It is old and difficult to reach for many veterans in the area, and a significant number of its beds are unused. After 80 years on the southern tip of the peninsula, Hampton Veterans Administration Medical Center faces an uncertain future.
Earlier this year, the AV’s study of its national health care system recommended replacing the center in Hampton with new centers in Norfolk and Newport News, while sending more veterans for medical and surgical care. at Portsmouth Naval Hospital and moving spinal cord injury cases to VA Center in Richmond.
Large increases in the number of Hampton Roads veteran patients and the region’s unique geography have been major factors.
For example, the study does not recommend replacing the hospital in Fayetteville, North Carolina, even though the number of VA enrollees is expected to grow even faster and the building is older than the one in Hampton.
The upgrade would cost about half of Hampton’s bill, according to the study. It does, however, recommend moving the primary care, outpatient mental health, outpatient specialty care, and urgent care services provided at the Fayetteville VA hospital to nearby VA facilities, including a new health care center. in Jacksonville and a proposed community clinic in New Bern.
In San Antonio, where the number of VA patients is growing rapidly, and in Southwest Virginia, where the number will decline, the study recommends replacing existing facilities because space on current campuses is tight and costs high modernization costs, as is the case for Hampton.
In central Georgia, where the Dublin VA hospital is almost as old as Hampton, the study recommends replacing it with a new hospital in Macon, 55 miles away, where about half of its current enrollees live. Although much smaller than Hampton, retrofit costs are 25% higher for a facility that lacks single occupancy bedrooms or bathrooms, with poor plumbing and HVAC. outdated air conditioning that has exceeded life expectancy.
“The commission aims to care for veterans well,” said John Byrne, director of education for Concerned Veterans of America.
He said the commission’s recommendations, such as Hampton’s, are aimed at modernizing VA facilities and putting them in the right places with the right services for veterans.
The opponents’ alternative to the recommendation, he said, “is to simply throw more money at the VA and rely on them to do what is necessary.”
The VA Hospital of Hampton serves a relatively large number of enrollees in the VA healthcare system, from the East Coast south to the Outer Banks and from James City County east to Virginia Beach – approximately 87,000.
But the three places with the highest numbers are Virginia Beach, Chesapeake and Norfolk – and when Portsmouth and Suffolk are added, the total rises to around 50,000 who must cross the Hampton Roads Bridge Tunnel or the Monitor Merrimac to get to go to the hospital.
The South Hampton Roads towns are also where the greatest growth in new patient numbers is likely.
The VA study predicts an increase of nearly 49% in enrollment in Chesapeake over the next 20 years, 31% in Virginia Beach, 25% in Norfolk and 34% in Portsmouth.
By contrast, the Peninsula, with just under 26,000 registered veterans, is expected to see its workforce increase by 17%, well below the overall growth of 23.5% predicted by the Hampton center.
The center was built in 1940 and does not meet today’s standards for floor-to-floor height, hallway width, column spacing and utility infrastructure.
The VA Assets and Infrastructure Review Board study said the physical problems it found would cost about $179 million to fix.
Problems include a very old sewage system, limited parking and difficulty in working on its electrical systems because the circuits supplied by various circuit breakers are not standardized, according to the study’s facility condition assessment.
“Very old pipes, dead legs and asbestos” and difficult access are problems for plumbing maintenance and repair, while lack of standardization, difficult access, pneumatic controls make difficult maintenance of heating, ventilation and air conditioning.
The masonry construction of its buildings means it is difficult to install or update new medical gas systems, while it can be difficult for patients and staff to navigate the many buildings in the hospital and their confusing layout.
“Frequent flooding and severe access problems for a large portion of the veterans it serves due to heavy traffic in the bridge and tunnel infrastructure” are also major issues, according to the study.
The hospital’s inpatient beds aren’t particularly stretched, according to the latest audit from the VA Inspector General’s office.
On average, 20 of its 33 medical beds are occupied, as are 22 of its 40 psychiatric beds, six of its 29 rehabilitation beds and 37 of its 64 spinal cord beds, according to the audit. Only 55 of the 168 home beds – a service reserved for disabled veterans – and 56 of the 122 nursing home beds are occupied on average.
The hospital has struggled for years to deal with longer than average waiting lists and challenges hiring staff.
Data compiled for the VA National Study showed wait times for mental health appointments averaged 5.2 days for Hampton, compared to a national average of 3.6 days. The average wait for primary care appointments at 7 days versus 4.1 days nationally, and the wait time for specialty care appointments at 6.6 days for Hampton versus 5, 3 days nationwide.
New patients wait even longer. Wait times for new patient appointments for primary care were 33.7 days in Hampton compared to 22.6 days nationally, and 27.2 days for specialty care compared to 21 days.
The study found unacceptable readmission rates of almost 13% within 30 days. The rates for cardiorespiratory and cardiovascular patients were higher, at 18% and 15%. Rates of preventable post-acute care problems and care transitions were also at unacceptably high levels, according to the commission’s study.
The audit, meanwhile, found that veterans complained about communication, cleanliness and food choices while in hospital.
Veterans complained of difficulty reaching staff because phone calls weren’t transferred properly, while some specialty areas had only one provider, the inspector general’s audit found.
During a follow-up audit, the inspector general reported a delay in diagnosing a patient with cancer after several Hampton staff members failed to notify the patient of abnormal test results over a period of nearly two years. A vascular surgeon has failed to communicate and act on a 2019 CT scan result in which a radiologist found a potentially malignant lesion in the patient’s prostate.
The patient’s primary care provider failed to notify the patient of an abnormal PSA test and did not order necessary follow-up testing and consultation with a urologist. A nurse practitioner failed to investigate the patient’s urological complaints during a phone call to check on him after a hospital visit.
The Hampton center ranked in the bottom 20% of VA centers for mental health population coverage as same-day appointments and care coordination for veterans in its medical home program patient-centered, according to the audit.
Review of medical records by auditors found that in nearly one in five cases there was no evidence that patients had received for management medication, as required for an antiviral drug, while the Surgical working group didn’t always meet monthly, as an VA directive says. these groups should.
More than a third of patients were not screened for suicide risk while in the emergency room, according to the audit.
The commission was created by legislation in 2018 that aimed to make it easier for veterans to access care outside of VA facilities. His job is to recommend ways to restructure the VA health care system in response to changes in the number of veterans in different parts of the country and their changing medical needs.
For Hampton Roads, in addition to a new VA hospital on the South Side, which would support Hampton’s inpatient mental health services as well as outpatient services, a community living center and residential rehabilitation services for alumni fighters at South Hampton Roads were recommended.
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A new Newport News Medical Center would support outpatient services, a community living center and residential rehabilitation services for the peninsula. Current research programs at Hampton would be transferred to Newport News facilities.
Portsmouth Naval Hospital would take over acute medical and surgical hospital care currently provided in Hampton, as well as emergency services; in addition, these services would also be provided in civilian hospitals, according to the commission’s plan.
The plan itself faces significant political opposition – a group of senators have vowed to block it.
The VA, meanwhile, said it was still committed to modernizing its system.
Dave Ress, 757-247-4535, [email protected]