For months, the VA insisted it had no legal obligation to provide house-to-house breakdown of deaths and infections – although nothing prevented the agency from doing so voluntarily, as some do. States have done so. He changed that policy on Thursday.
Citing pressure from Congress, the VA said on its website that homes in the state will have to report “information related to COVID-19” to both the VA and the CDC, and the veterans agency will begin. in turn to make them accessible to the public week after week.
“VA now provides a downloadable spreadsheet with reports for individual HOs,” the agency said in its statement. “VA also displays a graph showing trends in cases and deaths among residents and staff. “
The Centers for Medicare and Medicaid Services oversee most homes, but not all. He had refused to publicly disclose the data of houses outside his jurisdiction. Homes that looked more like assisted living centers than full-fledged nursing homes do not receive CMS monitoring, and these Covid counts remain rare in first batch of data in new public spreadsheets from the VA. Many are currently reporting zero deaths, but the VA stressed that the numbers are still being submitted and reviewed for the charts to be updated.
However, some of these assisted living facilities may continue to show little or no fatalities because they – and their civilian counterparts – were not required to report their numbers until February 2021, a VA spokesperson explained. At that time, cases were decreasing in long-term care facilities as vaccines were available. They did not have to report earlier cases as of 2020.
“We have seen far too many unacceptable deaths during the COVID-19 pandemic at veterans’ homes across the state and VA must be held accountable for monitoring the quality of care for veterans at these facilities run by the state. the state, ”said Senate Veterans Affairs Committee Chairman Jon Tester (D -Mont.) said in a statement. “This is why my colleagues and I have pushed VA to provide public data on the state’s veterans’ homes that will increase transparency and align them with nursing home safety standards – ensuring that may they do their part to protect the men and women who have served our country. “
In August, POLITICO released a five-month investigation into flawed surveillance, the high number of cases and the lack of transparency in these homes for state veterans. Specifically dedicated to caring for elderly American veterans, the homes – which are funded under the VA, but run by state governments or the contractors they have hired – have suffered from a lack of oversight, States and the federal government blaming each other for any breach.
The result was disastrous, according to partial data assembled by POLITICO, which showed a much higher per capita death rate in homes across the state compared to similar facilities operated by the VA itself. But at least 46 of the state’s 158 veterans homes did not provide any data, making the true scale of the pandemic’s toll unavailable. Neither the families of the residents who died in the homes, nor veteran advocacy groups nor the media could really find out what was going on inside the homes.
Since the end of the summer, POLITICO has contacted, often repeatedly, all homes that were missing on the CMS Nursing Homes website. Some have voluntarily published data on infections and deaths; others simply ignored questions and requests. Most of the blocked data was in states particularly affected by the Delta wave last summer, such as Alabama, Mississippi and Missouri.
Data from some of those homes was still missing from the VA website’s spreadsheet on Friday, but the VA said it was working on verifying the state’s data and filling the gaps.
Lawmakers on the House and Senate veterans affairs committees had pushed the VA to release the data. As part of a huge package of credits at the end of 2020, Congress had included language requiring disclosure of the VA. But the VA had so far insisted on the fact that the precise wording of this measure required only national accounts, and not house-to-house reports. Hill staff said the intention was clear and they had discussed with the VA a more comprehensive response.
Under pressure, the VA changed its mind. The data appeared on the VA website on Thursday. It also includes data on immunization rates in homes of state veterans.
The data black hole is part of a larger issue of oversight and accountability of these homes. Born out of the need to house aging Civil War veterans, State Homes have long served and honored the country’s veterans in their last days. As states have embraced the need to care for veterans, the federal VA has gradually taken over the funding. Still, it only took one annual inspection to make sure homes were following proper health and safety procedures, and inspectors lacked the power to order changes. In particular, some states have refused to force homes for ex-combatants to follow the procedures required of private retirement homes. Some also did not require senior officials overseeing the homes to have experience in healthcare or serving elderly residents.
So when Covid-19 first struck in early 2020, some homes in states under vigilant surveillance, like California, fared reasonably well. Many other outbreaks have experienced devastating epidemics.
Following POLITICO’s report over the summer, Senator Chuck Grassley (R-Iowa) on August 30 demanded that the Department of Veterans Affairs answer questions about quality of care, infection control and surveillance .
“The VA routinely provides over $ 1 billion a year to state veterans’ homes, to cover all or part of the care of veterans in need,” Grassley wrote to VA secretary Denis. McDonough. expenses. “
“Our veterans deserve the best possible care after giving so much for our country,” Grassley said in a statement at the time. “Sadly, it appears the standard of care and quality controls at many veterans’ homes across the state are far below those required by other government-backed nursing homes.
For some veterans advocates, the VA’s lack of transparency has been frustrating but not surprising. Linda Schwartz, a former state and federal government official in Virginia, attempted to write a report with the Vietnamese veterans of America on the performance of state homes during the pandemic last year.
“We thought it would be an easy thing to do, but it wasn’t,” she said. “VA has a wake-up call. They thought everything was fine there – and it isn’t.
Joanne Kenen is the Commonwealth Fund Journalist in Residence at the Johns Hopkins School of Public Health.