There is a recent article from the Washington Post about several suspicious deaths at a Veterans Administration (VA) Hospital in West Virginia:
"An investigation into the suspicious deaths of 11 veterans, who may have been given deadly insulin injections at a West Virginia VA Medical Center, is reportedly focusing on a nursing assistant who worked the overnight shift and had “improper access” to a supply room. The woman, whose name was withheld by the Washington Post, was fired from the facility last year and has not been charged. Seven veterans’ bodies have been exhumed as part of the homicide probe, which has raised troubling questions about the Department of Veterans Affairs’ health-care system. “You mean to tell me that for nine months you didn’t know what was going on in your hospital?” Sen. Joe Manchin told the Post. “Either you didn’t care, or there was a lack of competency.”
In one instance, a non-diabetic man had a progressively decreasing blood glucose, without known cause, and died shortly thereafter.
This is just the latest in a string of issues at various VA Hospitals:
August, 2019 a former VA pathologist in Fayetteville, Ark., was indicted on three charges of manslaughter after officials say he misdiagnosed thousands of patients while using drugs or alcohol.
In Beckley, W.Va., a former VA doctor is under investigation for sexually assaulting as many as 20 of his male patients, according to two people familiar with the case.
Should the VA Hospitals be overhauled? There are many other issues at VA hospitals all over the US. From USA Today:
At the Loma Linda VA Hospital the average wait time in the ED is >7 hours
Almost all VA Hospital fare worse than their civilian counterparts in patient satisfaction surveys
In 2014, the Phoenix VA came under scrutiny when it was reported that vets were dying while waiting for appointments.
Equipment sterilization issues in a Washington VA Hospital
How should this be addressed? The VA says they care for elderly, very ill, sometimes immunocompromised patients. In June 2019 the VA published information about the new Veterans Community Care Program and here are some of the details:
Veterans can work with their VA health care provider or other VA staff to see if they are eligible to receive community care based on new criteria. Veterans may elect to receive care in the community if they meet any of the following six eligibility criteria:
A Veteran needs a service not available at any VA medical facility.
A Veteran lives in a U.S. state or territory without a full-service VA medical facility. Specifically, this would apply to Veterans living in Alaska, Hawaii, New Hampshire and the U.S. territories of Guam, American Samoa, the Northern Mariana Islands and the U.S. Virgin Islands.
A Veteran qualifies under the “grandfather” provision related to distance eligibility under the Veterans Choice Program.
Is this enough? It's a start for sure. It is yet to be seen if this initiative will improve care to our vets.
As a veteran do you trust the care at the VA? Do you use the VA?
I concur on the rebuilds and opening new facilities. We did get a new clinic recently and it is nice. It did have a leaky roof which delayed the opening. I was reminded of the movie space cowboys where the Russian cosmonaut commented about what do you expect when your parts are built by the cheapest bidder. In the VA hospital I worked at we usually carried a water bottle and a urinal when we got on an elevator. You never knew how long you were going to be in it as they broke down so frequently.
We had a very good husband and wife MD team until politics chased them away. Now we have a another guy on loan from a different clinic. Scuttlebutt is he isn't very happy either.
I definitely concur about the need for more administrators that are veterans.
I mean some of these hospitals were built in the early 1900's! I will say some of the good things about the Mission Act is it allows vets to get care the VA cant provide (for my facility its neuro) and it forces the VA to up their standards since they have to compete with the big boy hospitals in my area.
The Veterans Administration (VA) needs to get out of the healthcare business and stick to administering benefits. That might also help with the backlog in claims in the Veterans Benefit Administration (VBA).
The Veterans Health Administration (VHA) has no competition. It is competition in healthcare that fuels quality, innovation, value and safety.
The VHA has no real oversight -is it's own watchdog and cannot be trusted to police itself. The VHA tracking its own quality metrics is a joke.
As a service-connected Veteran, I say we deserve to have a choice in where we receive healthcare. There is nothing the VHA does that the private sector cannot provide.
The VHA should be eliminated and proceeds used to fund insurance. We could use that insurance to get our care where we choose rather than relying on a failed corrupt healthcare system that is killing Veterans.
