Robert Wilkie, acting secretary of the Department of Veterans Affairs, was confirmed by the Senate to lead the VA on Monday, capping a contentious selection process that saw President Trump's previous nominee fall amid sweeping, unproven misconduct allegations.
Wilkie will lead the government's second-largest department, with 360,000 employees serving 9 million veterans. The department has been paralyzed by infighting over the role of private care for veterans.
Trump selected Wilkie, who was confirmed 86-9, for the post in May after firing David Shulkin amid investigations into alleged spending abuses and reports of internal dissension at the VA.
In February, the VA's internal watchdog found that Shulkin had improperly accepted Wimbledon tennis tickets and his then-chief of staff had doctored emails to justify his wife traveling to Europe with him at taxpayer expense. Shulkin agreed to reimburse the government more than $4,000 in that case.
Trump's initial replacement choice, White House doctor Ronny Jackson, had long served as White House doctor and a Navy admiral. He withdrew his nomination to lead the VA earlier this year.
Jackson had been besieged by unproven allegations compiled by Montana Democratic Sen. Jon Tester’s office concerning his prescription-drug practices and use of alcohol. Tester is the top Democrat on the Republican-controlled Senate Veteran Affairs Committee.
Among the most prominent charges: that Jackson had drunkenly banged on a female colleague's door in the middle of the night during a presidential trip, and that he had "wrecked" a vehicle after attending a boozy Secret Service party.
But officials who checked Jackson's driving record found no evidence he crashed a government car, and the Secret Service could not confirm the nighttime episode that supposedly came close to waking a sleeping President Barack Obama.
Trump had come to Jackson's defense, and has since campaigned against Tester in Montana.
On Monday, Tester was one of the 86 senators who voted to confirm Wilkie.
All of the "no" votes came from Democrats, including some reported to have 2020 presidential ambitions, such as Cory Booker, Kirsten Gillibrand, Kamala Harris, Bernie Sanders, and Elizabeth Warren. There were five absent senators, including Arizona Sen. John McCain, who is battling brain cancer.
Wilkie takes on the task of fulfilling President Donald Trump's promises to fire bad VA employees and steer more patients to the private sector. While pledging to "shake up complacency" at VA, the Air Force and Navy veteran has also assured Democrats he will not privatize the department and will keep VA health care "fully funded."
Fox News' Chad Pergram and The Associated Press contributed to this report.