Gov. Rick Scott is the latest politician seeking answers about deaths at Department of Veterans Affairs hospitals.
Upset by five deaths in the VA region serving Florida and the lack of answers about where those deaths took place, Scott asked Elizabeth Dudek, secretary of the state’s Agency for Health Care Administration, to inspect VA hospitals in the Sunshine Healthcare Network and publicly report those findings.
VA officials say one death is too many and that they work to identify and correct problems.
The Tampa Tribune reported earlier this year that five cancer patients died and nine others sustained injuries because of delays in diagnosis or treatment through the network, which includes Florida, south Georgia, Puerto Rico and the U.S. Virgin Islands. The report cites internal VA documents obtained by the Tribune.
VA officials have refused to say in which hospitals the deaths occurred. They said the documents were “preliminary” when denying a Freedom of Information Act request by the Tribune seeking the location of the 19 deaths and 63 injuries nationwide, including those in the Sunshine Healthcare Network.
U.S. Sen. Bill Nelson visited Tampa’s James A. Haley Veterans’ Hospital last week after the Tribune ran a story and editorial about the VA’s lack of response to questions about the deaths. Nelson said none of the deaths occurred there. Mary Kay Hollingsworth, a spokeswoman for the Sunshine Healthcare Network, said the deaths did not occur at the C.W. Bill Young VA Medical Center at Bay Pines in Pinellas County.
However, neither Nelson nor Hollingsworth could say where the deaths occurred or whether any of the nine injured patients received treatment at either facility.
The deaths were the result of delayed endoscopy tests, according to the documents. In most cases, the delays were less than a year but more than 90 days.
The VA has also refused to answer questions raised last September by the House Veterans Affairs Committee, which will hold hearings on the matter Thursday.
“Because the VA is refusing to reveal the locations where veterans whose deaths or injuries are linked to delayed VA care sought treatment, independent, outside oversight is clearly warranted,” said U.S. Rep. Jeff Miller (R-FL), chairman of the HVAC. “Veterans seeking VA care have a right to know about problems within the VA system as well as the steps the department is taking to solve them and hold those responsible accountable. In this case, VA is denying our veterans that right.”
Like Nelson, who wrote to VA Secretary Eric Shinseki last week, Scott expressed his concern in a letter about the unanswered questions.
“Perhaps even more troubling, many questions in this tragedy remain unanswered,” Scott wrote to Dudek. “Which of these incidents happened at which veterans hospitals in Florida. ... How can the federal government increase transparency on the quality of care provided to veterans so taxpayers can ensure these federally funded hospitals are providing excellent care for our nation’s heros?”
AHCA has the knowledge and experience to conduct the review, according to a spokeswoman.
“While federal VA medical centers are owned and regulated by the U.S. Department of Veteran Affairs and its vendors, the agency has the local field support and expertise to assess the risk management programs and internal incident reporting practices with hospitals,” said Shelisha Durden. “The agency regulates more than 200 hospitals in Florida so we have the knowledge to assist the VA in reviewing procedures. We are committed to helping protect the health and safety of our veterans who are deserving of quality care.”
The VA “cares deeply for every veteran we are privileged to serve,” said Meagan Lutz, a spokeswoman, responding to Scott’s letter. “Our goal is to provide the best quality, safe and effective health care our veterans have earned and deserve. We take seriously any issue that occurs at any one of the more than 1,700 VA health care facilities across the country.”
Lutz said that “when an incident occurs in our system we aggressively identify, correct and work to prevent additional risks. We conduct a thorough review to understand what happened, prevent similar incidents in the future, and share lessons learned across the system.”
VA medical facilities are accredited by The Joint Commission, said Lutz, an “independent, non-profit panel that ensures the quality of U.S. health care by its intensive evaluation of more than 20,000 health care organizations.”
A positive report by the commission doesn’t always mean a clean bill of health. The AP reported in September that “six deaths have been linked to delayed screenings for colorectal cancer” at a South Carolina VA medical center that two months later would be named a Joint Commission “top performer” for the second or third year, according to the VA.
According to the AP, the problems, revealed by a VA Office of Inspector General report, stemmed from a backlog in colorectal screenings built up in 2011 and 2012 that were resolved in October of 2012. The VA, in a press release, said that the Joint Commission’s ratings were “based on an aggregation of accountability measure data reported to The Joint Commission during the 2012 calendar year.”
A call to the Commission Tuesday evening was not immediately returned.
The AP reported that nine families filed suit as a result of the deaths that occurred in South Carolina.
Aside from self-inspection and internal monitoring, the “VA welcomes external reviews from dozens of independent medical and outside organizations, such as the Office of Inspector General, the American College of Radiology, and the American Legion, to name just a few,” said Lutz. “These organizations inspect our facilities and all facets of our health care system to help ensure VA consistently meets and exceeds industry standards.”