Watchdog: Vets in D.C. Waited More Than a Year For Home Health Care

This story has been updated.

Some veterans in the Washington, D.C., area waited more than a year for home health care services, including one who died before he could receive it, according to a new watchdog report.

Demand among vets for at-home nursing care, and spending on it, more than tripled at the Washington, D.C., Medical Center between fiscal years 2010 and 2014, the VA inspector general found, which created a wait list for patients requiring those services. Wait lists for home health care are used when the department doesn’t have the money to meet demand. Priority is given to vets who need nursing home care for the treatment of a service-connected disability rated at 50 percent or more. The program provides an alternative to nursing home care, and help vets with daily activities, such as eating and bathing.

By late 2013, there were 584 patients on the wait list for home health care at the D.C. facility, with an estimated wait time of more than a year. The IG conducted the investigation at the request of Sen. Barbara Mikulski, D-Md. The D.C. VA facility serves approximately 70,000 vets living in the District of Columbia, Maryland and Virginia.

The report substantiated that the VA in October 2013 approved for home health care a male veteran in his 70s with a history of mini-strokes, and added him to the wait list. But he did not receive the care before his death in April 2014. According to the report, the vet last visited the D.C. VA facility in 2010. Between that time and his death, he visited a vets’ facility in Miami, in addition to a non-VA hospital in Bethesda, Md. The vet did not qualify for priority for VA home health care services because his service-connected disability rating was less than 50 percent, and his referral was related to his history of stroke and heart valve disease.

Staff at the facility told the IG that they became aware of the growing wait list for home health care services in 2012. Eventually, the facility was able to supplement its funding for home and community-based services, and it eliminated the wait list by February 2015. But as of this past summer, the wait list had returned. “Beginning June 17, 2015, because of funding constraints, the DC VAMC has needed to re-institute the use of the electronic waiting list for H/HHA [homemaker/home health aide] services,” said D.C. VA Medical Center Director Brian Hawkins in July 2015 comments to the IG’s report.

Government Executive asked the VA about the current status of the wait list for home health care services at the D.C. VA Medical Center, but the department did not provide that information in time for publication.*

Washington, D.C., wasn’t the only VA medical facility that had “challenges” with wait lists related to in-home nursing care. During its investigation, the VA IG found that the total number of vets on a department wait list for such care was 2,566 nationwide as of March 31, 2015 – an increase of 845 patients from September 2014. Five VA facilities accounted for more than half of the patients on the national wait list for home and community-based service: Los Angeles, Calif; Beckley, W. Va.; Richmond, Va.; Puget Sound, Wash.; and White City, Ore.

The VA also did not provide more current information requested by Government Executive on the national wait lists in time for publication.**

In addition, the IG found that staff at the DC facility “did not comply with all elements of local policy and VHA requirements regarding quality of care, communication, and documentation related to” home and community-based services. Hawkins said the facility has reviewed the local and national policies and made sure they are aligned, as well as ensured veterans’ electronic health records reflect the most up-to-date information regarding H/HHA services.

VA Undersecretary for Health Dr. David Shulkin agreed with the IG’s recommendation to better address the needs of vets on the home health services waiting lists, calling it a “high priority” of the department.

*VA spokesman Randal Noller said on Nov. 19 that the D.C. facility does not have any patients on the H/HHA electronic wait list currently.

**As of Nov. 18, there were 5,100 vets on the wait list nationwide, according to Noller.

(Image via Lighthunter / Shutterstock.com)