during a free mobile clinic at the end of September. Photo from St. Catherine hospital

They lost patients, sleep and time with their families and yet, through some of the most difficult conditions in over a century, they persevered, brought together by the shared goal of saving lives threatened by the pandemic.

The Times Beacon Record Newspapers is pleased to honor the health care workers who put themselves in harm’s way to offer comfort, cures and solutions for COVID-19.

State Sen. Jim Gaughran (D-Northport) described health care workers as “heroes beyond belief.” He added, “There are folks who have gotten sick and died, simply because they were just doing their jobs.”

Unusual Requests

Indeed, in some cases, these health care workers took on tasks that aren’t typically a part of their job description or training.

Tricia Coffey on the phone at Huntington Hospital. Photo from Coffey

Take Kristen Thomas, a registered nurse at Mather Hospital in Port Jefferson. A priest came up to her in the halls of the hospital to ask for an unusual favor. A person had died and the family, who couldn’t be by his side, asked for last rites. The priest knew he couldn’t enter the room.

He asked, “Would you mind taking holy water and anointing the patient?”

She approached the patient, made the sign of the cross and prayed, as the priest stood outside the door.

“A moment like that, you never really plan to do that,” Thomas said. “We tried to give the family a little bit of closure. They didn’t get to attend the normal [rituals].”

For the community and health care workers, normal took on new meaning, especially in the first few months of the pandemic, when Suffolk County became an epicenter of the virus.

With family unable to sit by the bedside, nurses often stepped up, holding up iPad and phones so the family could spend time together virtually.

Marilin Dilone, Emergency Department nurse at Stony Brook University Hospital, called the young family of one of her patients.

Marilin Dilone, emergency department nurse at SBUH decked in full PPE gear. Photo from SBUH

His wife “put the baby on the phone — the baby looked like he was maybe 10 months old. The baby was making noises. I swear [the patient] opened his eyes. The wife is crying. Such a moment, we take for granted. He could hear her say, ‘I love you.’ To be able to provide that was very humbling for me.”

Like Dilone and so many other nurses, Robert Collins, a nurse at Mather Hospital ,shared how he held an iPad up to patients whose conditions were deteriorating so they could say goodbye to their families.

He had to stay in the room because some of the patients couldn’t hold the iPad.

“You do that once or twice, it kind of sticks with you,” Collins said.

Deep Connections

The connections the medical staff made to the families of patients extended well beyond the typical interactions.

“We had patients for an extended period of time,” said Patricia Coffey, nurse manager of the Critical Care Unit at Huntington Hospital.

Coffey, who spent 11 weeks actively caring for patients as her managerial duties “went to the wayside,” said the staff talked to families for extended periods of time. She spoke with some families daily, spending as much as two-and-a-half hours each day on the phone.

The nurses felt like members of the family because the normal support system couldn’t provide bedside support.

“You were channeling the family to the patient,” Coffey said. The nurses were “rooting so hard” for the patients.

When one of those patients who was in the hospital died after a long battle, she said it was “unbelievably heartbreaking — you felt like one of your own family members had died.”

She still keeps in touch with family members.

Mather Nurse Robert Collins. Photo from Mather

Coffey said one of her neighbors was admitted to the hospital with COVID and was on her floor. Coffey’s children and her neighbor’s children grew up together and their daughters were friends.

She not only spoke with his wife every day during her 60-hour weeks, but she also called her coworkers over the weekend to ask how he was doing.

The conversations with the neighbor’s wife were “a little hard. I wanted to be honest with her. He was very critical. At the same time, I was trying to be hopeful. It was a hard balance.”

Coffey said he was “one of the lucky ones who survived.”

Dilone of SBUH described how the work was more physically demanding.

She would “try not to ask for people” as she didn’t want to expose others if it wasn’t necessary. “You are taking care of patients more by yourself, turning them and doing chest PT [physiotherapy] — it was physically more demanding,” Dilone said.

Dark Moments

Watching patients who died took its toll, even on people who have been in the medical profession for decades.

MaryJane Finnegan, chief nursing officer at St. Catherine of Siena Medical Center in Smithtown, described the unusually high number of people dying from the virus. The hospital was running out of space for the dead. The morgue was filled and an additional refrigeration truck outside also filled quickly.

Mather Nurse Kristen Thomas. Photo from Mather

“One day, eight people died — usually in a week, you can have eight people die, but not eight in a day,” Finnegan said.

Nikki Fiore-Lopez, chief nursing officer at St. Charles Hospital in Port Jefferson said a nurse was present for the death of her mentor. Watching her die was “one of the darkest moments” for the nurse, Fiore-Lopez said.

Many medical professionals encouraged their patients to fight through the worst of the virus.

Stony Brook’s Dilone stayed with a patient whose blood oxygen level kept dropping. She wouldn’t let him fall asleep because she was worried he’d get intubated. She reminded him of his family and that he needed to help himself.

“I felt like Nurse Ratched,” Dilone said, referring to the dreaded nurse from the movie “One Flew Over the Cuckoo’s Nest.”

