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COVID-19 screening lapses plagued San Diego veterans' care

V.A.'s response asserts stealth audit "put our patients and staff at risk"

"At the V.A. San Diego HCS—Imperial Valley VA Clinic, patients and visitors were permitted to freely enter the waiting room."
"At the V.A. San Diego HCS—Imperial Valley VA Clinic, patients and visitors were permitted to freely enter the waiting room."

A snap audit by agents for the Veterans Affairs inspector general has called out San Diego region Veterans Health Administration staffers for failing to properly screen visitors for the coronavirus and asserted that local V.A. facilities are short on supplies and equipment.

"Visits to selected facilities were completed from March 19 through March 24, 2020," according to a March 26 report regarding the system's COVID-19 readiness.

"Inspectors drove to [Veterans Health Administration] medical facilities that were close to their homes and observed or underwent the screening process or both."

"Upon arrival to a facility, [Office of Inspector General] staff did not immediately make their identity known to VHA staff.

"After observing VHA personnel screen individuals who were seeking entrance or being screened themselves or both, OIG staff sought entrance to community living centers ...to determine if they would be denied entrance as a visitor."

"The unannounced visits to facilities were planned to minimize exposure and potential transmission of the novel coronavirus for both V.A. and OIG personnel as well as patients and visitors," the document adds.

"A total of 237 facilities (58 medical centers, 125 community-based outpatient clinics, and 54 community living centers) were visited," according to the report. The bulk of the V.A. facilities received adequate grades, with the San Diego region one of a few outliers.

"Four facilities were observed as having no screening procedures in place. At three locations, [Office of Inspector General] staff presented themselves as visitors and were politely greeted but not asked any COVID-19 screening questions."

"At the fourth facility, the V.A. San Diego HCS—Imperial Valley VA Clinic, patients and visitors were permitted to freely enter the waiting room. The [Office of Inspector General] team entered, stood in the waiting room for 10 minutes, and were not greeted or screened by VHA staff." The Chula Vista VA mental health clinic was also among the four that failed the screening. Veterans clinics in Lakeside and Auburn Gresham, Virginia were faulted for similar failures.

Compounding San Diego's bad marks, officials here reported no plans to share either beds or personal protective equipment supplies with community providers, according to the document.

"Facility leaders were asked about plans to share intensive care unit beds or personal protective equipment with community hospitals, whether there was a written agreement for transfer of COVID-19 patients to non-VA community hospitals when a higher level of care was needed, sharing of V.A. staff with non-VA facilities, and referral patterns."

Fewer than half of the V.A. facilities reviewed nationally had reported such plans, the report notes. "As of March 19, 2020, 23 of the 54 (43 percent) facility leaders reported plans to share ICU beds, personal protective equipment supplies, or both, with community providers. "

Auditors cited the San Diego region for having inadequate supplies of hand sanitizers, N95 respirators, disposable level 4 gowns, surgical masks, and disinfecting/sanitizing wipes, per the report.

"The OIG recognizes that conditions at VHA facilities and veterans' needs related to the COVID-19 pandemic may change rapidly." concluded John Daught, M.D., the agency's assistant inspector general for Health Care Inspections.

"It is hoped that the findings in this report will assist VHA leaders in gaining a better assessment of screening, access, and emergency preparedness at its facilities. This may also be a useful reference for facilities that were not visited to gauge their status."

A March 26 memo from the Veterans Health Administration fired back, contending that the inspector general's audit itself may have jeopardized patient and staff safety.

"We are...deeply concerned that these investigators (many of them clinicians) did not abide by CDC guidelines regarding social distancing, and their movement from one V.A. hospital and Community Clinic to the next could very possibly make them COVID-19 vectors and put our patients and staff at risk."

Responded auditors: "The "'investigators' were nearly all clinicians who volunteered to drive to facilities to conduct the inspection. To leverage that opportunity, OIG leaders determined that asking some questions about readiness and medication, supply, and equipment needs would be of immediate use to both V.A. and other stakeholders.

"All OIG staff screened for conditions before traveling to facilities and did observe CDC guidelines on site. Any inference to the contrary is inaccurate."

