Two Department of Veterans Affairs nursing homes in Tennessee are under investigation as part of a national review launched by officials this week after the the VA released internal ratings for the first time that showed that almost half of the centers were given the lowest possible score.
House VA Committee Chairman Rep. Phil Roe, R-Tenn. ordered the investigation following an investigation by USA TODAY and The Boston Globe that found 60 VA nursing homes rated only one out of five stars for quality last year.
The investigation also found that patients in more than two-thirds of the homes were more likely to suffer pain and serious bedsores than their private sector counterparts. The VA nursing homes performed worse than private nursing homes on a majority of key quality indicators, including rates of anti-psychotic drug prescription and decline in daily living skills.
There are two VA nursing homes in Tennessee. The nursing home in Murfreesboro received a two-star rating while the Mountain Home nursing home received five-stars. Compared to the scores of 133 VA nursing homes across the country, the two in-state locations were ranked above the VA’s average.
The VA certifies state owned and operated nursing homes across the country. In Tennessee, the Tennessee State Veterans Homes are located in Humboldt, Knoxville, Clarksville and Murfreesboro. They are not included in the report.
VA Press Secretary Curt Cashour said Monday that agency officials "welcome the committee's oversight."
“We look forward to informing the committee about the care we provide veterans in our nursing homes and how it compares closely to care in the private sector, even though the department on average cares for sicker patients in its nursing homes than do private facilities,” Cashour said.
Tenn. VA nursing homes broken down
Here's how the Tennessee VA nursing homes stack up against private care facilities:
The VA operates nursing homes in 46 states that serve some 46,000 veterans annually. The agency has tracked detailed information about the quality of care they provide since at least 2011 and instituted a ranking system in 2016, but hadn't released that data until June 2018.
A representative with the VA said when it comes to the sub-metrics above, the differences between private and VA-run nursing homes in terms of pain and anti-psychotics can be attributed to the VA having to care for sicker patients in its nursing homes on average.
The VA said it serves a higher proportion of residents with conditions such as spinal cord injury, mental illness, homelessness, PTSD, and combat injuries not as commonly seen in private nursing homes.
"Those differences in case-mix, rather than a difference in quality of care, often account for an unfavorable comparison to the private sector on specific metrics such as pain and type of treatment," Kristen Schabert with the VA said. "What’s more, VA nursing homes have a higher staff-to-resident ratio than private sector facilities, meaning residents in VA facilities get more direct attention from nursing home staff than do residents in the private sector."
Editor's Note: This article incorrectly stated Mountain Home VAMC scored two-stars. It has been updated to reflect the correct rating of five-stars according to the VA's data.
Includes reporting by USA TODAY reporter Donovan Slack and The Boston Globe. reporter Andrea Estes.
Yihyun Jeong covers veterans and military affairs for the USA TODAY NETWORK - Tennessee. Reach her at yjeong@tennessean.com or 615-881-7309. Follow her on Twitter @yihyun_jeong.