Dilone spent hours with this patient. Later, a doctor told her keeping the man awake prevented him from getting intubated.

Unexpected Challenges

With a virus no one had battled before, health care workers had to be flexible, learning about everything from new protocols for admitting patients to the latest and best treatments.

Chief Nursing Officer at St. Charles hospital Nikki Fiore-Lopez delivers flowers to patients at Christmas with Foundation Board Chair member Doug Casimir in 2019. Photo from St. Charles

The staff had to confront the “speed with which everything changed,” said Dr. Eric Morley, associate professor and clinical director in the Department of Emergency Medicine at Stony Brook University’s Renaissance School of Medicine. “Every day, there were new protocols, new ways to deal with things.”

Hospitals had to create a forward triage system to deal with the flood of COVID patients amid all the other potential emergencies hospitals routinely have.

These efforts required hundreds of employees to “get on the same people to sort people out,” Morley said. Training staff to manage the flow of patients required constant communication.

Even some of the smaller elements of managing the crisis took Morley’s time, such as getting new traffic signs to direct people to an alternate site.

Hospital managers were continually confronted with numerous unexpected challenges.

Ken Roberts, president of Mather Hospital, said the hospital had to ensure the PPE was hospital grade and not counterfeit.

“There were a lot of suspicious and unscrupulous suppliers when supply and demand was unbalanced, and everyone was in crisis,” he explained in an email.

Health care workers tapped into their personal skills to connect with patients.

Angel Figueroa, a registered respiratory therapist at SBUH who grew up in New York City and learned Spanish thanks to his Puerto Rican heritage, walked into some rooms and spoke Spanish to patients.

When he greeted patients in Spanish, “I would see their eyes open up [and think], ‘Somebody understands me.’”

They would ask him numerous questions, particularly because the medical information came at them so quickly. 

Mather’s Collins described how the routine changed so dramatically the moment he arrived at work.

Mather President Ken Roberts holds a sign thanking health care workers. Photo from Mather

“Rapid response bells were going off as soon as you walked in,” he said. “You didn’t take your coat off” before patients needed attention. “People were not doing well. That was happening more frequently than before. That was an adjustment.”

On the other side of the struggle, health care workers felt a tremendous sense of relief when patients continued their recoveries at home.

“When people were discharged, the staff was thrilled,” St. Catherine’s Finnegan said. “We’d play the [Beatles] song, ‘Here Comes the Sun.’ A lot of hospitals did that. People would gather as many as possible to wish the person well as they were wheeled out.”

Teamwork

Through the difficulties, though, Morley appreciated the support from the community and the families, along with the teamwork and camaraderie from so many departments and staff that all pulled together.

Roberts expressed similar sentiments.

“I was extremely pleased at the teamwork displayed by all hospital staff during the height of the pandemic,” he said.

The Mather president was also grateful for the letters, cards, donated meals, handmade masks and donated PPE.

“The local communities we serve gave us and continue to give us tremendous support and encouragement,” Roberts said. “That has meant so much to the staff to know that the community was supporting them and recognizing their efforts.”

Stony Brook Respiratory Therapist Angel Figueroa wearing mask and shield. Photo from SBUH

Coffey, from Huntington Hospital, was impressed with how, even amid such extraordinary and challenging times, numerous groups collaborated.

“In many ways there were positive things — the community, the team, everyone working together,” she said. “Parts of it were so uplifting. As hard and as difficult and sad and heart wrenching [as it was], so many other parts, you just saw such humanity. It was amazing.” 

Lasting Thoughts

Finnegan said the staff was incredibly appreciative of all the food local restaurants donated.

In fact, some of them joke that they gained the “COVID-19,” referring to the weight they put on while they were working numerous shifts and benefiting from all the donated food.

Morley “rediscovered” Twinkies during COVID in the break room. He has since been able to lose the weight the snack cakes added.

While gyms were closed, Collins relieved stress by buying a 400-pound tractor-trailer tire that he flipped up and down along his driveway. He also took a sledgehammer and “beat on it.”

The exertion would make him tired enough that the stress would dissipate for the day.

Dr. Eric Morley from SBU participates in COVID testing. Photo from SBU

Ultimately, what made an ever-expanding job — that affected so many aspects of health care workers’ personal and professional lives — manageable was the shared sense of purpose and the inspiration people drew from each other.

“The fact that the staff was out there doing it” helped give her energy, St. Charles’ Fiore-Lopez said. “We had patients to care for, we had shifts. We had days and weeks and months to get through. They put one foot in front of the other and I needed to do the same.”

Morley appreciated the way the Stony Brook staff pulled together during an intense and challenging time.

“Although it was grueling, it was a special thing to go through with that group of people,” he said.

File Photo by Alex Petroski

By Perry Gershon

Representative Lee Zeldin (R-NY1) is a master at telling half-truths. He goes to great lengths to tell his constituents that he supports health care coverage for people with pre-existing conditions and lowering prescription drug prices, but his voting record says differently. Zeldin voted against coverage for pre-existing conditions, and just recently, shot down a bill for prescription drug coverage reform and prescription drug coverage reform. He even has the audacity to take credit for programs he voted against. A quick look at his record, however, is quite revealing.

