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A VA hospital rating system and how it can fail patients

Rating systems can have unintended consequences as administrators look for ways to improve their numbers. The stories from one hospital illustrate what can go wrong.

Doctors and administrators at VA hospitals and clinics have clashed over recommended care. In one case, an 81-year old came to a VA hospital malnourished and dehydrated after falling and breaking several ribs. He waited for nine hours in an emergency room for a nurse to tell him that he was not sick enough to be admitted under administration restrictions. This was at a facility with empty beds where doctors recommended admitting him.

How could this happen?

Metrics are increasingly used in various industries to improve productivity. And the federal government is no different especially as it has sought to reform the Veterans Affairs Medical system.

About four years ago, the Department of Veterans Affairs started to grade hospitals on 110 performance indicators. These were things like infection rates and the amount of time patients had to wait. In 2016, the department found that 82 percent of its facilities had improved on the metrics.These metrics also came with financial implications for administrators. Ratings affect annual leadership bonuses.

Here is one example of how administrators have sought to game the system: a coding change The VA ratings penalize a hospital for patients admitted for congestive heart failure, which tends to indicate poor preventative care. Administrators instructed doctors to instead list hypervolemia, too much fluid in the blood, a condition the VA does not track. Another was related to avoiding dings for deaths that occur within 30 days of discharge. To get around this one, doctors and nurses allege that veterans have been encouraged to be admitted as hospice patients. In many cases, these veterans were not terminal and still desired treatment.

When administrators start to weigh in so heavily that is affects the standard of care, there is recourse. A lawsuit against the VA may provide compensation and ensure that improvements are made in the standard of care.

There is no time to delay when seeking recourse after an accident or inadequate care at the VA causes significant suffering/pain to you or a loved one. The timing for filing a claim is limited. Call for a free consultation with one of our experienced Weisfuse & Weisfuse medical malpractice attorneys.

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