Six months into her new job, interim VA director wants to stay

Dr. Cathy Cruise is six months into stepping up to guide the Northport VA Medical Center, and she is embracing the challenge. Now, she is looking to stay on permanently.

The Huntington native became acting director in July after director Scott Guermonprez resigned a year into his tenure, citing personal and family reasons. She also holds the title of chief of staff.

Cruise, 53, has a lot of work ahead as leader of Long Island's only veterans hospital. She is responsible for everything from managing 1,800 employees and a multimillion-dollar budget to ensuring the care of more than 30,000 patients a year and running a string of satellite clinics that stretch from Valley Stream to Riverhead.

Health experts warn that the next top administrator will have to deal with fixing and improving the medical center's aging infrastructure, as well as keeping enough nurses on staff. Less certain, they said, is the fallout from decisions being made in Washington. 

Still, Cruise said she is ready for the challenges and already has plans to improve the medical center — if she gets the job. The VA hasn't indicated when it will fill the post.

A key goal for Cruise would be to consolidate more of the medical center's operations into the hospital, one of nearly two dozen buildings on the 268-acre campus.

A consolidation would improve communication between employees and their supervisors and would limit the need for patients with several medical conditions to go to several buildings for care, she said. 

“We’re going to do whatever we can to bring our clinical operations in as tight as we can so that it is easier for veterans,” she said.

Cruise comes from a military family and knows firsthand the challenges of patients. "My father-in-law is a veteran who receives care here, my brother is a veteran, my father was a veteran,” she said. 

And she has an association with the VA that stretches back to her days as a student at Holy Family High School in South Huntington, when she volunteered at Northport. She read to patients, helped them write letters and pitched in at mealtime.

"When an opening came for me to work right here," Cruise said, "I thought that was my dream job."

A graduate of New York University School of Medicine, Cruise began her career at the VA hospital in Manhattan, specializing in physical medicine and rehabilitation. From there, she moved to the VA's New York region, where she supervised the virtual health and rehabilitation programs.

Heading the virtual health program put Cruise at the center of the VA’s growing push to use video links and other technology so patients could see doctors remotely for routine appointments — an initiative important to veterans from eastern Suffolk or southern Nassau who can face hours of travel time to reach Northport.

After more than a dozen years, Cruise left the regional job in 2016 to come to Northport. 

She is the medical center's fifth leader since she arrived. In the past two years, the medical center has had turnover in virtually all of its key administrative roles: four medical center directors, three chiefs of staff and three nursing department directors, as well as the heads of the human resources department and physical plant.

And 2018 brought other challenges. In January, the 91-year-old medical center had to close a homeless shelter on its campus after the heating system went out. A month later, the hospital had to shut down all five of its operating rooms to repair the air conditioning.

In September, three months after Cruise took over, the VA's independent watchdog released the findings of a yearlong investigation into nursing shortages at the medical center. Northport’s senior leaders, the report said, knew about the staffing shortages, mismanaged the nurses to fill the gaps and allowed overtime costs to balloon to $1.5 million in 2017, a nearly $750,000 increase from the year before.

In an addendum to the report, Cruise told the VA's Office of the Inspector General that she agreed with the findings and would address the staffing shortages.

Today, attention is back on the homeless shelter. Ten days ago, U.S. Reps. Lee Zeldin (R-Shirley) and Thomas Suozzi (D-Glen Cove) went to Northport for an update on the building. They liked what they heard: The medical center is moving as quickly as possible to reopen the building. 

Though Cruise wasn't at the meeting because of a scheduling conflict, the lawmakers said she has impressed them with her eagerness to sit down with them and community stakeholders, who they described as essential to building support for Northport. 

“She has been very accessible, and the best possible communication is essential,” Zeldin said.

The new director will face other challenges.

Health analysts warn that growing pressure to increase the privatization of VA health care — allowing more veterans to see private doctors paid for by federal dollars — could divert resources during a time when the agency is already stressed by staffing shortages and squeezed to keep up with the latest technology.

“Privatization is a real concern,” said Bob McDonald, who served as VA secretary under President Barack Obama.

Already, more than 2 million veterans have used VA health dollars to schedule 41 million appointments under the Veterans Choice Act, signed by Obama in 2014. Under the program, for example, a veteran could see a private doctor if the nearest VA hospital was too far away or if the VA couldn't provide care within 30 days of requesting an appointment.

And that outsourcing is expected to increase under the VA Mission Act of 2018, which President Donald Trump signed in June to replace the Veterans Choice Act. Many of the new law's provisions build on the 2014 legislation, especially on the timeliness of appointments and distance of travel.

For Zeldin, the law is a plus for the East End veterans he represents. They face hourslong drives to the Northport campus.

“For a veteran out near Montauk, that can be totally unrealistic,” he said.