Most private sector healthcare organizations in the U.S. are not-for-profit organizations which promote a culture that’s service-driven. The private sector could compete to earn the Veteran's insurance dollars adding value, safety and quality to Veterans healthcare.
OMG, not-for-profit? typically means we don't give big raises we hide the money as bonuses. Many CEOs make more than the top doctors at the facilities. There was a push by Concerned Veterans of America to move away from VA healthcare. They were funded by the Koch brothers and if it concerns Koch industries it is probably going to be good for Koch also. Every other Veterans group that I know of has opposed that move to privatization. Putting veterans into the claws of private health will mean lengthier stays, testing of questionable worth and unnecessary procedures.
I too am a disabled veteran and when I had to go the the local ER for chest discomfort I was admitted for "observation". The nitro relieved my severe indigestion and my EKG and labs were normal so I stayed for R/O MI. The first thing they did was loose my paperback. The next thing was put me on telemetry and then come in with sequential compression devices as I was on "strict bedrest", I declined both orders. Next was lab was in to re draw a CBC as mine was "abnormal", it was 1% off of the average, Every other value was WNL. Next was to redraw my CK MB and I expected that. It too was WNL. A couple of ours later they came in to do a D-dimer. Odd I thought as I had zero symptoms of a PE. I declined that one also. Unbeknownst to me one had been added to my initial labs and it too was normal.
8 hours later the last of my serial enzymes is drawn, My EKG was repeated and was without change. the blood came back also without change. Yay! I've ruled out and am ready to go home. Nothing happens. I hit the call button and my nurse comes in. I ask her what's holding up my discharge and she says, "I'll call the PA". He's in shortly and says the hospitalist wanted to do a fourth enzyme that night and check my cholesterol in the morning!
This turns a less than 24 hour stay into a greater than a day stay. To the best of my knowledge 3 normal serial enzymes are still the standard of care for R/O MI. Checking cholesterol in a hospital setting is rarely needed urgently and if not can always be done as an outpatient. I looked at the the PA, said "My 3 sets are normal and my EKG is without change. If you think I still need to stay in the hospital I want to transfer to a higher level of care. In my case that is a VA hospital. You know with three normal MBs and no change on the EKG they will refuse the transfer and tell you to discharge me to followup with my primary care provider. I was then discharged.
Bill padding? Staggering the lab draws for the repeat CBC and again the repeat D-dimer adds 2 charges for the blood draws. Telemetry was invented way back in the olden days when I was a younger nurse. It was great because it allowed ambulation in the room. Strict bedrest means a charge for SCD's. I can almost agree with a D-dimer as part of an additional initial workup but there were no symptoms of it.
Adding the fourth CK MB was padding as was wanting to keep me overnight for a cholesterol prior to discharge. Seriously?!
As an aside the cholesterol was ordered because of my history of high cholesterol except for that I don't have it. My VA doctor liked to put veterans on the low dose statin's to keep hypercholesterolemia from becoming a problem. They got the dose wrong when they generated my med list. It also never occurred to them to ask when I had it checked last. It was completely normal 8 days prior when I had last seen my doc for a routine visit.
Next unwanted outcome was leaving the hospital with a history of HTN on my H&P. Reason was my med list showed beta-blocker use. Never had HTN and went on the beta-blockers for frequent PVCs. But once again the doctor never asked.
The most upsetting was being discharged with a history of Alzheimer's. I was an Army medic 50 years ago and the experience gave me PTSD. Working ER for 25 years exacerbated the disorder. I also had a probable TBI when my aid station was blown up while I was inside of it. As I've aged (I'm 2 weeks from 70) I worry about cognitive decline. Because of those concerns I went through a 2 day neuro-psych exam and was found to have no deficits. My VA PTSD doctor put me on Namenda because he felt it might slow the normal cognitive decline of aging. Never diagnosed with Alzheimer's but ips fcto ,the hospitalist put it in without asking about my history.
When the bill came due I was not personally worried as my VA disability rating is high enough that the VA pays for my emergent care. When the VA reviewed the charges they declined to pay many of them.
Getting the VA out of health care is not a good idea unless you are into enriching the movers and shakers in the heath care industry.