Zeldin voted to repeal the Affordable Care Act. He has cast several such votes in his three terms in office, most recently May 2017 (and he openly urges the courts to overturn the ACA now). The federal requirement to provide coverage for people with pre-existing conditions comes directly from the ACA, so Zeldin’s opposition to coverage for pre-existing conditions is right there in his votes. Zeldin and President Donald Trump (R) claim to offer ACA replacement legislation that provides for pre-existing condition coverage, but these bills do not protect consumers, especially those with pre-existing conditions. They provide no requirement that these individuals will not be penalized in pricing and availability of coverage.

When Congress, in Dec. 2019, passed its bill to make prescription drugs more affordable, Zeldin voted against the bill (HR-3). His position on this critical issue is again demonstrated by his vote. The only effective way to control the cost of prescription drugs is to let Medicare, the largest consumer, negotiate drug prices directly with the manufacturers. It’s no surprise that Zeldin continues to prohibit Medicare from negotiating because much of his campaign contributions comes from drug makers and their affiliates. This isn’t me saying this, it’s right there in his campaign finance reports that he is legally obligated to file with the Federal Election Commission. Given Zeldin’s benefactors, it’s no wonder he opposes true prescription price reforms.

Zeldin takes credit for funding medical research at Stony Brook. His most recent February “newsletter” stated that he secured $3 million of new National Institutes of Health grants to Stony Brook for medical research, and he cites a bipartisan letter he signed requesting a budget increase specifically for NIH research. What Zeldin does not tell you is that when the actual budget came to a vote on July 25, 2019, he voted against it. His own voting record proves that Zeldin did not vote to increase NIH appropriations, or increased funding for Stony Brook.

But Zeldin’s biggest deception of all is that he is has listened and knows what his constituents need for their health care. Again, the facts belie that. Zeldin’s last public town hall was in April 2017, before his vote to repeal the ACA. He has not held one since then. He has no idea what his constituents want or need!

Town halls are meant to be open to all constituents who want to attend. There should be no prescreening of questions or questioners (to exclude critics) or else it is not really a true town hall. I know this from first-hand experience.

I have held five open town halls since last September, and I will hold five more before the end of June. I take questions from Democrats, Republicans — whoever attends and wants to ask a question. As a matter of fact, I take each and every question asked of me and I give truthful, fact-based answers. There is no prescreening and no spin at my town halls.

People on Long Island deserve a representative who will listen to them when they speak out about health care. I want to see universal health care for everyone — and I believe we can do it with the ACA supercharged with a public option. We need to allow Medicare to negotiate drug prices to achieve true pricing reforms. This November, we have a chance to give NY-1 a representative who will fight for us in Washington and tell us the truth here at home.

Perry Gershon is a national commentator on business, trade, policy and politics. A congressional candidate for New York’s 1st District, he holds a bachelor’s degree from Yale and a master’s in business administration from the University of California, Berkeley.

Photo from Suffolk County District Attorney’s Office

An East Setauket man faces a multicount indictment for allegedly receiving more than $400,000 through insurance fraud.

On Feb. 28, Suffolk County District Attorney Tim Sini’s (D) office announced the unsealing of a 70-count indictment against former health care worker Joseph Basile, 50. It is alleged he fraudulently received more than $400,000 through a health insurance fraud scheme where he would file claims for unperformed procedures and list a former employer, a colorectal surgeon, on the forms.

“This was an act of pure greed,” Sini said. “He used his knowledge of the health care insurance system to illegally pocket hundreds of thousands of dollars, money that would have otherwise been used to care for people who were sick and in need.”

Basile was charged with insurance fraud in the first degree, three counts of health care fraud in the second degree, two counts of grand larceny in the second degree, health care fraud in the third degree, grand larceny in the third degree, scheme to defraud in the first degree and 60 counts of criminal possession of a forged instrument in the second degree.

Basile was employed as an office manager for a private health care practice by a colorectal surgeon in Port Jefferson before the practice closed in 2013, according to the DA’s office. From January 2014 through July 2016, Basile allegedly fraudulently filed insurance claims for medical procedures, including colorectal surgeries, to Empire BlueCross BlueShield in excess of $3.8 million on behalf of himself and others, listing his former employer as the provider. The medical procedures had not been performed.

Basile then allegedly forged the signature of his former employer and deposited the checks into his own account. The more than $400,000 received was paid by both the insurance company and John T. Mather Hospital.

The former health care worker also allegedly filed fraudulent insurance claims on behalf of another individual whose health care is provided through Teamsters Local 1205’s welfare fund, according to Sini’s office. Basile allegedly stole more than $3,000 from the fund by filing false health care insurance claims.

Basile was released on $5,000 bond and is due back in court March 12. If convicted of the top count, he faces a maximum sentence of eight and one-third to 25 years in prison.

