Secrecy Nursing Home Performance

Trump’s VA Boasts Of Bucking Obama-Era Secrecy In Agency Press Release

In another curious press release from the Department of Veterans Affairs, the agency’s propaganda arm highlighted its release of nursing home ratings as bucking Obama-era resistance to transparency.

“For years, the Obama administration had resisted making certain VA quality data public. But under President Trump’s leadership, transparency and accountability have become hallmarks of VA,” wrote a VA public affairs official.

The statement is not exactly accurate in that VA is the most corrupt agency in the Cabinet and has resisted transparency for decades, not just under President Obama.

RELATED: Is Fixing Wait Time Fraud Like Boxing A Glacier?

But truth be told, the Obama Administration did allow the massive cover-up of the wait list scandal where veterans died as a result of the fraud scheme where vets went without care and died to help VA managers receive bonuses with artificial numbers.

He also allowed disbanding of the Office of Medical Inspector in 2014 to allow each VA medical center to investigate its own wrongdoing. Sloan Gibson reportedly shut down the investigation office with the intent of obfuscating review to avoid excessively tarnishing the agency’s reputation.

RELATED: VA Shuts Down OMI In Middle Of Massive Wait List Scandal

And guess what? America was treated to a whitewash of the scandal while practically all wrongdoers were allowed to retire.

Today, we still see a fair amount of corrupt officials in positions of authority playing shell games with assets owned by American taxpayers working against veterans rather than for them. Congress passed the Accountability Act to deal with these remaining cling-ons only to have whistleblowers pushed out of the agency at an increasingly fast rate.

RELATED: VA Creates New Wait Time Problems To Fix Old Wait Time Problems

Let’s hope President Trump does not repeat the sins of Obama by brushing scandals under the rug in favor of positive optics in the press. Instead, President Trump has an incredible opportunity to fix decades of wrongdoing – – starting with the remaining cling-ons.

VA Nursing Home Data

The newest data release in question focuses on VA nursing home care quality, and how those 130 community living centers compare with the private sector, highlighting that VA “on average cares for sicker patients in its nursing homes than do private facilities.”

RELATED: Phoenix VA Official Retires After News Scandal Erupts On TV News

Ramping up the rhetoric, a VA spokesman wrote, “In fact, the overall star rating for VA’s nursing homes compared to the 15,487 private sector nursing homes rated by the Centers for Medicare and Medicaid Services (CMS) shows that VA has a significantly lower percentage (34.1 percent lower) of one-star, or lowest rated, facilities than the rest of the nation.”

“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.

RELATED: Voodoo Medicine Used To Investigate Phoenix VA Deaths

“Further, we will release this data annually and use it to drive improvements across the VA nursing home system, including aggressive efforts to improve our 11 one-star facilities by sharing best practices,” he said.

The present release follows a series of other moves toward transparency about:

How VA Nursing Homes Compare

Below is the remainder of the press release in italics:

How VA Nursing Homes Compare with Private Sector

The best comparison of VA nursing homes to the private sector is in the overall star rating. Using that overarching and most important metric, VA’s performance compares very closely with that of the private sector. See here for a comparison of quality ratings using CMS’ Nursing Home Compare Five Star Quality Rating System as of April 2018.

VA’s Unique Patient Base

Of note, VA nursing homes often serve residents with more numerous and challenging medical conditions than do private sector facilities.

Specifically, VA nursing homes serve a much higher proportion of residents with conditions such as prostate obstruction, spinal cord injury, mental illness, homelessness, PTSD, combat injury, terminal illness, and other conditions rarely seen in private nursing homes. 

Also, private sector nursing homes admit patients selectively, whereas – unlike the private sector – VA will not refuse service to any eligible Veteran, no matter how challenging the Veteran’s conditions are to treat. In other words, VA nursing homes often house residents with more complex medical needs that private sector facilities will not accept, which makes achieving good quality ratings more challenging.

As a result, VA nursing homes at times rate lower than private sector facilities on specific metrics such as pain and type of treatment. Despite that fact, VA nursing homes compare well with private sector facilities in overall facility rankings.

VA Nursing Homes Provide More Direct Nursing Care

Additionally, VA nursing homes have a higher staff-to-resident ratio than private sector facilities, meaning residents in VA facilities get more direct attention from nursing home staff than do residents in the private sector.