The VA is also doing cutting edge research on spinal cord injury as well as TBI injury.
It is not with out problems but fixing the problems should be where the emphasis is, not on eliminating the problems by eliminating the VA.
I worry about any one of my relatives getting care there.We have been told by some that the care was good but they actually could not afford anything else.I have never heard anything great about VA in all my years in nursing,either for a patient or to work there.
The Veterans Administration (VA) needs to get out of the healthcare business and stick to administering benefits. That might also help with the backlog in claims in the Veterans Benefit Administration (VBA).
The Veterans Health Administration (VHA) has no competition. It is competition in healthcare that fuels quality, innovation, value and safety.
The VHA has no real oversight -is it's own watchdog and cannot be trusted to police itself. The VHA tracking its own quality metrics is a joke.
As a service-connected Veteran, I say we deserve to have a choice in where we receive healthcare. There is nothing the VHA does that the private sector cannot provide.
The VHA should be eliminated and proceeds used to fund insurance. We could use that insurance to get our care where we choose rather than relying on a failed corrupt healthcare system that is killing Veterans.
Most private sector healthcare organizations in the U.S. are not-for-profit organizations which promote a culture that’s service-driven. The private sector could compete to earn the Veteran's insurance dollars adding value, safety and quality to Veterans healthcare.
I think the VA does a far better job with SCI and TBI than private sector. I think they also do a very good job with prosthetics. I work at the VA and my medical center is one of the better ones. Alot of our vets like the care they receive. If we cant do a procedure they are sent to a large medical center that is 5 minutes away (they also have a partnership with the VA).
Unfortunately the media focuses on the bad and not the good the VA does. It isnt a perfect system. Neither is the private sector. There are large hospital systems that make mistakes, kill patients. The reason you dont hear about it is because they are able to settle out of court. The VA is government funded therefore they cannot.
I strongly disagree with giving insurance companies more government dollars. They are one of the primary reasons why we are in the mess we are in.
If you think dumping vets on private sector doctors will make them seen faster you are mistaken. Sometimes it takes me months to schedule an appointment. There will be an even bigger backlog.
As far as TBI SCI goes, the work the VA does is in partnership with academic institutions and the private sector. If we eliminate the VHA the private sector will pick up where the VHA left off and do a better job than the VHA did.
The problem with our Veteran Service Organizations is they get money from the VA and that is why they are losing members. The American Legion recently dropped war-time service as a membership requirement -which shows how desperate for members they are considering the eligibility period went back to 1990. I did not renew my membership in the Legion this year for that very reason.
The VHA is going away and all the big money, paid holidays, generous benefits and retirement for VHA employees and all the will be transformed into better healthcare for Veterans.
It's not about "dumping Vets on the private sector" -it's about giving Veterans choice and control of their healthcare rather than depending on a bloated bureaucracy that has failed as a healthcare system. Veterans have earned the right to choose where they get healthcare -gubberment cheese is not what we need.
As far as TBI SCI goes, the work the VA does is in partnership with academic institutions and the private sector. If we eliminate the VHA the private sector will pick up where the VHA left off and do a better job than the VHA did.
The problem with our Veteran Service Organizations is they get money from the VA and that is why they are losing members. The American Legion recently dropped war-time service as a membership requirement -which shows how desperate for members they are considering the eligibility period went back to 1990. I did not renew my membership in the Legion this year for that very reason.
The VHA is going away and all the big money, paid holidays, generous benefits and retirement for VHA employees and all the will be transformed into better healthcare for Veterans.
It's not about "dumping Vets on the private sector" -it's about giving Veterans choice and control of their healthcare rather than depending on a bloated bureaucracy that has failed as a healthcare system. Veterans have earned the right to choose where they get healthcare -gubberment cheese is not what we need.
I can say with 100% certainty the private sector hospitals would not do a better job with TBI and SCI patients because they dont deal with either if those populations.
While I agree there are alot of bloated salaries in the VA its mostly upper administration.....the same issue in private sector. You sound very bitter. The VA offers great benefits, its one of the perks of working there. I never understood why people who dont enjoy the same benefits at their employer dont try and fight for the same. You would rather see those who do enjoy those benefits be miserable like you.