He is being represented by Legal Aid of Suffolk County attorney Kathleen Evers who could not be reached for comment.

Businessman Greg Fischer (D) is challenging Sen. Ken LaValle (R) for his seat in New York State’s 1st District. Photos by Kyle Barr

It’s déjà vu in New York State’s 1st Senate District.

State Sen. Ken LaValle (R-Port Jefferson) finds himself once again being challenged by Democrat Greg Fischer to retain his seat representing the district. The two squared off in 2016 when LaValle won with more than 67 percent of the vote.

“We’ve created literally a generation of homeless people.”

— Greg Fischer

Fischer, a Calverton resident and businessman who specializes in strategizing and consulting, said during a debate featuring the candidates at the TBR News Media office in Setauket he is concerned that no one on either side of the political aisle is doing anything to increase personal incomes in the state. He said this lack of progress is leading to a brain drain on Long Island where residents pay the overhead to educate the youth but get none of the benefits when they move on for better opportunities.

“We’ve created literally a generation of homeless people,” Fischer said. “Those are people that can’t leave their houses and have their own homes. But they’re not necessarily on the streets — they’re on the couches or they’re still in their childhood bedrooms.”

When it comes to strengthening the economy, LaValle said he sees potential in places like the Research and Development Park at Stony Brook University and Cold Spring Harbor Laboratory as economic centers on Long Island. He said he supports more high-tech parks being constructed along the expressway to connect to these centers.

“We cannot afford one system for all.”

— Ken LaValle

The two had differing opinions on how to improve transportation for Long Islanders. While LaValle is looking locally, Fisher is thinking more statewide.

Fischer is proposing a bond-funded transportation system which would produce jobs statewide to connect New York City and Long Island to places like Quebec in Canada and Buffalo, and everywhere in between. He said the system would use subterranean vehicles able to go 150 mph on tracks that curve and 600 mph on straight tracks.

“It creates tens of thousands of jobs,” Fischer said, adding the use of bonds to fund such a project would see immediate payback.

The incumbent said he has led the charge in getting a state investment of $150,000 to conduct a feasibility study of electrifying the northern Long Island Rail Road line between Huntington and Port Jefferson, something he said people have talked about since before he took office 42 years ago.

“I believe, especially considering the economics of our day, that health care becomes a right.”

— Greg Fischer

“It’s something that I think that we’re finally, with money that I put in, that we’re going to get some attention,” the incumbent said.

Fischer criticized the idea of committing funds to invest in what he called “outdated technology.”

“No matter how much money we spend on horses and buggies it’s not going to help us,” Fischer said.

Both candidates said they believe better health care should be accessible to all.

“I believe, especially considering the economics of our day, that health care becomes a right,” Fischer said.

LaValle said the goal of the senate is to ensure access to health care for all. However, there are obstacles.

“We cannot afford one system for all,” LaValle said. “We tried. We looked at Obamacare and other types of things. I think we need to tweak what we have and make sure that no person goes without health care.”

“Waste, fraud and abuse cannot be tolerated at any time.”

— Ken LaValle

When it comes to education, Fischer said he believes there should be an inspector general assigned to NYS Education Department to investigate departmental waste, as its expenses are more than 50 percent of the state budget. He said currently any waste and mismanagement falls to the attorney general while other departments have inspector generals. Fischer, who has done audits of school districts, said he has found a lot of waste including not using best-value contracting.

LaValle said he has no problem looking into an inspector general for education.

“Waste, fraud and abuse cannot be tolerated at any time,” LaValle said.

Both candidates agreed more could be done for those suffering from drug addiction, especially in schools and colleges, including organizing public forums.

“Young people growing up today have lots of pressures, and it’s starting to show in so many ways, opioids being one of them,” LaValle said.

Fischer said he believes addiction comes from helplessness many young people feel from not being able to make a decent living and afford their own homes.

“As you become less and less of a stakeholder in the future, you destroy yourself,” Fischer said.

 

Feds recommend trio of changes in staffing, hiring and overtime management to facility’s new leadership

Northport VA Medical Center. File photo

A federal investigation into Northport Veterans Affairs Medical Center’s four community living centers has shown a troubling trend of chronic nursing staff shortages and excessive overtime, issues that could have placed patients “at a higher risk for adverse events.”

In one case, federal investigators found a nurse’s assistant worked double shifts for six straight days — more than 96 hours in a single week – while expected to diligently oversee a patient requiring one-on-one care.

As the Northport facility is the only VA Medical Center on Long Island it serves more than 31,000 patients per year and oversees several outpatient clinical sites. Its four nursing homes are located in two buildings, with an approximate capacity of 170 beds.

The Office of Inspector General, a division of U.S. Department of Health & Human Services, charged with independent oversight of Department of Veterans Affairs programs, received several anonymous complaints about the quality of care received at Northport VAMC in 2017 following the deaths of two patients.

