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VA Health Care: Inadequate Planning in the Chesapeake Network

HEHS-95-6 Published: Dec 22, 1994. Publicly Released: Dec 22, 1994.
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Highlights

Pursuant to a congressional request, GAO reviewed the Department of Veterans Affairs' (VA) planned construction of a new nursing home in the Baltimore, Maryland, area, focusing on whether VA used sound planning criteria in: (1) choosing the new nursing home site; and (2) developing its plans to replace the former medical center and nursing home.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs Before requesting funding of any future Chesapeake Network construction projects, such as the Fort Howard replacement hospital and nursing home, the Secretary of Veterans Affairs should provide Congress with a revised plan for meeting the future medical care needs of Chesapeake Network veterans. This plan should include: (1) a thorough assessment of the needs for all types of care throughout the Network, rather than assessments made on a facility-by-facility basis; (2) a thorough assessment of alternatives to new VA construction, including renovation and conversion of unused space at VA facilities; and (3) identification of planned VA construction and renovation projects that the Secretary considers necessary after need has been determined and alternatives explored, prioritized according to need.
Closed – Not Implemented
VA required its Veterans Integrated Service Networks (VISN) to develop 1-, 2-, and 5-year strategic and business plans. These plans were completed in 1996. In addition, action has been taken to integrate management of the Baltimore, Perry Point, and Fort Howard facilities. Several ongoing assignments are assessing the adequacy of the network plans.
Department of Veterans Affairs The Secretary of Veterans Affairs should consider requiring completion of similar plans for all other VA medical care networks.
Closed – Implemented
VA required VISNs to develop strategic and business plans. These plans were completed in 1996. The plans do not, however, include the type of facility-by-facility assessments envisioned by the recommendation.
Department of Veterans Affairs The Secretary of Veterans Affairs should direct the Undersecretary for Health to revise VA strategic planning guidance to: (1) better support networkwide, rather than facility-based, planning; and (2) improve the methodology for conducting community nursing home surveys.
Closed – Implemented
With its shift to VISNs, VA has emphasized networkwide planning. In addition, guidance issued to VISNs encourages greater use of contracting when it is cost-effective.

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Topics

Community health servicesConstruction costsFacility constructionstate relationsHealth care cost controlHealth care planningHealth care servicesNursing homesSite selectionVeterans benefits