Alot of the RNs I work with at the VA bust their tail day in and day out. Again, dont paint the whole VA as the same just because of a few bad medical centers.
What about the vets who do enjoy their care at the VA? If you close the VA you are dumping those vets in the private sector. You seem to be only considering one half of the patient population. Not every vet dislikes the VA and is satisfied with their care.
I can say with 100% certainty the private sector hospitals would not do a better job with TBI and SCI patients because they dont deal with either if those populations.
Alot of the RNs I work with at the VA bust their tail day in and day out. Again, dont paint the whole VA as the same just because of a few bad medical centers.
The VHA isnt going anywhere, sorry to say.
Em, yes civilians suffer TBI & SCI every single day too and are treated in the private sector. And PTSD too for that matter.
Just because they VHA says they can do something better than the private sector does not mean that they can. They also said they reduced wait times then it came out they were cooking the books.
"A few bad medical centers" -the VHA is in the news everyday it's one scandal after another, from VISN to VISN across the country. If the VHA was a private sector healthcare organization they would have been out of business a long time ago. Veterans deserve better! Veterans deserve choice!
What about the vets who do enjoy their care at the VA? If you close the VA you are dumping those vets in the private sector. You seem to be only considering one half of the patient population. Not every vet dislikes the VA and is satisfied with their care.
A 50% patient satisfaction rating?
Hardly something to brag about let alone something to justify spending $220.2 billion a year on a failed healthcare system that is killing Veterans.
If a private sector healthcare organization scored a 50% on the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey the Centers for Medicare & Medicaid Services would put them out of business.
While I agree there are alot of bloated salaries in the VA its mostly upper administration.....the same issue in private sector. You sound very bitter. The VA offers great benefits, its one of the perks of working there. I never understood why people who dont enjoy the same benefits at their employer dont try and fight for the same. You would rather see those who do enjoy those benefits be miserable like you.
Don't make this personal. I am not bitter or miserable. I am satisfied the salary and benefits that I earn.
Salaries and benefits should be based on performance and not longevity with automatic step increases as it is with the VHA.
13 sick days annually with no limit on accumulation, 26 days of annual leave, and 10 paid federal holidays-49 days of paid time off a year and salaries that exceed the private sector paid for by the taxpayer.
The VHA's performance does not merit those salaries or benefits.
Organizations that pay good salaries and benefits are the ones that compete and generate revenue. That is the problem with the VHA -no competition and the mentality of many VHA employees that if they do the minimum they will still get their next grade/step and all the benefits.
Bottom line: the VHA is ripping-off the taxpayer and is killing Veterans.
Veterans earned the right to choose where they get healthcare and should not have to depend on a system that fails them on a daily basis.
Becker's Health IT and CEO report, Becker's Blockchain report and Becker's CFO report. are websites for hospital administrators that are worth following for what is happening in the hospital community.
It is seldom that I have a day where I don't read about who is going on trial for fraud, malpractice, or medicare schemes. Or what hospital is laying off staff and or closing. Not all of th news was for out and out crime. Much of it is legal. There was a recent article on one large eastern medical center's policy of suing most everybody who is having trouble paying their bills.
Think about it, Dad is under-insured has a massive MI, runs up a million dollar plus bill and dies shortly afterwards. His savings have already gone to pay bills and now the house he was going to leave the kids is going to be sold by the hospital to pay those bloated executive salaries. In all fairness, other bills will also be paid.
Remember that the Disabled American Veterans, The Veterans of Foreign Wars, The American Legion, The Vietnam Veterans, Paralyzed Veterans of America and AMVETS all came uagainst this new scheme which was apparently hatched in Mar-A-Lago by three crony's of POTUS. All of the high level business executives, none of them in health care.
By all means give the veterans more choice. But presumption that civilian health care will be less costly and better for the veterans could be a GRAVE mistake, Fix it, don't kill it.
OUxPhys, BSN, RN
1,203 Posts
I mean some of these hospitals were built in the early 1900's! I will say some of the good things about the Mission Act is it allows vets to get care the VA cant provide (for my facility its neuro) and it forces the VA to up their standards since they have to compete with the big boy hospitals in my area.