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Veterans advocate: VA hospitals’ ‘improvement’ doesn’t tell whole story

By   /   January 3, 2017  /   News  /   No Comments

Part 39 of 47 in the series Tomah VA Scandal

MADISON, Wis. — The headlines last month declared that most U.S. Department of Veterans Affairs medical centers saw improvement in fiscal year 2016.

It seemed like a positive end to another rough year for the VA and the people the government-run health care system is supposed to put first.

But a veterans advocate is advising news consumers to read the fine print. While the vast majority of VA hospitals did note improvement in at least one category, that doesn’t mean the broken single-payer system is anywhere near fixed, said Kevin Nicholson, a veteran of two wars and member of the Wisconsin Board of Veterans Affairs.

“If you saw an individual facility that did improve a call response time, that’s great. I think we should all be rooting for the VA hospitals to improve,” Nicholson told Wisconsin Watchdog last week on the Vicki McKenna Show, on NewsTalk 1130 in Milwaukee.

“But I would not go and say that 82 percent of the hospitals measured in this study saw a collective widespread improvement that would indicate a directional change in the VA that we should be extremely happy about,” he said.

Photo by Kevin Nicholson

NOT IMPRESSED: Veterans advocate Kevin Nicholson is not impressed with the VA’s idea of ‘improvement’ at its troubled hospitals.

Last month, the department finally released its Strategic Analytics for Improvement and Learning Model report after criticizing USA Today for previously publishing the internal ratings. SAIL, as the ratings system is known, “accesses 26 quality measures in areas such as death rate, complications, and patient satisfaction, as well as overall efficiency at individual VA Medical Centers,” according to a department news release.

But not all quality categories are created equally. The categories include some measures not necessarily critical to veteran care.

Of the 146 medical centers rated, 120, or 82 percent, “improved” in the past year, according to the VA’s fiscal year 2016 ratings.

“When they say that 82 percent of facilities saw improvement, what they are saying is amongst these [26] metrics, 82 percent of hospitals measured bounced up in at least one of these metrics,” Nicholson said.

And one area of improvement does not a changed medical center make.

The VA’s improvement metrics include a one-star to five-star rating.

The Phoenix VA hospital, ground zero of a veteran care wait-time scandal, still ranked among the worst VA medical centers in the country.

Wisconsin’s scandal-plagued Tomah VA Medical Center also saw a decline in its rating, dropping to three stars. In 2015, the hospital was the subject of congressional investigations for its prescription policies that led to the death of a Marine veteran. Whistleblowers said they were retaliated against, and some patients who complained were treated terribly, according to multiple sources.

Most recently, the medical center earned more unwanted national attention after reports of a dentist potentially exposing hundreds of veterans to serious diseases.

The real baseline metric, Nicholson said, should be real improvement at the hospitals in Phoenix and Tomah and the John D. Dingell VA Medical Center in Detroit, which like Phoenix, received a one-star rating.

Phoenix, Nicholson said, is the “canary in the coal mine.”

“If that individual facility has not improved given the nationwide storm that descended upon it with the problems the Phoenix VA has had, that would indicate that collectively there has been no strong directional change in the VA system,” said the Milwaukee-area conservative who is mulling a 2018 run for the U.S. Senate seat held by Madison Democrat Tammy Baldwin.

“This is why I get upset with people like [President] Barack Obama, [U.S. Rep.] Nancy Pelosi and Tammy Baldwin. They just can’t turn their eyes toward these problems and just admit that, yes, there is a problem with huge government-run health care facilities,” Nicholson added.

The businessman and veteran of the wars in Afghanistan and Iraq asserts that Tomah is symptomatic of a Titanic federal health system that does not have the will or the means to right the ever faltering ship. And while commendable, Tomah’s new leadership cannot solve the systemic problems of government-run health care, Nicholson said.

“If you look at the bureaucratic issues that create this kind of problem in the first place, boy it would be a lot better if something like Tomah were pushed down to the state level or to the private sector where people would be held accountable much, much earlier in the process, when these problems start to pop up and we’d actually see much greater response,” Nicholson said.

VA officials earlier said they did not release the internal rating because doing so “would likely confuse our veterans and the general public.”

They charged that USA Today was irresponsible for publishing earlier ratings, before lawmakers applied heat on the VA to publicly release them.

“It is a disservice to veterans to lead them to believe that a one-star facility means they won’t get care they need,” said David Shulkin, the VA’s under secretary for health.

U.S. Reps. Debbie Dingell, D-Mich., and Tim Walberg, R-Mich., said it would be irresponsible for the VA not to release the information.

