The Department of Veterans Affairs (VA) completed inspections of 99 VA nursing home facilities recently. The results of the inspections show conditions that are largely substandard. Two facilities were deemed as causing “actual harm” to residents. Eight others were deemed as placing the health of residents in “jeopardy.” Three more were classified as particularly dangerous, as they placed the well-being of these veterans in “immediate jeopardy.” Over 20 facilities had notable problems with residents who developed pressure ulcers—commonly referred to as bedsores.
Infection Control Concerns
Residents of institutional environments such as long-term care facilities are vulnerable to infection. The recent report indicated that some of the most basic infection prevention measures were not being taken. Some of these rudimentary techniques include that staff is to wear sterile gowns and gloves when providing any treatment. Several facilities were found to be caring for residents in a manner that lacked “dignity.” The Government Accountability Office has presented their concerns to the U.S. Senate recently.
About VA Long-Term-Care
The VA provides a host of services associated with long-term care including:
- Around-the-clock nursing and medical services
- Rehabilitation such as through physical therapy
- Assistance with personal care including bathing, food preparation, and administration of medication
- Various forms of pain management, as chronic pain is extremely common among veterans
- Respite care services for those acting as caretakers
In recent years, the VA has begun offering more options for those with chronic conditions and disabilities who wish to remain in their home. This has been a goal in the overall U.S. health care system in recent years. This is conducted by providing home health care, which includes in-home medical care administered by physicians, therapists, and nurses. Day-to-day assistance provided by nurse aides ensures that bathing, dressing, and other tasks are completed.
VA Budget Spending
In recent years, many leaders and regulatory entities have questioned whether the VA is insufficiently funded. Since 2001, the budget allocation for the VA has grown from $45 billion to nearly $200 billion. The massive funding growth has thus far led to marginal results. Personnel (staffing) increases have also been significant over this time. Between 2014 and 2017, the VA has provided care for roughly 3.6% more veterans and staffing levels have risen by 12.5%.
Several regional facility inspections have been conducted, such as in Florida. Negligence, such as medical errors and patient neglect, was attributed to 54 otherwise preventable fatalities among veterans in the state's nursing homes. Recently an AARP leader explained that older people should not be subjected to such insufficient care when “they are most vulnerable.”
Report From New Hampshire
VA facilities in New Hampshire have been accused of providing poor quality care. There have been instances of insect infestation and reports of surgical equipment that was unsanitary. The Office of the Medical Inspector did not confirm many of these allegations; however, at least four senior leaders at the Manchester VA were terminated.
VA Defends Care Standards
Why is the level of care in these facilities still poor with the increased oversight, funding, and personnel? VA Secretary Robert Wilkie says that their nursing home residents are more likely to be in poor health and have complex conditions. The problem with that retort is that many of the problems cited, such as bedsores, are preventable.