Oregon VA Hospital Turns Veterans Away Because of "Risk"

At Veterans Hospital in Oregon, a Push for Better Ratings Puts Patients at Risk, Doctors Say
New York Times
By DAVE PHILIPPS
JAN. 1, 2018

“The doctors were mad; the nurses were mad,” said Mr. Savage’s son-in-law, Mark Ridimann. “And my dad, he was mad, too. He kept saying, ‘I’ve laid my life on the line, two years in Vietnam, and this is what I get?’”

ROSEBURG, Ore. — An 81-year-old veteran hobbled into the emergency room at the rural Veterans Affairs hospital here in December, malnourished and dehydrated, his skin flecked with ulcers and his ribs broken from a fall at home.

A doctor examining the veteran — a 20-year Air Force mechanic named Walter Savage who had been living alone — decided he was in no shape to care for himself and should be admitted to the hospital. A second doctor running the inpatient ward agreed.

But the hospital administration said no.

Though there were plenty of empty beds, records show that a nurse in charge of enforcing administration restrictions said Mr. Savage was not sick enough to qualify for admission to the hospital. He waited nine hours in the emergency room until, finally, he was sent home.

Fewer patients meant fewer chances of bad outcomes and better scores for a ranking system that grades all veterans hospitals on a scale of one to five stars. In 2016, administrators began cherry-picking cases against the advice of doctors — turning away complicated patients and admitting only the lowest-risk ones in order to improve metrics, according to multiple interviews with doctors and nurses at the hospital and a review of documents.

Those metrics helped determine both the Roseburg hospital’s rating and the leadership’s bonus checks. By denying veterans care, the ratings climbed rapidly from one star to two in 2016 and the director earned a bonus of $8,120.
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UPDATE

Roseburg VA official calls New York Times story about patient care 'false'

"At its core, the Roseburg VAHCS is primarily an outpatient center, and that’s why the hospital’s clinical leadership has made clear to its physicians that the facility has limited capabilities to care for patients with certain clinical conditions that are far better treated in nearby community hospitals.

This is precisely why we’re being transparent with our doctors about the conditions that the facility is unable to treat, because it’s in Veterans’ best interests for them to be seen at other hospitals in the community with greater capabilities to deliver them the best care for those conditions." You can read the rest here