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Comments
4

If this isn't a perfect example of your government at work, I cannot think of a better one. The VA clinics and facilities should be at the cutting edge of getting it right in this health crisis. But some of them aren't there at all, and are seemingly unaware of the simplest steps to take. So the VA inspectors show up at some such healthcare operations and find them deficient or utterly deficient in keeping visitors away from residents or patients. And what does management say? They say the inspectors could have spread infection, and in conducting those unannounced inspections actually did endanger the inspected facilities and their clients. And they go on to explain that everything is okay now and always really was.

Who do you care to believe? The VA healthcare system or the VA inspectors? That's your call, but this conflict within the Department of Veterans Affairs doesn't speak well for the VA at all. One side is calling out the system's other side, and vice-versa.

I get certain services from VA in Oceanside for a number of things not covered by Medicare. I've had some treatments and diagnostic tools provided by VA. But I also use Medicare Part B for many other services. And what's my take? Locally the operation is good. But it can lapse badly here and there and from time to time. I sure don't want to depend on VA for all my needs. I have Medicare coverage that gets me into plenty of good outcomes.

If you want to take something out of this controversy, it is that VA healthcare is as close to full-on socialized medicine in the US. And what do we get? Usually the job is done, but when it isn't done, the result is really bad. Control and accountability? Has anyone gone to prison for some of the most egregious lapses? Uh, I don' think so.

Since this system is the closest to Medicare-for-all, it can give a picture of what the new Medicare will bring. Is this what we want to deal with in many, many ways? I'd guess not. Asking the federal government to take on a whole new system would bring it to a near-standstill. No, Americans will not settle for Euro-style sluggishness, or anything else.

As screwy as it is, the current system is probably bringing better healthcare than any other. For profit/non-profit/governmental considerations need to be listened to and used without socialistic meddling.

Who really knows?

April 4, 2020

If the bulk of the V.A. facilities received adequate grades, San Diego and other outliers need to step it up a notch or two. Why aren't they doing it?

April 4, 2020
This comment was removed by the site staff for violation of the usage agreement.
April 5, 2020
This comment was removed by the site staff for violation of the usage agreement.
April 6, 2020

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"At the V.A. San Diego HCS—Imperial Valley VA Clinic, patients and visitors were permitted to freely enter the waiting room."
"At the V.A. San Diego HCS—Imperial Valley VA Clinic, patients and visitors were permitted to freely enter the waiting room."

A snap audit by agents for the Veterans Affairs inspector general has called out San Diego region Veterans Health Administration staffers for failing to properly screen visitors for the coronavirus and asserted that local V.A. facilities are short on supplies and equipment.

"Visits to selected facilities were completed from March 19 through March 24, 2020," according to a March 26 report regarding the system's COVID-19 readiness.

"Inspectors drove to [Veterans Health Administration] medical facilities that were close to their homes and observed or underwent the screening process or both."

"Upon arrival to a facility, [Office of Inspector General] staff did not immediately make their identity known to VHA staff.

"After observing VHA personnel screen individuals who were seeking entrance or being screened themselves or both, OIG staff sought entrance to community living centers ...to determine if they would be denied entrance as a visitor."

"The unannounced visits to facilities were planned to minimize exposure and potential transmission of the novel coronavirus for both V.A. and OIG personnel as well as patients and visitors," the document adds.

"A total of 237 facilities (58 medical centers, 125 community-based outpatient clinics, and 54 community living centers) were visited," according to the report. The bulk of the V.A. facilities received adequate grades, with the San Diego region one of a few outliers.

"Four facilities were observed as having no screening procedures in place. At three locations, [Office of Inspector General] staff presented themselves as visitors and were politely greeted but not asked any COVID-19 screening questions."

"At the fourth facility, the V.A. San Diego HCS—Imperial Valley VA Clinic, patients and visitors were permitted to freely enter the waiting room. The [Office of Inspector General] team entered, stood in the waiting room for 10 minutes, and were not greeted or screened by VHA staff." The Chula Vista VA mental health clinic was also among the four that failed the screening. Veterans clinics in Lakeside and Auburn Gresham, Virginia were faulted for similar failures.