In September 2017, the OIG launched a year-long investigation into staffing shortages after receiving two further emails: the first from an employee at Northport VAMC, the second from a liaison to the House Committee on Veterans’ Affairs. The investigation produced a Sept. 18 report (click here to read the full report) that found Northport VAMC’s leadership knew about the staff shortages, forced administrative level nurses to care for patients, and yet still continued to accept new patients despite knowing they wouldn’t have the staff needed to provide the expected level of care.

Federal investigators recognized in August 2017 there was significant turnover in the leadership at the Northport VAMC, affecting key positions such as its director, acting chief of staff and acting nurse executive, who were cited “as catalysts for this change.” Staff members’ remarks indicated it’s given them hope for a better future.

The agency recommended a series of changes for the Northport VAMC pertaining to the nursing staff currently being enacted, and the facility says is bringing immediate tangible results.

Two patient deaths

Anonymous complaints about two patient deaths at the Northport VAMC in 2017 started the series of federal investigations into the facility.

The first death was a male patient in his late 60s who died as a result of choking on his food. Federal inspectors found insufficient evidence the man’s death was due to a lack of nurse oversight, as alleged in the complaints, but did conclude Northport VAMC had ongoing challenges in maintaining basic necessary staffing levels.

“Conditions such as staffing shortages could create an environment where the increased workload assigned to each staff member was such that it became more difficult to remain vigilant,” the report reads.

A forum was held for the Northport VA nursing homes staff to voice their concerns with the facility and its operation while an investigation of the first patient’s death was ongoing.

“Many [staff members] shared a concern about staffing levels being too low,” the report reads.

A second death raised claims of poor quality of care in the Northport vets nursing homes, after a patient in his mid-60s slipped, fell and fractured his hip. He underwent surgery and six days later stopped breathing. Allegations included the VA staff failed to protect the patient from falling and failed to properly provide
one-on-one observation post surgery, neither of which was substantiated by federal investigators.

The investigation into the second death showed the nurse’s assistant caring for him was on her sixth consecutive day of double shifts — 16 hours at a stretch. Investigators again cited “concern that working extra hours with double shifts could lead to staff becoming tired and less vigilant.”

A staff member working double shifts was not common practice, according to Northport VAMC spokesman Levi Spellman, who said union workers are contractually required to have 10 to 12 hours off between nursing shifts.

Closer look at staffing numbers

Records pulled by the federal investigators showed Northport VAMC has been chronically short of nursing staff dating back to at least 2016. Allegations were made that understaffing could lead to a higher rate of “nurse-sensitive outcomes,” such as surgical wounds getting infected, urinary tract infections, ulcers and pneumonia.

Northport’s four nursing homes were found to be short approximately 6.3 full-time employees in 2016 needed to meet VA’s recommended number of nursing hours spent with patients per day. By 2017, the facility’s staffing shortage had more than doubled, with 15.3 additional full-time employees needed. Northport VAMC’s nursing homes were only staffed at 60 to 80 percent of recommended levels over the two years, according to federal investigators.

Northport VAMC’s leadership attempted to tackle the short staffing issue by using “floating” shifts and overtime — sometimes mandatory, according to the federal report. Floating shifts meant staff from other areas of the VAMC were brought in to assist with patients in the nursing homes.

In 2016, Northport VAMC’s nursing home employees put in a  total of 19,991 hours of overtime. It nearly doubled by the end of 2017 as only 107.9 of the facility’s authorized 128 full-time positions were filled, according to Spellman, causing the facility’s overtime costs to skyrocket to nearly $1.5 million.

“Nurse managers had no mechanism to alert them if one of their unit nursing personnel worked excessive OT,” the report reads.

Federal investigators found part of the nursing homes’ staffing issues were due to an inability to hire and retain the members of its nursing staff. Northport VAMC got approval to hire 10 additional registered nurses and 10 nurse assistants as intermittent staff in November 2016, though the team wasn’t assembled until August 2017.

Often the process of hiring new nursing staff was delayed. In one instance, Northport’s leadership said two applicants interviewed and hired in January 2017 were told they would not start working until July.

“This delay in hiring often resulted in the loss of selected applicants who took other jobs,” the report reads.

The leadership of Northport VAMC said the high cost of living on Long Island has also made finding and maintaining a full-time staff difficult.

“Not only does this affect our ability to retain talent, but to recruit it as well,” spokesman Spellman said.

Steps to improvement

The federal investigators made three recommendations to Northport VAMC in order to  ensure it has adequate nursing care for its patients and improve quality of care for residents.

First, that the VAMC’s acting director, Dr. Cathy Cruise, completes a review of the nursing homes to ensure staffing levels align with the needs of its current residents. More staff should be recruited and hired to fill the current vacancies “until optimal staffing is attained,” reads the report.

Spellman said leadership of Northport VAMC, including Cruise, have already started taking action, implementing changes to improve the quality of care and working conditions.

A registered nurse clinical coordination position has been added in order to streamline nursing staff’s efficiency, according to Spellman. At the beginning of 2018, the facility was given approval to hire 2.6 more full-time employees and another 10 staff members were recently approved to bring the total nursing staff to the equivalent 140.6 positions.

