The Department of Veterans Affairs assigns star ratings, similar to those used by the federal centers for Medicare and Medicaid services to evaluate nonprofit and for-profit nursing homes, to our country’s 133 VA nursing homes. The VA relies on an outside company, the Long Term Care Institute, to conduct inspections of VA nursing homes.
The VA banned the public release of the institute’s findings after the Pittsburgh Tribune-Review in 2009 published the findings of the institute’s assessment of Philadelphia’s VA nursing home that detailed poor resident grooming and other substandard conditions. The newspaper reported that a disabled veteran’s leg had to be amputated because a foot infection was untreated for so long his toes turned black.
USA Today and the Boston Globe recently obtained VA documents showing that 60 of the 133 VA nursing homes received the lowest rating, only one out of five stars, as of Dec. 13, 2017. Of the 11 VA nursing homes in New York, only the VA Hudson Valley Health Care System in Castle Point received five stars. Three VA nursing homes received three stars; four VA nursing homes received two stars; three VA nursing homes, including the one at Canandaigua VA Medical Center, received only one star.
Of the three VA nursing homes that received only one star, Canandaigua had quality ratings even lower than the VA one-star nursing homes in Buffalo and the Bronx. Overall, VA nursing homes scored worse than private-sector nursing homes, even though VA nursing homes have a better staff-to-resident ratio than other nursing homes.
It is not enough to merely upgrade VA nursing homes to the point that they are equal to other nursing homes, because nursing home conditions overall are America’s shame.
Government and university studies have concluded that 10 percent of nursing home caregivers have physically abused, and at least 40 percent have psychologically abused, nursing home residents in America. (These studies are based on information provided by the caregivers themselves, after being assured of anonymity). If you factor in neglect as well as abuse, one nationwide survey in 2010 indicated about 50 percent of nursing home caregivers admitted they have mistreated residents.
Four years ago, the federal Office of Inspector General studied people admitted to nursing homes for Medicare rehabilitative services. One-third of them subsequently suffered from preventable harm, which required prolonged nursing home stays or hospitalization, caused permanent injury, necessitated life-sustaining intervention or resulted in death. If the experiences of people admitted for short-term care are often awful, consider the plight of even more vulnerable long-term care nursing home residents suffering from preventable pressure ulcers (bedsores), dehydration, malnutrition, nasogastric and catheter tube misuse, excessive psychiatric drugging, preventable injuries, inadequate medical and hygiene care and/or brutality or humiliation by some caregivers who are callous and sometimes even sadistic.
Camera monitoring should be implemented at all facilities housing our most vulnerable citizens to help prevent and detect abuse and neglect. Without camera monitoring, fear of reprisals, sometimes violent ones, are realities that often prevent the reporting of abuse or neglect witnessed by conscientious but fearful caregivers, or by residents and their families.
Canandaigua VAMC personnel need to closely examine what Castle Point has done and is doing to earn and maintain a five-star rating, so that Canandaigua VAMC’s nursing home will also attain and maintain a five-star rating. All VA nursing homes should do likewise. As U.S. Rep. Tim Walz, D-Minnesota, said, “Widespread underperformance at VA nursing homes is a betrayal of veterans’ trust and wellbeing.”
Considering that about one-half of all women and one-third of all men in our country will spend time as nursing home residents, much more needs to be done to overcome the deprivation of a persistently ignored segment of our population.
Joel Freedman, of Canandaigua, is a frequent Messenger Post contributor.