Mixed report card for VA medical centers serving Florida veterans
WASHINGTON — The Department of Veterans Affairs rated VA hospitals in Orlando, Lake City and Gainesville below average at the end of last year, according to an internal review by the federal agency.
The internal ratings, obtained by USA TODAY, were based on dozens of factors, including death and infection rates, instances of avoidable complications and wait times.
Of 146 VA medical centers nationwide, 46 were given one or two stars for the three-month period ending Dec. 31, 2015.
None of the seven medical centers in Florida received the lowest rating, but Gainesville, Lake City and Orlando each got two stars. In addition, VA hospitals in Biloxi, Miss., and Montgomery, Ala., which serve many veterans from the Florida Panhandle, also received two stars.
Florida’s four other medical centers all received three stars: the Miami VA Healthcare System, the C.W. Bill Young VA Medical Center in Bay Pines, the James A. Haley Veterans’ Hospital in Tampa, and the West Palm Beach VA Medical Center.
Representives for the two-star centers in Florida said they have made significant strides in care and access this year.
Orlando is now a four-star, while the hospitals in Lake City and Gainesville have been elevated to three-star status, according to representatives for those medical centers.
VA Undersecretary for Health David Shulkin cautioned against using the star ratings as a “ranking tool” and said they are primarily employed as an internal measure to home in on areas needing improvement.
“My concern is that veterans are going to see that their hospital is a one-star in our system, assume that’s bad quality and veterans that need care are not going to get care,” he said. “And they’re going to stay away from hospitals, and that’s going to hurt people.”
For those where quality has declined, Shulkin said they get extra scrutiny and help from national VA officials. If they still don’t show sufficient progress, hospital management could be replaced.
Florida Rep. Jeff Miller, chairman of the House Committee on Veterans’ Affairs, said the VA should immediately release all the ratings and quality data and do so on a continuing basis. He argued that the status quo — “in which VA officials often attempt to downplay and sometimes mislead the public about serious problems until it's too late” — is unacceptable.
"The secrecy with which VA treats these quality ratings is alarming,” Miller told USA TODAY. “Veterans seeking care at VA hospitals deserve to know exactly what they are walking into. Additionally, Congress, taxpayers and other stakeholders need to have a quick and efficient means of comparing the performance of various VA medical centers in order to identify facilities in need of improvement.”
Documents measuring the performance of every VA medical center show that Orlando was below average in several categories for the three-month period ending Dec. 31, including the ability for patients to get timely appointments and mental health care, and patients’ overall ratings of their primary care providers.
Michael Strickler, a spokesman for the Orlando VA Medical Center, said the hospital has taken numerous steps to improve service in recent months, such as faster scheduling for and access to audiology, optometry and Urgent Care Center treatment.
“We have also focused on preventive health measures, including the recent development of a clinic for complex heart failure patients who require frequent monitoring, medication adjustments and hospitalizations,” he said, noting that Orlando is the first medical center in Florida equipped with a Cardio MEMS device to support patients with special cardiac needs.
The medical centers in Lake City and Gainesville also documented problems at the end of 2015, including pneumonia readmission rates, long wait times for appointments and preventable in-hospital complications, according to VA records.
Both hospitals are now rated three stars thanks to more than 30 projects that made “systematic changes to improve the quality of patient care” such as mortality and infection rates, said Daniel L Henry, spokesman for the North Florida/South Georgia Veterans Health System that includes both medical centers.
County officials along the Treasure Coast say veterans they talk to are generally satisfied with the West Palm Beach VA Medical Center where they usually go for treatment. The hospital received a three-star rating last year.
“The medical staff in place go to great lengths to ensure they are taking care of the men and women who served our country,” said Doy Demsick, program manager for the Veterans Council of Indian River County. “As with any major operation, there are going to be issues. The important thing is that we track the information as it comes in, adjust fire and move ahead as a team.”
“You’re going to have people happy with the service, and occasionally you’re going to have those who think things don't meet their needs exactly, so they're not going to be happy," said Tony Reese, supervisor of Martin County Veterans Service Office. But “I think in this area we’re pretty lucky with West Palm Beach as compared to other facilities in the country.”
Contributing: George Andreassi, Treasure Coast Newspapers
Contact Ledyard King at lking@gannett.com; Twitter: @ledgeking