Wisconsin VA Leaders Defend Quality Of Care At Veteran Nursing Homes

As national officials question the quality of nursing homes run by the U.S. Department of Veterans Affairs, VA leaders in Wisconsin say they welcome increased transparency around the care they provide.

USA Today reports the U.S. House Committee on Veterans Affairs will be investigating quality of care at VA nursing homes. The review comes after reporting from USA Today and the Boston Globe found last year’s internal quality measures at VA facilities were worse than the private sector.

That data showed the Tomah VA and Milwaukee VA were rated 2 out of 5 stars based on quality measures like pain levels, rates of bed sores and use of anti-psychotic drugs. The Madison VA nursing home received three stars.

Victoria Brahm, director of the Tomah VA Medical Center, said VA facilities will always face a high level of scrutiny, but it’s something she welcomes.

“I think that it’s really great that we are now being so transparent with our data,” she said. “I think that open investigations and looking into how we provide care is a good thing.”

But Brahm said she does think the VA needs to provide more information on how to interpret the newly available data.

The VA recently released this year’s ratings of nursing home facilities on their website. Madison and Tomah both increased their quality ratings from last year, up to four and three stars, respectively. The Milwaukee VA dropped to one star under the quality rating.

The department also published their overall rating of the nursing homes, which is based on quality ratings, yearly unannounced inspections and staffing levels. Overall, Milwaukee and Tomah were rated four-star facilities while Madison received five stars.

Brahm points out that these ratings are based on the last three years of data for the facility.

“We certainly project our data to be phenomenally better next year,” Brahm said. “Since our opioid crisis, we have implemented so many pain interventions.”

Detailed quality data shows the percentage of VA patients who report moderate to severe pain is six times the national average for long stay patients. For short stay patients, the VA average is more than double the national average. Both Milwaukee and Tomah were higher than the VA average in both pain categories.

But James McLain, acting director of the Milwaukee VA Medical Center, said it’s not fair to compare the VA to regular nursing homes because the VA provides a higher level of care.

“We don’t transfer them to another hospital, we are a hospital so we provide that service in house,” McLain said.

McLain said the Milwaukee VA has worked to provide more alternative treatments for pain, like yoga or water therapy.

“We also have to be realistic. As anyone ages, the likelihood of them experiencing pain at some time or another is going to increase,” McLain said.

As the public pays more attention to these previously internal ratings, Brahm said she hopes the VA can work with private sector nursing homes to create a standard for evaluating quality.

“I think it’s incumbent upon us to be partnering closer with the private sector to make sure that the data that we put out is standardized,” Brahm said. “If you’re measuring mortality, let’s measure it the same way and let’s all be transparent so that it is comparative and so that the public can make good decisions.”