Next Steps

So do we buy the ramped up rhetoric or do we maintain a wait and see approach? Please chime in if you have an experience or know of a loved one who is living in a facility. Are they improving or is the report more bean-counter-hype?


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  1. All these lies are enough to validate why Veterans are committing suicide. Providers will lie and plot to vilify a Veteran. Patient Advocates will not advocate for patients. I have personally witnessed a Check in Clerk tell a Veteran if he didn’t like the way he was speaking to him, he could go to United Health Care? When the Vet told the Clerk he could go F*%! himself, the Clerk called Security stating the Veteran was “threatening.” When I brought this up to a Provider, stating that the Veteran was antagonized by this Clerk. There was nothing threatening, other than the Clerk being disrespectful and escalating- provoking the Veteran’s anxiety, the Provider stated he would be sure to get the story straight. Months later I encountered this same Clerk, different location, but same attitude. Tried to tell me I was wrong with appointment information; I was not on the schedule, and Provider would not be able to squeeze me in…..I requested he at least check with Provider, in the meantime I found my appointment card, went to another floor and checked in on a Kiosk machine; called the Provider’s Nurse from my cell phone and requested a Wheelchair escort. I made no mention of Clerk’s comments to me, but ‘mentioned’ to Provider that I almost missed my appointment and she stated how backed up she was. There were no other patients in her exam rooms, and her Nurse who had come to escort me thanked me for coming in early, so that Provider could leave early too. I had bypassed this Clerk altogether. Cannot believe anyone, anything when it comes to VA. Unfortunately, many of us cannot afford private HealthCare, nor the monthly premiums of Medicare. We have earned the right to be treated respectfully, starting with giving us Choices to outside Healthcare. The only way to stop this once and for all is to close down VA facilities. If they can’t find quality Health Care Providers to staff their over burdened facilities, shut them down. Or better yet, have them join the real Military and Serve, work a Real 40hrs/week. Walk in our Boots.

  2. cj ¯¯̿̿¯̿̿’̿̿̿̿̿̿̿’̿̿’̿̿̿̿̿’̿̿̿)͇̿̿)̿̿̿̿ ‘̿̿̿̿̿̿\̵͇̿̿\=(•̪̀●́)=o/̵͇̿̿/’̿̿ ̿ ̿̿ says:

    They “simply don’t give a damn and show it well.” is exactly right T.

    Just as DaveF
    “Never trust a medical care provider who has a financial interest in your death.”

    Your both exactly right. I have nothing to add.

    Later gators -!ii!-

  3. cj ¯¯̿̿¯̿̿’̿̿̿̿̿̿̿’̿̿’̿̿̿̿̿’̿̿̿)͇̿̿)̿̿̿̿ ‘̿̿̿̿̿̿\̵͇̿̿\=(•̪̀●́)=o/̵͇̿̿/’̿̿ ̿ ̿̿ says:

    Vote out any politician who wants to protect any union members job, over the proper care of a Veteran.

    Fuck all of you goddamn useless pussies called politicians, grow a pair and put these damn unions in their proper place, behind Veterans, not in front of them.

    You better heed this, assholes, there are many more Veterans then there are union members, you best start catering to the right crowd, you mangy jackals.

    Thanks for the link T.

    1. Hell. cj go take a look my FaceBook page at how I am being black balled locally from getting health care since the VA threats and crap. Union hospital, UAP clinic refuses to pass my med files along to a new MD since I have been chased away by them too using the same VA tactics and meddling in our files, playing nice and then creating all the maliciousness and chaos they can.

      Went up two days ago to sign papers to get copies to hand-carry. One phone call back and no records to pick up yet. Been four weeks for the files to forwarded to the new MD per chance I’ll be seen by him. A woman’s word claiming she’d have my own copies in no time but have to buy them. Nothing. VA orientation slime said if I left the VA I’d never find health care in Indiana again since the VA, IU controls it all. Plus some others. The scum must have been telling the truth on that threatening point.

      That’s how life is in a corrupt “Union Strong-hold town” ruled totally and totalitarian styled by one political party being Democrats. The same ones we were told at the VA to vote for for better health care. A far lefty 3 college town to boot. You piss off one person in the VA, report wrongs, try to get medical boards involved and any others that might help and end up totally shunned and a house damn near burned down and much more.

