A federal administrative judge has ruled against a former clerk at the Kansas City VA Medical Center who is seeking to get her job back after being fired last year for failing to schedule dozens of heart patients in need of appointments.
NaNette Chaney “intentionally failed to complete her duties because she did not agree with the procedures utilized in the Cardio Clinic to schedule patients,” Judge Erin Brandenburg ruled late last month. “The VA was left with little choice but to remove (her).”
Chaney’s lawyer, Dale Ingram, called the ruling “one of the poorest decisions I’ve ever read. It’s pretty clear she ignored the evidence.”
Ingram said he would petition for a review of the ruling by a panel of the federal Merit Systems Protection Board. Further appeals are possible through federal court.
The Kansas City VA Medical Center did not respond this week to requests for comment.
Chaney, an Army veteran who had worked eight years at the hospital, was at the heart of Kansas City’s connection to the patient scheduling scandal that roiled the VA health care system nationwide last year.
The scandal erupted in April 2014 with news reports that at least 40 patients died while waiting for care at VA health facilities in Phoenix. Soon, similar problems with “secret waiting lists” and patients denied care were uncovered at other VA hospitals. At the Kansas City VA Medical Center, officials revealed that several dozen heart patients in need of care had been left waiting for appointments.
Publicly, they blamed that lapse on a “serious clerical mistake.” Internally, they blamed Chaney. The hospital fired her in July 2014 for failure to perform her duties and for improperly disclosing patient information. Chaney said she was unaware that the person to whom she sent an email mentioning a patient’s name was no longer employed at the hospital.
Chaney argued that she was given an impossible job. She said she was assigned to schedule patients attending two clinics, told to ignore VA rules and doctors’ orders and given ever-changing rosters of physicians available to see patients, as well as conflicting orders left on sticky notes, emails and voice messages.
Chaney said she complained frequently about being told to bend the rules for the convenience of nurses and to make it appear that patients were being seen within the VA’s time limits. She said she was told not to schedule certain patients.
The VA’s evidence against Chaney is a stack of about 1,000 “yellow sheets” — appointment requests doctors write for their patients — that VA officials say they found in her desk drawer and file cabinet.
Most of the sheets either didn’t require any action or were for appointments Chaney already had scheduled, but 39 were for patients whose appointments apparently were overdue. About 330 more were for patients whose appointments weren’t overdue, but hadn’t been scheduled.
At a civil service hearing this summer, hospital officials and employees she worked with testified that Chaney’s essential duty was to schedule timely patient appointments and that she never told them she was falling behind.
“There simply is insufficient evidence to support (Chaney’s) claim that her fellow team members instructed her not to complete the yellow sheets,” Brandenburg ruled. “Rather, the record is replete with evidence indicating that completion of those sheets was (her) primary responsibility.”
The testimony against Chaney by her supervisors was “consistent and supported by the record evidence,” Brandenburg said. “I simply am unable to discern a motive for them to lie; rather, they all seemed extremely concerned with making sure the busy Cardio Clinic ran as efficiently as possible so that veteran patients could be seen in a timely manner.
“There is no doubt that (Chaney’s) job was not easy and required attention to detail, common sense, and dedication... However, the clear impression I received from both the written record and (Chaney’s) testimony was that she thought she knew best how the Cardio Clinic should be run and she willfully refused to follow instructions from her team when she disagreed with them.”
Ingram, Chaney’s lawyer, said Brandenburg found the VA’s testimony credible “because they were all telling the same story.”
What the nurses Chaney reported to wanted her to do “wasn’t in accordance with VA policy,” Ingram said. “(Chaney’s) own way was the VA way.”