Breadcrumb

Audit of the Community Nursing Home Program

Report Information

Issue Date
Report Number
11-00331-160
VISN
State
California
Illinois
Minnesota
Mississippi
West Virginia
District
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Audits and Evaluations
Report Type
Audit
Recommendations
4
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
OIG evaluated VHA’s community nursing home program to determine if nursing homes met eligibility requirements. VHA’s Office of Finance reported nursing home program expenditures totaled $614 million in FY 2012 and were estimated to grow to $767 million in FY 2013. We found weaknesses and untimely VA healthcare facility eligibility reviews of 30 nursing homes resulted in the renewal of five ineligible nursing homes’ contracts. This occurred because VA officials did not effectively monitor the nursing home program and did not provide guidance needed to ensure the proper completion of eligibility reviews. Further, VA review teams did not always obtain and evaluate required operational information about the nursing homes when they performed their initial and subsequent annual reviews. Over the next 5 years, VHA will place about 33,500 patients at a cost of about $296.5 million in ineligible nursing homes if VHA does not strengthen program oversight and improve its eligibility reviews. This amount is not a “cost savings,” as veterans need these vital services, but future payments should be provided to eligible nursing homes that provide the quality of care our veterans deserve. We recommended the Under Secretary for Health update community nursing home policies, conduct a national review to ensure veterans are not currently in ineligible nursing homes, and strengthen nursing home program oversight and monitoring.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended the Under Secretary for Health ensure Veterans Health Administration community nursing home policies are updated and reissued.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended the Under Secretary for Health conduct a comprehensive national review of nursing homes to ensure veterans are not placed in any nursing homes deemed ineligible by Veterans Health Administration policy, and take appropriate remedial action where necessary.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended the Under Secretary for Health implement a formal oversight and communication process to ensure healthcare facilities comply with Veterans Health Administration nursing home policy and perform proper eligibility reviews.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
We recommended the Under Secretary for Health establish a monitoring mechanism to ensure the Office of Geriatrics and Extended Care Strategic Healthcare Group, and healthcare facilities, use the Community Nursing Home Certification Report to monitor the nursing home program and identify high-risk nursing homes.
Total Monetary Impact of All Recommendations
Open: $ 0.00
Closed: $ 296,500,000.00