Compounding San Diego's bad marks, officials here reported no plans to share either beds or personal protective equipment supplies with community providers, according to the document.

"Facility leaders were asked about plans to share intensive care unit beds or personal protective equipment with community hospitals, whether there was a written agreement for transfer of COVID-19 patients to non-VA community hospitals when a higher level of care was needed, sharing of V.A. staff with non-VA facilities, and referral patterns."

Fewer than half of the V.A. facilities reviewed nationally had reported such plans, the report notes. "As of March 19, 2020, 23 of the 54 (43 percent) facility leaders reported plans to share ICU beds, personal protective equipment supplies, or both, with community providers. "

Auditors cited the San Diego region for having inadequate supplies of hand sanitizers, N95 respirators, disposable level 4 gowns, surgical masks, and disinfecting/sanitizing wipes, per the report.

"The OIG recognizes that conditions at VHA facilities and veterans' needs related to the COVID-19 pandemic may change rapidly." concluded John Daught, M.D., the agency's assistant inspector general for Health Care Inspections.

"It is hoped that the findings in this report will assist VHA leaders in gaining a better assessment of screening, access, and emergency preparedness at its facilities. This may also be a useful reference for facilities that were not visited to gauge their status."

A March 26 memo from the Veterans Health Administration fired back, contending that the inspector general's audit itself may have jeopardized patient and staff safety.

"We are...deeply concerned that these investigators (many of them clinicians) did not abide by CDC guidelines regarding social distancing, and their movement from one V.A. hospital and Community Clinic to the next could very possibly make them COVID-19 vectors and put our patients and staff at risk."

Responded auditors: "The "'investigators' were nearly all clinicians who volunteered to drive to facilities to conduct the inspection. To leverage that opportunity, OIG leaders determined that asking some questions about readiness and medication, supply, and equipment needs would be of immediate use to both V.A. and other stakeholders.

"All OIG staff screened for conditions before traveling to facilities and did observe CDC guidelines on site. Any inference to the contrary is inaccurate."

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Comments
4

If this isn't a perfect example of your government at work, I cannot think of a better one. The VA clinics and facilities should be at the cutting edge of getting it right in this health crisis. But some of them aren't there at all, and are seemingly unaware of the simplest steps to take. So the VA inspectors show up at some such healthcare operations and find them deficient or utterly deficient in keeping visitors away from residents or patients. And what does management say? They say the inspectors could have spread infection, and in conducting those unannounced inspections actually did endanger the inspected facilities and their clients. And they go on to explain that everything is okay now and always really was.

Who do you care to believe? The VA healthcare system or the VA inspectors? That's your call, but this conflict within the Department of Veterans Affairs doesn't speak well for the VA at all. One side is calling out the system's other side, and vice-versa.

I get certain services from VA in Oceanside for a number of things not covered by Medicare. I've had some treatments and diagnostic tools provided by VA. But I also use Medicare Part B for many other services. And what's my take? Locally the operation is good. But it can lapse badly here and there and from time to time. I sure don't want to depend on VA for all my needs. I have Medicare coverage that gets me into plenty of good outcomes.

If you want to take something out of this controversy, it is that VA healthcare is as close to full-on socialized medicine in the US. And what do we get? Usually the job is done, but when it isn't done, the result is really bad. Control and accountability? Has anyone gone to prison for some of the most egregious lapses? Uh, I don' think so.

Since this system is the closest to Medicare-for-all, it can give a picture of what the new Medicare will bring. Is this what we want to deal with in many, many ways? I'd guess not. Asking the federal government to take on a whole new system would bring it to a near-standstill. No, Americans will not settle for Euro-style sluggishness, or anything else.

As screwy as it is, the current system is probably bringing better healthcare than any other. For profit/non-profit/governmental considerations need to be listened to and used without socialistic meddling.

Who really knows?

April 4, 2020

If the bulk of the V.A. facilities received adequate grades, San Diego and other outliers need to step it up a notch or two. Why aren't they doing it?

April 4, 2020
This comment was removed by the site staff for violation of the usage agreement.
April 5, 2020
This comment was removed by the site staff for violation of the usage agreement.
April 6, 2020

Sign in to comment

Sign in

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