Health Care

‘Queen of cover-ups’: Head of Kansas City VA hospital has history of withholding info

Director of Kansas City VA Hospital has history of cover-ups from her previous job at Florida VA hospital

Kathleen Fogarty, director of the Kansas City VA Hospital, has withheld information of a Veterans Affairs Police altercation with patient Dale Farhner, who died two days later.
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Kathleen Fogarty, director of the Kansas City VA Hospital, has withheld information of a Veterans Affairs Police altercation with patient Dale Farhner, who died two days later.

The leader of the Kansas City VA Medical Center has been under fire for withholding information about a patient’s death, allegedly at the hands of Veterans Affairs Police.

That secrecy seems to be a pattern.

Years earlier, that leader, Kathleen Fogarty, was also accused of cover-ups at her previous job as head of a Tampa, Florida, VA hospital.

A patient’s daughter there dubbed her “the VA queen of cover-ups” in 2014, after Fogarty authorized staff to install a hidden camera in the patient’s room. Fogarty was also accused of cutting veterans’ access to care outside the VA system to save money and denying she was doing it.

The incidents raise new questions about her administration’s handling of the death of Dale Farhner in Kansas City.

Farhner, a 66-year-old veteran from Kingston, Missouri, had hernia surgery at the Kansas City VA hospital in May 2018. The surgical wound became infected, and he was driving himself to the hospital’s emergency room three days later when a VA police officer confronted him for driving the wrong way in the parking lot. The ensuing altercation left Farhner nearly comatose, according to internal VA documents leaked to USA Today. He died two days later, but the documents reportedly made no determination about whether his death was due to injuries inflicted by VA Police.

The Star learned about Farhner’s death last year through an anonymous tip and filed a Freedom of Information Act request that revealed that the VA has documents, audio and video related to the incident. But the VA has repeatedly refused to provide them — or any other any information about the incident — to The Star, to members of Congress and even to Farhner’s family, which has since filed a wrongful death lawsuit against the agency.

Randall Barnett, the president of Vietnam Veterans of America’s Kansas City branch, has said it smacks of another cover-up.

“If they weren’t at fault or didn’t feel through their investigation they were somewhat at fault, why would they cover everything up?” Barnett asked. “Or try to cover everything up?”

The Star asked to talk to Fogarty this past week about her time in Tampa and the Farhner incident, but Kansas City VA spokesman Vernon Stewart provided only written responses via email.

“Federal law enforcement officials have already fully investigated this matter and determined that VA acted appropriately in its interaction with the veteran,” Stewart said. “VA will cooperate fully with any additional official investigations.”

Hidden camera

According to an interview she gave with a Florida public radio station in 2015, Fogarty started her career as a dietitian at the Kansas City VA in 1986.

She rose through the ranks over several decades and in 2011 became director of the James A. Haley VA Medical Center in Tampa — one of the nation’s largest VA hospitals.

The hidden camera controversy struck soon after.

The incident centered on Joseph Carnegie, a 79-year-old Korean War vet with severe brain damage.

According to an investigation by the VA’s inspector general — the agency’s internal watchdog — Carnegie’s nearly 400-day stay in the hospital was marked by tension. His family repeatedly accused the staff of poor care, and staff members increasingly suspected his relatives were sabotaging his care to set them up.

VA supervisors began discussing whether to hide a camera in the room — a question that eventually was elevated all the way to the executive level. According to meeting notes uncovered by the inspector general, there was disagreement among the hospital’s leaders, until Fogarty herself authorized it.

Carnegie’s relatives thought the new smoke detector in his room looked a little odd, and a maintenance man confirmed there was a camera in it. That set off a public controversy first reported by the Tampa Bay Times that drew the attention of then-U.S. Sen. Bill Nelson, who requested the inspector general’s investigation.

The inspector general determined that the use of a hidden camera outside of a formal law enforcement investigation was very unusual at the VA, but in this case it was done out of legitimate concerns for patient safety.

“VA’s inspector general thoroughly reviewed this nearly seven-year-old matter, determining that ‘the patient received extensive, even exhaustive, high-quality care at (the Tampa VA Medical Center) … the patient’s family was aware of the (camera) when it was activated and began to record video images,’ and that use of the camera was ‘reasonable,’” Stewart, the Kansas City VA spokesman, said.

The Tampa Bay Times, however, found that in the aftermath of the camera’s discovery, hospital staff working under Fogarty untruthfully said that the camera was never intended to be hidden (internal memos showed it was), it was not recording (the investigation turned up 43 days worth of video) and that the family knew about the camera and signed a release authorizing it (it hadn’t).

In an editorial, the newspaper said Fogarty was responsible for “the hospital’s culture of defiance and non-responsiveness to public concerns.”

When Fogarty was tapped to temporarily take over the VA’s troubled Southwest region in 2014 amid a crisis over falsified patient wait times, Carnegie’s daughter told The Arizona Republic she was “disgusted.”

“To send the VA queen of cover-ups to Phoenix — it’s just a spit in our face,” said Natalie Carnegie, who could not be reached for comment for this story.

Budget balancing

In the radio interview, Fogarty said she had no regrets about the hidden camera because “the decision was made for the safety of that patient.” But she also said that if faced with a similar situation she would use an overt camera, not a hidden one.

In 2015 Fogarty took the job as director of the Kansas City VA Medical Center, which she described as a homecoming and a chance to serve at a smaller, less hectic hospital. Her salary — about $190,000 a year — is roughly the same as what she was making in Tampa Bay.

The following year USA Today included her in a list of VA administrators “transferred to new jobs despite concerns about the care provided to veterans at the facilities they were previously managing.”

The news organization cited Tampa Bay Times reporting that showed Fogarty “cut veterans’ access to outside care to help overcome a multimillion-dollar deficit as director of the Tampa, Fla., VA, in 2011 and repeatedly denied publicly that she was doing it.”

Stewart said USA Today’s story was “flat-out false and repeating it to your readers would be irresponsible.”

“When Director Fogarty became director of the Tampa VA Medical Center in 2011, she inherited a nearly $48 million budget deficit,” Stewart said. “She balanced the budget by using commonsense management principles such as not filling unneeded positions and eliminating unnecessary overtime and travel. Under Fogarty’s leadership, the facility expanded its services to Veterans, and the blueprint she developed for managing the resources remains in place at the VAMC today.”

That’s not what she told the Arizona Republic.

“In her interview last week, Fogarty said she balanced the Tampa VA budget in three years by reducing the time veterans spent in non-VA hospitals,” the newspaper wrote in an article published Nov. 27, 2014.

At least one VA spokeswoman who worked under Fogarty at the Tampa VA denied in 2011 that there even was a deficit — a claim the St. Petersburg Times wrote was “contradicted by the facility’s own budget records.”

The Farhners’ lawsuit is still in its early stages. Their Kansas City attorney, James LaSalle, said the VA had not released any information to the family in response to an administrative complaint they had to file before they could sue.

The agency also has not provided information about what happened between Farhner and police to former U.S. Sen. Claire McCaskill and current U.S. Sen. Roy Blunt, who both requested it.

LaSalle said the VA could be forced to hand over the investigative documents revealed by The Star’s records request during the suit’s discovery phase, but he had no timeline for when that might happen.

“I know that once it moves to litigation,” LaSalle said, “that stuff is evidence at this point.”

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Kansas City Star health reporter Andy Marso was part of a Pulitzer Prize-finalist team at The Star and previously won state and regional awards at the Topeka Capital-Journal and Kansas Health Institute News Service. He has written two books, including one about his near-fatal bout with meningitis.
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