MILITARY

The Community Living Center at the Temple VA didn’t fare well after inspections of internal documents of 133 VA nursing facilities in 2017.

The local nursing center came up short when compared to private sector facilities. A USA Today report indicated the Community Living Center in Temple had received a 1-star rating out of a possible 5 stars.

However, the report for 2018 showed a significant improvement in care at the Temple VA Community Living Center.

The state-run William R. Courtney Veterans Home, located on VA grounds, is inspected by the state, but also has Veterans Administration inspections because the VA pays a portion of the bills for veterans who are residents in the home. Its overall rating is 5-star.

As of the first quarter of fiscal year 2019, ending Dec. 31, 2018, the Community Living Center in Temple had an overall 5-star rating, according to Dr. Olawale Fashina, Central Texas Veterans Health Care System chief of staff. For 2017, it had an overall 3-star rating and for 2018, it had an overall 4-star rating.

The USA Today report, according to Central Texas Veterans Health Care System administrators, cherry-picked isolated incidents that could make any facility look bad. But VA nursing homes — despite caring for sicker patients on average than non-VA facilities — provide good care overall, local VA administration said in email responses, noting this is supported by data found at www.accesstocare.va.gov/CNH/Statemap.

For the star ratings, there are 13 domains of quality measured, Fashina said. The Central Texas Veterans Health Care System reviews each area where there are challenges and then makes changes to service delivery plans and oversight.

“Our leadership team is actively involved in these efforts,” he said. “As reflected in the improvement from an overall 3-star rating in FY17 to an overall 5-star rating for the first quarter of FY19, our efforts have been very effective.”

The VA nursing homes were ranked on a scale from 1 to 5, with for both overall care quality and surprise inspections, with 5 being the best, according to the VA. Sixty VA nursing homes received a 1-star rating for care quality, which represents nearly half of the agency’s nursing homes nationwide.

These Community Living Center ratings are based on health surveys, staffing and quality of resident care measures.

The quality measure doesn’t measure quality of care specifically, rather it includes a range of criteria, some which are largely dependent on the patient’s overall health, such as pain, prescription drug rates and daily living skills, Fashina said.

That’s why VA Community Living Centers, 42 percent of whose residents in fiscal 2018 had a service-connected disability rating of 50 percent or higher for good reason, score lower on quality than do private facilities, VA responses said.

Specifically, VA Community Living Centers serve a much higher proportion of residents with conditions such as prostate obstruction, spinal cord injury, mental illness, homelessness, post-traumatic stress disorder, combat injury, terminal illness, and other conditions rarely seen in private nursing homes, Fashina said.

Of the facilities that received a 1-star rating for care quality in the first quarter of 2018, 11 received one star for surprise inspections, according to the investigation.

The Temple nursing center, which has 60 beds, received one star in the 2017 report and three stars in the 2018 report.

Central Texas Veterans Health Care System in Temple was one of the facilities that made positive strides in the benchmarks and is striving to continue progress — rising from a 4-star overall rating at the end of 2017 to a 5-star overall rating at the end of 2018.

“This result helps prove the Central Texas VA is delivering high quality health care,” said Andrew Garcia, interim director of the Central Texas Veterans Health Care System. “We’re very proud of the clinical team in this program, and their continued dedication to excellence. The Community Living Centers house some of the most vulnerable in our inpatient population of veterans. To have external benchmarks indicate they are receiving great care should make us all proud as Americans.”

Some of the differences between the Temple Community Living Center and private sector facilities sited in the 2017 inspections, according to a USA Today article, were: short stay residents in the serious pain the past five days, 46.07 percent VA, 13.32 percent private sector; short stay residents bed sores, 1.99 percent VA, 0.85 percent private sector; physically restrained on a daily basis, 0 percent VA, .04 percent private sector; short stay residents received anti-psychotic drugs, 2.61 percent, VA, 1.98 percent private sector.

VA health care inspections reports show that in comparison to non-VA facilities rated by the Centers for Medicare and Medicaid Services, VA has a lower number of low-performing facilities: VA 17.2 percent, non-VA 19.7 percent, according to Fashina. The VA also has an increased number of higher-performing facilities, VA 17.2 percent, non-VA 10.8 percent.

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