      We do not live in America any longer, far from it. Plenty of fear, corruption, lying media, lying government, lying phony elected officials… zero rights or protections they all claim is there for us. Try living in a closed off community full of haters, lefties, psychos and a community that simply puts up a big facade and very little reality. Damn sad when unions, professionals, elected officials locally and state-wide, media and more simply don’t give a damn and show it well.

  4. “”

    Busy, following.

  5. It’s a mess! Trump using to get Mueller off his ass. The VA can’t be fixed and Obama should be call an asshole on TV, solving problems by not letting people know problems. Now that’s the VA way of dealing with everything. Delete, erase and deny. If he can we can! Fuck them all

  6. @DaveF
    “Never trust a medical care provider who has a financial interest in your death.”

    1. @Ken,
      Thank you, but note please that I was quoting DaveF!
      Thank you for that breakdown.

  7. 06/13/2018

    Dear Benjamin Krause,

    ““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.
    ‘Further, we will release this data annually and use it to drive improvements across the VA nursing home system, including aggressive efforts to improve our 11 one-star facilities by sharing best practices,’ he said.”

    What was before????

    What happened to Lean Management, Deming, Six Sigma, etc…corrective actions reports [CARs]? I was next to the military at the LA Times in 1989/1990 at the Deming Meetings put on by Ernst Young Accounting sponsors. And Peter Drucker at Claremont University was not shy about his opinions at the time.

    All the smart doctors did not need the reports? Or were they just overworked and underpaid?

    Or was that top management did not want to know? Paperless Reagan which set the trend for the following administrations.


    Don Karg

  8. My experience in the VA Nursing Home section of the VA RMC DC.
    Given aspirin instead of Tylenol #3.
    Patient in next bed needed a 24 hour monitor which wasn’t available for his TBI residuals.
    I was low need and he was high need. I feel I was admitted because of my Hospital corpsman background to be the patients 24 hour long term watch. My problem was minimal arising from no wheel chair accessible apartment that I could afford.

  9. Instead of VA Star Ratings, I propose we change this rating system to be completely transparent, this new system will reveal through complete transparency which VAMC’s are absolutely worse, rather than which one’s the better flavored shit jellybean.

    The new rating system will simply be a series of asshole ratings:

    5 Assholes= Run for your life, don’t look back, because even the uncooked chicken has left the scene.
    4 Assholes= I’d still run but you may get an airlift assist by the vacating flies from operating rooms.
    3 Assholes= Legionnaires Disease is likely in water supply and even the CDC can’s fix it. Still, run!
    2 Assholes= This is the number of Patient Advocates sharpening their claws awaiting your arrival.
    1 Asshole = All it takes to soil good thing, like that one kid that shits in a swimming pool…same effect.
    0 Asshole = Easy, this is obviously a vacant VAMC with asshole remediation complete. Safe for Vets.

    Any questions, consult the assholes in-charge for full transparency…mind that gas cloud…

    1. Get rid of the VA and let all of us get the highest level care in the outside world. The “Choice” program is not really a valid choice because only doctors who accept as medicare the sole source of payment are not really the Doctors of CHOICE.

      1. I can state clearly and concisely that the VA in Florida is in fact the most corrupt government agency in Florida, bar none. And North Florida, Gainesville specifically, is more corrupt than the rest of the State. I’ve been involved in one way or another the VA in Cleveland, Ohio. In Tuscon, AZ, Seattle, WA and Charleston, SC. I would rate Charleston the best, Seattle 2nd and Gainesville, FL dead last, no pun intended.
        And Rosie, you just described the reason why the VA is so corrupt and only needed 14 words to spell it out precisely!

  10. Never trust a medical care provider who has a financial interest in your death. If they can expedite your passing, they will save money. The history of the VA has been that they can provide good health care for low to medium level heath issues such as a diabetes, blood pressure, sleep disorders, and in general anything that doesn’t require invasive medical treatment. But cross over that threshold of invasive care, and your mortality rates start to drastically increase. The VA practices money care, not medical care. If you primary care doctor wants to send you for an MRI or other expensive medical test, there is a series of hoops you have to go through. Physical therapy for starters. They don’t want to know what is wrong with you, they want to manage you demise not cure and help you live longer.

