FOR RELEASE: September 07, 2001

Congressional Watchdog Recommends Stronger VA vigilance of One-half Billion Dollar COMMUNITY AND STATE VETERANS’ NURSING HOME PROGRAM

Washington, DC - Lane Evans (D-IL), the senior Democratic member of the House of Representatives Committee on Veterans Affairs, today released a report done at his request investigating the VA’s oversight of nursing home care it purchases for veterans in community nursing homes and state veterans’ homes.  VA spent more than one-half billion dollars on these programs in fiscal year 2000.  The VA also operates its own nursing homes, but these facilities were not part of the report.  The report, prepared by the General Accounting Office (GAO), found that VA does not always comply with its own requirements to perform annual inspections of the community nursing homes where VA pays for veteran patients’ care.  In addition, VA often fails to visit VA patients in community nursing homes on a monthly basis.   

“The GAO says the veterans’ population over 85 years old—the part of the population most at risk for needing nursing home care—will triple by 2010.  VA’s failure to comply with its own oversight requirements may adversely affect the quality of care increasing numbers of veterans can expect to receive,” said Evans. 

GAO indicated VA medical centers had done a relatively good job monitoring state veterans’ homes on a yearly basis.  In addition, VA’s central office is putting mechanisms into place to assure that they provide reminders to VA’s state home inspectors and that they routinely analyze problems that arise from inspections.  VA also has the authority to withhold per diem payments or even to no longer recognize state homes.  These tools give VA the ability to encourage state homes to take corrective measures.   

Community nursing homes, on the other hand, are not as well or as consistently inspected.  VA may enter into a contract with a community nursing home to care for only one veteran.  This complicates the task of routine VA inspections and visits to community nursing home patients that may be some distance from the VA medical centers required to provide oversight inspections.  VA staff conducting reviews may also be less familiar with a community nursing home to be inspected. 

VA now reports that it plans to implement a new oversight process for community nursing homes that will allow its medical centers to use data from state Medicare and Medicaid inspections.  GAO was critical, however, that VA’s Headquarters in Washington did not have a plan or guidance to train inspectors to use this data effectively. 

Other report recommendations for VA included: 

Ø     Develop a comprehensive policy for overseeing all community nursing homes under local or national contract to VA and ensure it is applied;

Ø     Ensure consistent and comprehensive VA medical center oversight activities; and,

Ø     Ensure that VA medical centers follow VA’s community nursing home policies. 

VA agreed with GAO’s recommendations and reported it has a plan to implement them. 

“Thirty percent of all community nursing homes suffer from program deficiencies that actually lead to the harm of patients.  We want to ensure that VA is taking all of the necessary precautions to ensure that veterans are not exposed to these systemic problems.  We cannot tolerate veterans falling between the cracks”, said Evans.

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