Prescriptions for narcotic painkillers had skyrocketed, patients were overdosing and pharmacists who balked at filling prescriptions were fired or quit in disgust. The U.S. Department of Veterans Affairs hospital in Tomah, Wisconsin, had been dubbed “Candy Land” by veterans and staff and was being investigated by the agency’s inspector general.
Despite all these issues, the facility’s director, Mario DeSanctis, received an $8,025 bonus for 2013, a 5 percent bump atop his $160,000 annual salary. He says he earned it.
“I feel that it was warranted and justified,” DeSanctis told The Center for Investigative Reporting last month. The performance review on which the bonus was based, he said, was fair and “based on objective criteria.”
The VA has had a history of providing additional compensation to executives at troubled facilities. Last June, a senior VA official told the House Committee on Veterans’ Affairs that all of the 470 senior executives employed by the agency over the previous four years had received a performance rating of “outstanding,” “exceeds fully successful” or “fully successful.” None were rated unsatisfactory.
Less than a week before he resigned last May, Secretary of Veterans Affairs Eric Shinseki canceled all bonuses for 2014.
Longtime employees of the Tomah VA were baffled by DeSanctis’ bonus. Dr. Mary Eleanor Beal, who retired from her position at the Tomah-affiliated VA clinic in Wausau last month, said DeSanctis seemed “completely out of touch with reality. He would go around enumerating the wonderful things that were going on in Tomah. He should have had pompoms.”
CIR tried to obtain a copy of DeSanctis’ 2013 review, first asking the hospital’s public affairs staff, and then filing a formal request under the Freedom of Information Act. Although DeSanctis told CIR that he has no problem with its release, the VA’s Central Office has not yet done so. James Hutton, a spokesman for the VA in Washington, declined to comment.
The hospital has been the focus of intense congressional and media scrutiny during the past month. On Jan. 8, CIR revealed that the number of oxycodone pills prescribed at the Tomah VA had increased from 50,000 in 2004 to 712,000 in 2012 under the leadership of its chief of staff, psychiatrist David Houlihan, whom some had dubbed the “Candy Man.”
Houlihan has been removed from his post pending the results of a newly launched internal investigation.
For his part, DeSanctis argued that so far “nothing has been proven.” Indeed, the inspector general’s investigation underway when DeSanctis received his bonus resulted in a March 2014 report that found no criminal wrongdoing at the facility.
However, the VA Office of Inspector General report – uncovered by CIR in January but not officially published until this week – found startling numbers of opiates prescribed by Houlihan and two other health care professionals in Tomah, and documented the dismissal or resignation of pharmacy staff who complained of unethical behavior. The IG’s report also noted multiple incidents where veterans had been found dead in their homes by local police, surrounded by “large quantities of prescribed controlled substances.”
Five months after it was completed, 35-year-old Marine Corps veteran Jason Simcakoski died of an overdose in the hospital’s psychiatric ward. An autopsy report prepared by the University of Wisconsin Hospital and Clinics declared the cause of Simcakoski’s death to be “mixed drug toxicity,” a combination of narcotic painkillers, tranquilizers and antihistamine sleep aids, all prescribed by the VA.
“I can’t believe he would think it was OK to have his own son on that many medications,” Simcakoski’s father, Marvin, said of DeSanctis. “If he’s the boss then he should be held responsible.”
DeSanctis said he is withholding judgment on Simcakoski’s death pending the conclusion of internal VA investigations launched in his facility in recent weeks.
VA records obtained by CIR show that DeSanctis’ predecessor as director of the Tomah VA also received similar annual bonuses – $7,552 in 2009 and $9,904 in 2010.
After Jerald Molnar retired in 2011, Houlihan was named interim director. When DeSanctis was hired eight months later, Houlihan returned to his previous position as hospital chief of staff.