Generous bonuses continued flowing to top officials at the Department of Veterans' Affairs health network last year, despite a string of patient deaths and reports of mismanagement, unsanitary conditions and unprofessional practices.

Documents obtained by the Washington Examiner show six top administrators of the Veterans Health Administration received performance bonuses in excess of $16,000 last year.

In all, the top VA executives and medical professionals received more than $3.3 million in bonuses that are supposed to reward exceptional work. The figure does not include rank-and-file employees or other financial incentives not tied to job performance.

A VA spokesman issued a statement to the Examiner late Monday saying the 2012 performance bonuses for some top agency executives “have been suspended pending further review and are not being paid at this time.” That includes some VHA officials.

The statement does not say when or why the bonuses were suspended, or who is affected. The spokesman did not respond to requests for clarification. 

The 2012 bonuses for workers in the Veterans' Benefits Administration, which handles disability and pension claims, were cancelled in April amid congressional pressure and public outrage over the lingering backlog of unresolved cases.

VHA is under scrutiny after a series of reports from federal investigators that cited poor sanitation and management practices that contributed to five patient deaths in Pittsburgh and a rash of preventable suicides in Atlanta.

The Government Accountability Office on Friday blasted the agency for routinely awarding bonuses to doctors and other medical professionals who had been disciplined for lapses such as leaving the operating room during surgery and refusing to see patients in the emergency room.

Every medical professional eligible for extra pay received it, regardless of performance or disciplinary history, the GAO reported, citing bonus records at the four hospitals it reviewed. The doctors were not identified.

"This is an abysmal failure by the VHA and a slap in the face to every veteran waiting to have their claim processed," said Rep. Phil Roe, R-Tenn., a former Army surgeon and current member of the House Committee on Veterans' Affairs.

"VA's pay and bonus system needs to be linked to actual performance. Until the VA backlog is under control and we're keeping the promises we've made to our veterans by delivering quality health care and benefits in a timely fashion, it is completely inappropriate for officials at the Veterans Health Administration to receive bonuses," Roe said.

Also receiving a top bonus in 2012 was W. Todd Grams, who was VA's chief financial officer until he resigned earlier this year to become chief of staff at the Internal Revenue Service. Grams was paid a $15,930 bonus last fiscal year, according to documents obtained by the Examiner. That is a drop from the $23,010 Grams received in 2011 and $25,000 in 2010.

Six VHA executives each received $16,173, the top amount listed. They are:

• James Tuchschmidt, acting executive director of the Office of Healthcare Transformation.

• Patricia Vandenberg, assistant deputy under secretary for policy and planning.

• Rajiv Jain, assistant deputy undersecretary for patient care services.

• Elizabeth Freeman, director of the VA Palo Alto Health Care System in California.

• Jeffrey Murawsky, director of the Great Lakes Health Care System based in Illinois.

• Michael Finegan, who resigned in December as head of the multi-state regional VA health network based in Michigan.

One VHA official who did not receive a performance bonus in 2012 was Michael Moreland, a VA regional director who is under fire after an outbreak of Legionnaires disease killed at least five veterans at hospitals he oversaw in Pittsburgh.

In April, Moreland received a $62,895 bonus through the Presidential Distinguished Rank Award, which is not included in the performance bonuses issued by the agency.

The award was presented three days after the VA inspector general issued a report blaming unsanitary conditions at the Pittsburgh facilities for the deadly outbreak, which began in 2011.

Moreland's counterpart in Atlanta, Charles Sepich, did receive a performance bonus of $13,028 in 2012. A series of patient suicides in Atlanta-area facilities triggered a pair of VA IG reports issued in April, which found procedures there "did not sufficiently address patient care safety."

Rep. Jeff Miller, R-Fla., demanded in a letter sent last week that VA Secretary Eric Shinseki explain why top VHA officials received hefty bonuses in light of the numerous reports from federal investigators that document "management failures," which threaten patient safety.

Miller asked specifically about Moreland and Terry Wolf, director of the Pittsburgh VA health system, and the bonuses they received in spite of the Legionnaires' outbreak.

Wolf got a perfect performance evaluation but no bonus in 2012. She got nearly $13,000 in 2011.

"When evaluating employee performance and determining bonuses, does VA generally consider preventable patient deaths and/or inspector general findings of malfeasance that may have occurred on a particular employee's watch?" Miller asked in his letter to Shinseki. VA officials have not replied to Miller.

In response to the GAO report issued Friday, an agency spokesman defended performance bonuses as necessary.

"VA has used that authority to aid in efforts to recruit and retain highly skilled medical professionals in order to provide Veterans with the best possible health care," the spokesman said in a written statement.