VA Health Care:

Improvements Needed in Nursing Home Planning

HRD-90-98: Published: Jun 12, 1990. Publicly Released: Jun 12, 1990.

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Pursuant to a congressional request, GAO provided information on the Department of Veterans Affairs' (VA) nursing home planning process.

GAO found that: (1) VA based its bed-supply goal on the assumption that the proportion of veterans in all nursing homes that VA would support approximated its historical share; (2) VA used the most current data available on the number of veterans expected to use nursing homes in fiscal year (FY) 2000; (3) VA plans to provide 47,000 nursing home beds by FY 2000, an increase of 14,000 beds over the FY 1988 operating level; (4) VA plans to provide about half of the 14,000 beds in community and state veterans' homes; (5) VA plans to construct about 5,000 new beds, at a cost of $405 million, and convert 2,000 VA hospital beds to nursing home use, at a cost of $105 million; (6) VA might not need to add 7,000 new nursing home beds; (7) the VA planning process lacked guidance to ensure that VA accurately identified available beds used; (8) the potential for converting VA hospital beds to nursing home use increased because of a decrease in the number of VA hospital beds used; and (9) VA could convert hospital beds to nursing home care in less time and at half the cost of new construction.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: Final revision to Chapter 10 of the VA Veterans Health Administration Manual 9, "Strategic Planning" was issued May 18, 1992. This revision completes action on this recommendation.

    Recommendation: The Secretary of Veterans Affairs should require the Chief Medical Director to revise planning guidelines to remove limitations on the percentage of beds VA can use in a single community nursing home.

    Agency Affected: Veterans Administration

  2. Status: Closed - Implemented

    Comments: Final revision to Chapter 10 of the VA Veterans Health Administration Manual 9, "Strategic Planning" was issued May 18, 1992. This revision completes action on this recommendation.

    Recommendation: The Secretary of Veterans Affairs should require the Chief Medical Director to provide clear guidance to planners regarding the specific steps they should take to assess the availability of community nursing home beds.

    Agency Affected: Veterans Administration

  3. Status: Closed - Implemented

    Comments: Regional liaisons in the Strategic Planning Office will verify regional planner input in the state home assessments on an individual basis.

    Recommendation: The Secretary of Veterans Affairs should require the Chief Medical Director to ensure that planners follow guidelines in developing their counts of available state veterans' nursing home beds.

    Agency Affected: Veterans Administration

  4. Status: Closed - Implemented

    Comments: VA cited its long-term policy to require needs assessments for nursing home projects as meeting the intent of this recommendation. However, implementation of the other recommendations in this report is necessary to fully accomplish the intent of the recommendation.

    Recommendation: The Secretary of Veterans Affairs should require the Chief Medical Director to review planned nursing home construction projects before requesting funding to be sure that available beds in community and state veterans' homes were accurately counted and that opportunities for converting hospitals beds were identified.

    Agency Affected: Veterans Administration

 

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