“A staffing methodology is in the process of being completed, with additional staff expected,” Spellman said.

The Northport VA has received approval to directly hire its nursing staff and is giving new employees immediate start dates, according to him. It also had plans to expand its nursing floating pool, and to cross train other VAMC nurses in long-term care to continue to grow the available number of staff who can provide residents with care.

Third, Northport’s leadership was also told to improve its management of staff’s overtime hours and make sure of future responsible use of financial resources, citing the $1.5 million in 2017 overtime.

“Federal employees are expected to be good stewards of government funds,” the report reads. “The OIG found a lack of accountability for managing OT expenditures.

Spellman said the nursing homes staff had a total weekly average of 437.3 hours of overtime for the 2018 fiscal year, which ended Sept. 30. This indicates a significant drop from last year, where the total weekly average of overtime exceeded 750 hours.

“All of this is to say that, while the OIG has helped Northport identify areas in which we can improve, we have implemented measures to make those improvements — and we are already seeing results,” Spellman said.

Northport VA Medical Center. File photo

The director of Northport Veterans Affairs Medical Center has submitted his resignation, leaving the facility after a year at the helm.

Scott Guermonprez’s last day leading the Northport VA will be July 14 as he intends to retire after more than 30 years of military and federal service.

“Having the opportunity to come back to Long Island and my home, Northport, as a capstone assignment is a wonderful and awesome way to finalize my career,” Guermonprez said.

Having the opportunity to come back to Long Island and my home, Northport, as a capstone assignment is a wonderful and awesome way to finalize my career.”
– Scott Guermonprez

The director said this is effectively his second retirement from service. Guermonprez said he built his career in the military health  care system serving as an administrator there for 24 years, before initially filing for retirement. At the last minute, he transferred to the U.S. Department of Veterans Affairs to begin serving other veterans. Guermonprez worked for three years at Albany VA Medical Center before coming to Long Island.

“We’ve had a great time with health care professionally in Albany and Northport leading change, positive change we needed to make happen,” he said. “I am excitedly looking forward to future opportunities with family.”

Guermonprez said he believes he is leaving Northport’s facilities in better condition than when he arrived, claiming he’s improved the timely access to health care for veterans by making same-day appointments available for primary care and adding an increased capacity for telehealth, where elderly veterans can now use technology to talk and consult with their physicians from the comfort of their home. 

Dr. Cathy Cruise, recently promoted to permanent chief of staff at Northport VA, will step up to serve as the acting director while a national search is conducted to find Guermonprez’s successor.

“I can say I’m very happy to serve in the acting director position for as long as it takes; it’s an honor,” said Cruise, a Huntington native. “I’ve grew up here and developed my love of medicine here.”

Cruise has worked at the Northport center for approximately two years but has spent more than 23 years serving with the VA. She will take the reins of the $15 million in capital projects currently underway at the facility and, possibly, the long-awaited demolition of two buildings Guermonprez has focused on, for which permits were received and authorized July 5.

“I wish I could be here for it, but I’ve asked Dr. Cruise to save a brick for me,” he said.

Plan calls for the hiring of 40 additional engineers and police department staff

A temporary heating and air conditioning unit installed at the homeless shelter of Northport VA medical center. Photo by Sara-Megan Walsh

The new leadership at the reigns of the 90-year-old Northport VA Medical Center has unveiled a three-year plan aimed at making $21 million in repairs to address critical infrastructural and staffing concerns.

Director Scott Guermonprez said since taking up the position in June 2017, he has drafted together a plan that looks to address the out-of-date utilities systems and crumbling buildings that led to the closure of its homeless veterans housing in January, and a brief shutdown of its operating rooms in February.

““We have to figure out how we focus on the resources we have and use them as quickly and prudently as possible.”
– Scott Guermonprez

“There was a facility condition assessment done last year that came out that said if we were to try to fully rehabilitate the entire campus it would cost more than $450 million, or to try to build a new one would cost more than $1 billion,” Guermonprez said. “We have to figure out how we focus on the resources we have and use them as quickly and prudently as possible.”

There are approximately $7 million in projects getting underway this year, according to the director, which includes replacing four of the heating, ventilation and air conditioning units of the main medical center as well as a new roof.

The VA director said they had also received approximately $1.1 million to renovate the homeless veterans shelter, run by the nonprofit Beacon House, with new ductwork and an electronically controlled heating and cooling system. The work is expected to be completed by the end of the summer, according to Guermonprez.

The director said the three-year plan also calls for hiring 40 additional engineering and trade staff to oversee maintenance and upkeep of the 71-building campus under its new Chief Engineer Oscar Prue.

“[Prue] has been very successful in overseeing a large number of projects over multiple years and multiple locations,” Guermonprez said, noting he’s worked on VA medical centers in Albany and Syracuse.