    There are so many ways that the VA could save money and still give Veterans higher quality medical care. First, do away with the current system. Before the first penny is spent on Veteran care, billions are spent on salaries, benefits, maintenance, and utilities. Throw in new building costs, parking garages, and payouts from malpractice lawsuits and you have billions in cost that could instantly be used to provide private medical care to Veterans by medical providers in the private sector. Some Veterans, like myself, have medical insurance from where we work or from our retirement benefits. If the VA paid our co-pay on our private medical insurance, the cost savings go up.

    The massive cost to provide the first medical care to Veterans through the current system is only going expedite the deaths. We need change today but sadly, it is like trying to stop a ship in the ocean after it was going 1,000 MPH. I had high hopes President Trump would turn this around and maybe he will before his term or terms are complete, but judging from his picks to lead the VA, that hasn’t happened nor will it happen.

    God bless all Veterans. We suffer from our service related medical issues and some of us don’t have private insurance. Maybe one day, our politicians will give us the honor and respect they love to talk about in speeches but fail to deliver on when they go back to DC to pad their pockets and make sure to guarantee their kids go to Harvard or Yale paid for with insider trading deals that would put you or I in jail. I guess we need a new revolution but that will never happen. Americans are too complaisant and won’t put their lives in harm’s way to pay for the freedoms they love to protest for back on main street.

  11. My buddy’s wife, up in Illinois, wants to put him in a VA nursing home.
    This is what he said, “NO!” “Because once your in there, within six months you die!”


  12. Seriously, if Acting VA Secretary Peter O’Rourke approved the press release titled “VA Extends Record of Transparency with First-Ever Posting of Annual Nursing Home Ratings”. He needs to be fired immediately!!!

    The VA’s press release is nothing more than a piece of very poorly written VA propaganda. The propaganda is so poorly written it is a total insult to the intelligence of all Veterans who read it.

    The VA’s press release tries to make the claim the VA’s star rating system is comparable to the star rating system used by the Centers for Medicare and Medicaid Services (CMS) to rate nursing homes that CMS certifies. The VA is deliberately being misleading with their bogus star system that is not based on same types of data used by CMS.

    How the VA star rating system worked:

    A link from the press release at the VA website leads to a poorly written Excel spread sheet that shows the data used by the VA. To calculate the star ratings for each of the 130 nursing homes attached to a VAMC. The VA first rates the data for each nursing facility in its own 5-star system. Creating ratings between 1 to 5 stars for surveys, staffing and quality data. Then then provide an overall star rating for each of the nursing facilities.

    Survey star ratings-
    The survey ratings show that more than 70% of the facilities received a score of 3, 2 or 1. In other words 70% of the VA facilities scored less than average.

    Staffing star ratings-
    The VA gave all but 3 of its facilities a 5-star rating. Hampton VAMC received a 2, Tomah VAMC received a 3 and Cincinnati VAMC received a 4. Other wise the VA gave 5 stars to the remaining 127 facilities.

    Quality star ratings-
    The quality ratings show that 102 of the VA facilities scored only 1 or 2 stars in the quality of care rating for the facility. In other words, 79% of the VA facilities failed to provide even average quality of health care at their facilities.

    How the CMS star rating system worked:

    CMS creates the overall star rating for nursing homes from 3 parts: 1) Health inspections 2) Quality of resident care measures and 3) Staffing.

    Clearly the VA is trying to blow smoke up everyone’s butt with the bogus rating system they used for this press release. Substituting a VA survey for health inspections reports that is totally bogus and meant to mislead.

    Another thing worth mentioning is that CMS rates all of the nursing facilities it certifies for the ratings the VA claims they are matching. That is about 15,487 private sector nursing homes rated by the Centers for Medicare and Medicaid Services (CMS).

    While the VA chooses to ignore the 1,000s of state county and local nursing facilities that the VA is required to inspect and certify. They then only use the nursing homes that are attached to a VAMCs for their calculations.


    VA’s Excel Worksheet

    CMS Star ratings

    1. Just want to repeat the following which is based on the VA Excel worksheet.

      Quality star ratings-
      The quality ratings show that 102 of the VA facilities scored only 1 or 2 stars in the quality of care rating for the facility. In other words, 79% of the VA facilities failed to provide even average quality of health care at their facilities.

      So only about 20% of the VA nursing homes provide average quality of health care at their nursing homes. 80% of the VA nursing homes “do not” even provide average quality of care.

    2. Great sleuthing, Seymore Klearly! Transparency seems a tad opaque in certain light. 😀

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