Veterans Affairs Nationwide Ranking Nursing Homes

In an unprecedented move furthering transparency within the Department of Veterans Affairs (VA) it has released the internal rankings of 133 VA nursing homes nationwide. The 5-star ranking system helps veterans and their families to locate the best facility possible in their area. The posted performance ratings are slated to be updated annually and includes: the names of the nursing homes associated to the VA system, one to five star ratings for quality of environment, care, and staff based on unannounced on-site surveys at each facility from which an over all-star ranking is assessed for each facility based on the criteria scores.

The mandate for more transparency regarding veteran care began with other internal statistics that are now publically published including:

The VA is the first hospital system nationwide to publish these statistics. “Now that VA has made a commitment to reporting accurate quality and comparative data on its nursing homes, we are pleased to begin adding that important information to our transparency portfolio for the benefit of Veterans in making their health care choices,” said Acting VA Secretary Peter O’Rourke.

Of the 133 nursing homes ranked, 34 earned an overall 5-star ranking. 73 nursing care facilities experienced no relevant change in quality. One nursing home dropped from a 5 to a 4-star ranking but still retains a reputation for quality VA care. The acting VA Secretary is determined to use best practices to lift the 11 worst scoring; one star rated nursing homes to viability and overall drive improvements across the VA nursing home system.

The ranking system used within the VA system was designed to allow valuable comparisons to the already existing 5-star ranking system by the Centers for Medicare (CMS), a federal agency within the Department of Health and Human Services. The VA nursing home interactive map helps you identify your best options. Then you can compare those options against Medicare.gov Nursing Home Compare searches.

Overall the data shows that the VA nursing home system ranks very close to private sector nursing homes, even though the VA nursing homes on average cares for sicker patients than those in private care facilities. Of the 15,487 nursing homes ranked by CMS, almost 29 percent had 5-star rankings, compared to about 26 percent of VA nursing homes. However, the VA had only an 8 percent one-star ranking compared to 13 percent for CMS ranked private care facilities. It should be noted that because the VA does not turn away eligible veterans and they typically come with more complex medical conditions it is more difficult for the VA nursing home system to achieve higher rankings. Of course, these are just statistics, and while they help with the overview of options, this is a veteran’s story of care; it’s a story about people who served this country.

VA nursing home patients tend to have more numerous and challenging medical conditions than their private sector counterpart’s patients. Residents in a VA nursing home have conditions rarely seen in private nursing homes including higher incidents of prostate obstruction, spinal cord injury, mental illness, homelessness, PTSD, and combat injury. While a private sector facility can selectively admit patients, the VA will not refuse service to an eligible veteran no matter their condition.

Transparency of VA nursing home care and ranking systems that allow comparison to private care facilities can significantly help you or a veteran you love get the proper nursing home care required. There is a lot of information to understand how your specific military service record ranks you within the VA health care system in general and then explicitly applying those conditions to an adequately ranked nursing facility. If we can be of assistance, please don’t hesitate to reach out.

VA Mission Act not Living up to Expectations

It is no secret that the Department of Veterans Affairs (VA) has faced criticism in the past for its treatment of wounded veterans and their caregivers. On June 6, 2018, President Donald Trump sought to remedy this by signing the VA Maintaining Systems and Strengthening Integrated Outside Networks Act, or VA Mission Act. The Act was primarily designed to provide options and aid to expand private health care options through the VA. The Act also will eliminate, in stages, the previous limitation for caregivers of veterans who were wounded before 9/11 to receive government training and stipends.

Before the Act was passed by an overwhelming majority in both the House and the Senate, Representative Phil Roe, (R-TN) chairman of the House Veterans Affairs Committee, warned Congress to ensure that the VA has the resources to implement such an expansion. In a statement published by the American Legion, Roe said, “There has been miscommunication, confusion, and frustration from veterans, caregivers, and VA employees alike concerning practically every aspect of this program — from eligibility determinations to clinical appeals to revocations and more,” he continued, saying, “no veteran and no caregiver from any generation is well-served by having access in name only to a program that has the deficits this one does and is as ill-prepared as this one is to accept a sudden influx of new beneficiaries with complex, widely different caregiving needs from those veterans the program is currently serving.”

Roe’s foresight proved to be true as the VA and Congress have both struggled to provide direction and funding to move the program forward. The Senate estimates the cost of the Act will be around $55 billion over the next five years. However, Congress and the White House are locked in disputes over how to fund the program. As for the caregiver support portion of the Act, the cost is expected to be about $3 billion per year and increase from 21,000 veterans served to over 150,000 veterans and their families.

When the Act was signed, $5.2 billion in funding was provided to keep the current Veterans Choice program running through May 2019. Where funding will come from beyond that point continues to be unclear. Part of the reason for the funding crisis is that when Congress passed the VA Mission Act, it moved funding from mandatory appropriations to a discretionary program which must fit into overall domestic discretionary caps. However, the discretionary budget cap for 2019 and the projected caps for 2020 and 2021 do not include the increased costs necessary for implementing the Act, thus possibly leaving Congress with the inability to fund the program.

Eligibility for caregivers to receive training and financial assistance continues to plague veterans and their families. Congress still struggles to define exactly which veterans and caregivers are able to receive assistance. Currently, only post-9/11 veterans and those who suffered “severe, service-connected wounds or injuries” before May 1975 are eligible for benefits.

We will continue to post updates as Congress and the White House work out ways to pay for the VA Mission Act to take care of our veterans who have already done so much to take care of the citizens of this country. Please do not hesitate to reach out to our office if you have any questions.

 

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