#VAFail – At the Manchester VA, good performance ratings don’t equal good performance
One of the VA’s better-rated facilities has come under fire on multiple fronts for misconduct and poor quality of care for its patients. Whistleblowers at the Manchester, New Hampshire VA – the only VA hospital in New Hampshire – claim that facilities are unsanitary and infested with flies, veterans are waiting extensive amounts of time for follow up appointments for serious illnesses, and veterans are needlessly facing adverse effects from their care at the VA due to poor practices.
These issues may seem like they would earn the Manchester VA one or two stars on the VA’s hospital rating system. But this facility is considered one of the best in the country, according to the VA performance rating. In fact, the Manchester VA has recently been upgraded from three stars to four stars, all the while issues with management and patient safety have been festering for years.
The Boston Globe released an in-depth report over the weekend on allegations coming from staff inside the Manchester VA. The claims in this report are shocking, even by the VA’s standards. The seemingly least of these problems is the fly infestation in an operating room that has persisted over years and has shut the entire room down. The VA is certainly not new to pest problems in its facilities. Just a few months ago, the Hines VA facility outside Chicago was confirmed to have a cockroach infestation so bad that the roaches made their way onto the plates served to veterans. One nurse in Manchester claimed it had been a problem for the last 16 years. Of note, the staff member who spoke to the Boston Globe about the infestation did so under promise of anonymity, “out of fear of possible repercussions.” That is not the sign of a healthy work culture.
Other issues included the purchase of a $1 million piece of equipment that doesn’t fit in the examination room and remains unused until remodeling next year. Without this equipment, Manchester can’t offer tests contributing to the detection of tumors and heart disease. In addition, three veterans had surgeries canceled because of surgical instruments that arrived unsterile – with “what looked like rust or blood stains.”
Finally, and maybe most disturbing, is the amount of patients who’ve received improper care. A neurosurgeon from Boston “lamented that several Manchester patients sent to him had suffered needless spinal damage including paralysis, because the hospital had not provided proper care for a treatable spine condition called cervical myelopathy.” The number of cervical myelopathy cases have been described as “mind-blowing” and likened to conditions only common “in 3rd World countries.” Shoddy workmanship and lack of follow up and oversight have led to the disaster that is Manchester’s VA.
The US Office of Special Counsel has found “’substantial likelihood’ of legal violations, gross mismanagement, abuse of authority, and a danger to public health.” Again, not the words one would expect to describe a four-star hospital. Secretary Shulkin has already made moves to remove top leadership and rectify the situation in Manchester, but for many, the damage is already done. What’s even more troublesome is if those veterans had the choice to seek their care somewhere else, perhaps they would not be pointing out flies in the operation rooms or suffering damage to their mobility as a result of poor care.