“While this VA has plenty of work ahead of them, I am confident that they have a plan and are moving in the right direction…”
– Tom Suozzi

The first major project Prue is expected to tackle is the demolition of long-abandoned Buildings 1 and 2 which housed the facility’s original hospital, standing opposite the current medical center.

“It’s an eyesore,” the director said. “One of the biggest complaints we’ve had with Northport is insufficient parking. When it was built nearly 40 years ago, the intent was to demolish those buildings. It never happened.”

He anticipates the Department of Veterans Affairs will give him clearance to move forward shortly, with demolition tentatively scheduled to start in the late fall. These two of the 428 buildings nationwide the Veterans Administration has plans to demolish or repurpose. The space cleared will be converted to additional parking space for the medical center, allowing a few hundred spaces to be added.

“We want to add valet parking,” Guermonprez said. “We have the largest number of veterans over 80 years old in the New York-New Jersey health care system. We want to make it easier for them.”

Adding more parking and upgrading the heating and cooling systems will allow Northport VA to consolidate its medical treatment services into the medical center. Currently some programs like the outpatient mental health services and opthamology are in outlying buildings.

“[W]e are expanding police services given the unfortunate incidents occurring across the nation with shootings as we want to keep our veterans safe.
– Colleen Luckner

“While this VA has plenty of work ahead of them, I am confident that they have a plan and are moving in the right direction to ultimately upgrade and restore these facilities so that they can properly serve and honor our veterans here and in the community,” Congressman Tom Suozzi (D-Glen Cove) said after touring the VA facility with the director in late April.

Other key components of the VA’s three-year plan include replacing the campus’s steam vents and expanding its security force to deal with modern threats, said Colleen Luckner, associate director of Northport VA.

“In addition to the construction projects, we are expanding police services given the unfortunate incidents occurring across the nation with shootings as we want to keep our veterans safe,” Luckner said.

The Northport VA will be hiring on additional staff for its police department as well as implementing new systems such as additional cameras, panic alarms and other such measures.
Later this year, the Northport VA expects to celebrate the grand opening of expansion of its Riverhead outpatient clinic to include more physical therapy space and hearing services in July, before adding physical therapy, occupational therapy and more services to its Patchogue location.

U.S. Rep. Lee Zeldin, standing, visits with James and Noreen Saladino after the couple shared how adult day health care has helped them face service-related health issues in 2016. File photo by Phil Corso

By Alex Petroski

Disabled veterans received some good news March 28.

President Donald Trump (R) signed the Adult Day Health Care Act into law this week, a bipartisan bill sponsored by U.S. Rep. Lee Zeldin (R-Shirley) that will expand access to health care for disabled veterans who need extra assistance and special attention in their daily lives, according to a press release from Zeldin’s office.

“This is important legislation that provides a valuable and necessary service to our nation’s veterans,” Zeldin said in a statement. “By expanding access to [the] Adult Day Health Care [Act], we can ensure that all veterans receive the best and most efficient outpatient services that provide each veteran with the assistance and special attention they need, while still allowing them to maintain their independence.”

The bill defines the program as a reimbursable treatment option through the U.S. Department of Veterans Affairs. Previously, the program was only accessible for disabled veterans at three state veterans homes in the country, leaving the expense of health care oftentimes directly shouldered by the veteran and his or her family, according to the press release. One of the three homes was Long Island State Veterans Home in Stony Brook.

The Adult Day Health Care Act provides comprehensive medical and personal care combined with engaging social activities for the physically or cognitively impaired, as well as an array of therapies and counseling.

With the passage of the bill, now those who are 70 percent or more disabled as a result of their service are able to access the in-home day care at no cost at any of the 153 state veterans homes in the U.S.

“I am grateful to Congressman Zeldin for having the foresight to introduce this bill on behalf of all severely service-connected veterans who reside in state veterans homes across the country,” Vietnam veteran and patient of the Stony Brook facility Al Anderson said in a statement. “The bottom line is that this legislation will allow me to return home to my family while still having the ability to receive essential services through the Adult Day Health Care program. I can keep my chronic conditions in check and still enjoy the comforts of my own home.”

Fred Sganga, director of the Long Island State Veterans Home, also thanked Zeldin for his efforts in advancing the legislation.

“This legislation helps to restore a veteran’s freedom to remain an active member of their community even after succumbing to the perils of military service,” he said. “Congressman Zeldin never forgets the sacrifice of brave women and men who donned the uniform to protect the freedoms we all enjoy today.”

The Senate version of the bill was sponsored by U.S. Sen. Orrin Hatch (R-Utah).

“Our nation’s veterans and their dedicated families have sacrificed enough,” Zeldin said. “This bill will give veterans the care they have earned while providing families with the support and relief they need to help their veteran loved ones to lead a fulfilling life, while keeping families together and strong.”

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In the wake of a political battle that characterized 2017, it appears solutions for potentially improved and more affordable health care may be on the horizon.

While federal lawmakers bicker over the Affordable Care Act, three corporations are teaming up to resolve the issue for their employees. If the companies are successful in creating an effective health care system, it’s possible their idea could benefit all Americans.

