Veterans Administration Making Positive Strides to Improve Inspections & Patient Outcomes

The Department of Veterans Affairs (VA) should be commended for two recent moves to improve the lives of veterans in its facilities and in state veterans homes: bringing volunteers back into facilities and addressing recent inspection recommendations made by the U.S. Government Accountability Office (GAO). The patriots under the care of these facilities devoted their lives to this nation, and we all owe them the same level of devotion in return.

Bringing Volunteers Back

First, the VA’s plan to gradually and safely reintroduce volunteers to its healthcare facilities is an important and timely step. As VA Secretary Robert Wilkie said in a statement announcing the decision, “Volunteers are an integral part of our health care teams, offering fundamental services.” Indeed, volunteers are critical to almost all health care facility operations.

Volunteers serve as some of the most keen eyes and ears in a facility. They are working with vulnerable populations because of their passion for helping others. Introducing these volunteers back in facilities will be an important part of re-establishing oversight of health and safety. Many volunteers have established personal relationships with the individuals they interact with and help care for, and thus serve as a vital link in the chain of communication with VA and other oversight agencies.

Strengthening Inspections

Secondly, the VA is giving serious consideration to recent recommendations made by the GAO, and is beginning the process of making changes. In particular, the GAO’s report called on the VA to strengthen its oversight of inspections conducted in state veterans homes (SVHs).

The VA outsources on-site inspection visits to a contractor. The practices used by one contractor drew particular GAO scrutiny. That feedback was helpful, because the VA deserves the very best from its contractors.

The key takeaways at the heart of GAO’s findings involve transparency and quality assurance.

• Transparency is the quickest one to fix, by simply publishing information about the quality of state veterans homes on the VA’s website.
• As for quality assurance, the VA’s contractor should adhere to regulations from the Centers for Medicare & Medicaid Services (CMS) in conducting long-term care facility inspections.

The Right Contractor Is Key

It’s vital to be clear about the contractor’s proper role:

• The inspection contractor serves the VA, not the facility. The inspection is intended to identify and document deficiencies and report those to the VA.
• The inspector should never cite a deficiency but then collaborate with the facility and allow them to fix the issue during the inspection, nor should the inspector ever tell them how to fix it.

After the inspection and reporting process is complete, the VA may choose to send a contractor in to do a revisit.

• The goal of the revisit is to improve the lives of people in the facility while helping the facility maintain lower costs by not repeating negative practices.
• During the revisit, the contractor works with the facility to develop a plan of correction to make sure the facility makes cost-effective and sustainable changes.

Without a rigorous inspection process that creates a paper trail, a facility could lapse back into negative practices in between site visits and never fully address underlying problems. That would not only put veterans in the facility’s care at risk, but also lead to waste. As a steward of Americans’ tax dollars, the VA suffers when work needs to be redone, forcing the agency to spend additional money.

Selecting a high-quality healthcare facility survey firm can prevent problems. One key to success is ensuring that the chosen contractor has both an impeccable track record and a high-performance company culture with three vital qualities:

• Competence
• Excellence
• Adherence to best practices

We know that the decision makers in the VA responsible for following up on the GAO report’s findings are conscientious and concerned about the well-being of veterans under the care of state veterans homes. Healthcare Management Solutions, LLC (HMS) is prepared to support those leaders in taking the actions GAO outlined.