“Veterans, just like every other patient, deserve to know how their hospitals are performing and what services need to be improved,” Dingell and Walberg wrote last week in a letter to VA Secretary Bob McDonald, as quoted by Stars & Stripes. “Having a secret rating system only serves to increase distrust of the VA and may give the appearance that the department has something to hide.”

Part of 47 in the series Tomah VA Scandal
  1. After damaging silence, Baldwin now calls for probe of troubled VA center
  2. Legal expert says U.S. Sen Tammy Baldwin is in full ‘damage control’
  3. Baldwin aide breaks silence, alleges senator engaged in ‘coverup’
  4. Baldwin’s public relations team kicks into high gear following ethics complaint
  5. Ethics watchdog urges Senate committee to investigate Baldwin
  6. Tammy Baldwin’s political fixer is helping Hillary attack voter ID
  7. Senate committee asking if FBI missed the call in veteran’s death at VA
  8. When lawmakers failed Wisconsin’s veterans
  9. Is political pressure behind Lin Ellinghuysen’s differing accounts on VA memo?
  10. Bernie Sanders failed to act in deadly VA scandal, whistleblower says
  11. Does government union chief’s threat show AFGE’s hand on veterans care?
  12. What would Russ Feingold’s 1992 self say to the 2015 version?
  13. Ad attacking Feingold asserts veterans died because of ‘politicians who looked the other way’
  14. Feingold’s campaign caught up in VA scandal memo war
  15. PolitiFact Wisconsin trusts Russ Feingold to deliver its facts
  16. Sources: Ron Kind received call from Jason Simcakoski not long before Marine’s tragic death
  17. Captain Campaign Finance Reform, Russ Feingold, changes ‘dark money’ tune
  18. Baldwin talks transparency while keeping her secrets in Tomah VA scandal
  19. Ron Kind knew about Tomah VA abuse years before the story broke
  20. Ron Kind now solving Tomah VA scandal one press release at a time
  21. Tammy Baldwin silent on her failures as she blasts Tomah VA medical center
  22. Tomah VA whistleblower says he’s getting pressure from unhappy Dems
  23. Feingold’s facts fail again in face of Tomah scandal
  24. Senate field hearing to shine more light on Tomah VA scandal
  25. Tomah VA supervisor accused of misconduct gets promoted
  26. Senate hearing to look deeper into scandal-plagued Tomah VA hospital
  27. Kind flees questions, Senate committee turns up heat on Tomah VA hospital scandal
  28. Report: Tomah VA hospital story is one of ‘systemic failures’
  29. Tomah VA hospital whistleblower: ‘It will not change’
  30. Ron Kind breaks silence on call from veteran victim at Tomah VA hospital
  31. VA union holds rally to save itself, Tomah whistleblower says
  32. Sound familiar? Illinois Rep. Tammy Duckworth accused of retaliation at VA
  33. Emails say Tomah VA patient reached out to Feingold, Kind, in 2008 about abuse
  34. Johnson: Hold accountable those who put Tomah veterans at risk of HIV, hepatitis
  35. Veteran jumps out of third-floor window at Tomah VA hospital
  36. Tomah VA employee: ‘We have forgotten who we work for’
  37. Congressional committees want answers on Tomah VA hospital
  38. Senators ask Pence, Trump transition team, to hold troubled VA accountable
  39. Veterans advocate: VA hospitals’ ‘improvement’ doesn’t tell whole story
  40. Tomah VA Medical Center’s ‘Candy Man’ stripped of license
  41. Opinions differ on whether it’s ‘meet the new boss, same as the old boss’ at Tomah VA
  42. Latest data show Tomah VA hospital improving in opioid prescriptions, veteran satisfaction
  43. VA secretary nominee faces little resistance, lots of challenges
  44. Insiders: Tomah VA troubles continue with nurse shortage, neglectful care
  45. VA whistleblower has questions for Congressman Ron Kind
  46. Johnson brings back whistleblower protection bill as Sunshine Week opens
  47. Iraq war veteran burned by ‘very frustrating process’ at VA


M.D. Kittle is bureau chief of Wisconsin Watchdog and First Amendment Reporter for Watchdog.org. Kittle is a 25-year veteran of print, broadcast and online media. He is the recipient of several awards for journalism excellence from The Associated Press, Inland Press, the Wisconsin Broadcasters Association, and others. He is also a member of Investigative Reporters & Editors. Kittle's extensive series on Wisconsin's unconstitutional John Doe investigations was the basis of a 2014 documentary on Glenn Beck's TheBlaze. His work has been featured in Town Hall, Fox News, NewsMax, and other national publications, and his reporting has been cited by news outlets nationwide. Kittle is a fill-in talk show host on the Jay Weber Show and the Vicki McKenna Show in Milwaukee and Madison.