Online retailer Amazon, holding company Berkshire Hathaway and bank JPMorgan Chase issued a press release Jan. 30 announcing plans to start an independent health care company. The statement provided little detail about the joint venture except that “the initial focus of the new company will be on technology solutions that will provide U.S. employees and their families with simplified, high-quality and transparent health care at a reasonable cost.” The hope is that it will balance rising health care costs with enhanced patient satisfaction and outcomes. The release also mentioned a desire to transition away from a profit-based health care system.

After the announcement of the initiative, stock prices of major health insurance companies dropped, and rightfully so. If it expands in the future, the new partnership may create much-needed competition in an arena fraught with overpricing, complicated procedures and an abundance of paperwork. Competition is always a good thing. It prevents medical costs from being controlled by just a handful of insurance providers, and in an important area like one’s health, everyone should have coverage options that will ensure
receiving the highest quality of care possible.

“The ballooning costs of [health care] act as a hungry tapeworm on the American economy,” said Berkshire Hathaway Chairman and CEO Warren Buffet.

The joint venture also creates opportunities for other employers to join forces with the giants, or attempt to come up with their own answers to provide better health care options for their workers.

But this isn’t the first time a corporation has become involved in health care. In December, CVS Health bought health insurance giant Aetna for $69 billion with a similar goal — to remake the consumer health care experience and build a health care platform around individuals.

In an era where many Americans fear that one accident or illness will drastically alter their financial future — because they can’t afford health insurance to assist with potentially high medical expenses — the idea that legitimate solutions are being sought is refreshing. What’s even more uplifting is that these companies understand the importance of their employees being able to afford health insurance and, in theory, politics will be held out of the discussion.

Considering all three corporations have enjoyed immense successes in their respective fields, the potential for innovative ideas from the three giants is exciting.

We look forward to seeing if the private sector can produce what elected officials were stuck in the mud trying to accomplish all of 2017.

John T. Mather Memorial Hospital in Port Jefferson. File photo from Mather Hospital

A historic change at a nearly 90-year-old Port Jefferson institution has been finalized.

John T. Mather Memorial Hospital will officially finalize an affiliation agreement with Northwell Health Dec. 21, according to a Mather board member, who asked not to be referred to by name. Leadership from Mather Hospital signed a letter of intent to join Northwell, New York’s largest health care provider, in August, though the sides had not yet finalized the terms of the agreement at that time. It is the first time in the hospital’s history it will be affiliating with a larger health system, and a signing ceremony is set to take place Thursday, Dec. 21, at 3 p.m. in a conference room at the hospital. The board member said he expects Northwell Health president and chief executive officer Michael Dowling as well as Mather board of directors chairman Ken Jacoppi to attend the signing.

Mather Hospital is set to join Northwell Healht. Photo from Huntington Hospital

“We’re very pleased Northwell has committed to making an investment in our community and bringing their extraordinary capabilities to our community,” the board member said. “They’ve committed to preserve our culture of patient safety.”

The board member said part of the agreement is that Mather’s board and CEO will remain in place through an initial period of five years, allowing the hospital to remain “largely self-governing” during that time with collaboration and cooperation from Northwell. The Mather board member did not specify the total length or any other specifics of the agreement. A spokesperson from Mather confirmed the ceremonial signing will take place Dec. 21 and that the agreement has been reached, but declined to confirm any details relating to the contract.

The board member summed up what the change might mean for hospital patients going forward.

“In the near term the experience should not change at all,” he said. “We happen to believe that’s a good experience, generally speaking. In the long term Northwell has greater capabilities than we do and we’ll gain those. They’re committed to supporting our residency program as well.”

In August, state Sen. Ken LaValle (R-Port Jefferson) voiced opposition to the agreement, saying he would have preferred Mather affiliate with Stony Brook University Hospital.

“I don’t think it’s a good decision,” LaValle said at the time. “For 50 years-plus there’s been a culture in place if people needed tertiary care they would go from Mather to Stony Brook. Stony Brook will still be in place, will still offer services and people if they choose can go to Stony Brook.”

Mather Hospital vice president of public affairs Nancy Uzo said in August Stony Brook was considered an option for affiliation and offered an explanation by email.

“Our goal through this process is to ensure that our communities continue to have access to advanced, high-quality care and superior satisfaction close to home, and to serve the best interests of our medical staff and employees,” she said.

Dowling commented similarly about Mather Hospital’s reputation around the letter of intent signing in August, and as to why Northwell would be a good fit for Mather.

“Mather Hospital is known for patient-centric care both in the community and throughout the industry,” he said. “That deeply embedded sense of purpose is the type of quality we want to represent Northwell Health, along with an excellent staff of medical professionals and physicians. Together, Mather and Northwell will play a crucial partnership role expanding world-class care and innovative patient services to Suffolk County residents.”

A public relations representative from Northwell did not immediately respond to requests for comment.

This story was updated Dec. 19 to include a Mather spokesperson’s confirmation of the signing ceremony.