The Veterans Affairs office spends more than $1 billion yearly funding state-run nursing homes, while requiring only a single annual safety inspection, public records show.  This once-a-year inspection is performed by a third-party contractor, and for many years, watchdogs and advocates have questioned why these homes aren’t monitored more closely and felt the funding is misdirected.  Then, when the coronavirus pandemic hit and nursing homes were plagued with infection (some of the highest rates in the country), the issue took center stage.“More than 1,400 people (at least 1,394 residents and 40 staff) have died of coronavirus in 110 state veterans homes,” according to a POLITICO analysis.  And those who pulled this data expect that it is even higher.  Counts from another 48 homes, mostly in the South, haven’t been made public, and many of these homes are now reporting high rates of the Delta variant.

Photo by Lucas Alexander on Unsplash

State VA facilities tend to have higher clusters of death rates than non-VA facilities, in general, “110 at a 126-bed home in western New York, 62 (plus two staff) in one at the southern tip of Maryland, 47 at a complex in rural Wisconsin, 44 near the shore of Lake Erie in Sandusky, Ohio,” the data shows.“For a long time, the state veterans homes were neglected,” said Linda Schwartz, a former Air Force flight nurse who ran veterans affairs for the state of Connecticut. “It’s been terrible, and in some ways shameful.”Despite the fact that the homes are funded by the federal government, a VA spokesperson insisted that the agency doesn’t control the conditions so the funds can’t be misdirected, stating, “The State Veterans Homes (SVH) are owned, operated, and managed by the states.  VA has no authority over the management or control of any SVH other than that single yearly inspection.”The federal government offers another type of long-term care to veterans, called “community living centers.”  The VA, not the states, directly runs those centers.  State homes serve a little more than twice as many people as the federally run community centers, but their pandemic-Congress has funded some VA nursing home Covid expenses and allocated funds to renovate older homes, but the regulatory body has yet to address the poor oversight protocols.“What Congress did is not the big picture fix,” said Rep. Ed Case (D-Hawaii). “What Congress did is address this specific crisis as best as we could then. But fundamentally – is this the best way to operate a veterans care system across the country?”In states that have chosen not to make the veterans homes live up to the same standards that apply to other nursing homes the main source of oversight is the VA itself.  Sometimes, the federal Centers for Medicare and Medicaid Services provides a say in patient safety and care.  This state-federal structure only creates gaps in accountability and makes it easier to point fingers when things go wrong.Congress is now putting more than an additional $1 billion into the homes for renovations, and yet, this money continues to be misdirected and accountability gaps remain.  This is as structure that is just not working, and advocates remained appalled by the lack of adequate oversight and the high number of coronavirus deaths.

Sources:

Sadness and death: Inside the VA’s state nursing-home disasterAmong Nursing Homes Hit by Covid-19, Veterans Homes Struggled the MostThe Impact of COVID-19 in State Veterans Homes