Healthcare Inspection – Access and Oversight Concerns for Home Health Services, Washington DC VA Medical Center, Washington, District of Columbia

OIG conducted an inspection at the request of Senator Barbara Mikulski to assess the merit of allegations regarding access to purchased home and community based services (HCBS) at the Washington DC VA Medical Center (facility), Washington, DC. We substantiated that the facility had wait times exceeding a year for patients needing homemaker/home health aide services, a component of HCBS. However, the facility reduced the electronic wait list from 584 patients in December 2013 to zero patients in February 2015. We also substantiated that multiple Veterans Health Administration facilities had patients waiting for HCBS. Incidental to our review, we found that local HCBS program managers did not comply with all elements of national and local policy regarding quality of care, patient communication, and electronic health record documentation. In addition, despite being required to use an electronic wait list for HCBS patients since 2006, the facility used a manual wait list until early 2014. We recommended that the Interim Under Secretary for Health require facilities to develop action plans to address the care needs of patients on HCBS electronic wait lists. We also recommended that the Facility Director ensure HCBS staff comply with all elements of national and local policies and that oversight and management of HCBS is adequate and in compliance with national policies.