GAO: VA Health Care: Additional Data Needed to Inform the COVID-19 Response in Community Living Centers

“In August 2020, we began work reviewing VA’s response to the COVID-19 pandemic in CLCs under the CARES Act provision that GAO monitor the federal response to the pandemic.9 In this report, we examine the extent to which VA has data on COVID-19 cases and deaths among CLC residents and staff. Future GAO work will address more broadly selected CLCs’ experiences responding to the pandemic and VA’s oversight of this response.”

“To examine this issue, we interviewed VA officials about the data that VA has on COVID-19 cases and deaths among CLC residents and staff, including officials from VA’s Healthcare Operations Center; Office of Geriatrics and Extended Care; and Office of Reporting, Analytics, Performance, Improvement, and Deployment. Further, we analyzed the available facility-specific data that VA had on COVID-19 cases and deaths among CLCs as of February 2021 and calculated cumulative case rates and cumulative death rates. We evaluated the available data against Centers for Disease Control and Prevention (CDC) guidance and prior GAO work on national surveillance of public health events, such as the COVID-19 pandemic, as well as federal internal control standards related to risk assessment and information and communication…”

While VA Has Facility-Specific Data on COVID-19 Cases and Deaths among CLC Residents, It Does Not Have Such Data for CLC Staff

VA Has Had Facility-Specific Data on COVID-19 Cases and Deaths among CLC Residents since November 2020

“VA has facility-specific data—that is, data by individual CLC—on COVID-19 cases and deaths among CLC residents to inform its response to the pandemic in this nursing home setting. According to officials, VA had these data beginning in November 2020. Prior to that time, VA only had CLC-specific data on the number of COVID-19 cases and deaths among all residents nationwide, which, according to agency officials, the agency began to work to compile in June 2020 retroactive to March 1, 2020. Officials told us that they were unable to compile reliable facility-specific data until November 2020 because of challenges in classifying resident cases and deaths by individual CLC…”

Conclusions

“Veterans who receive nursing home care in one of VA’s 134 CLCs are at increased risk of contracting COVID-19 and experiencing severe morbidity or mortality related to this disease. CLC staff are also at elevated risk of contracting the virus or transmitting it to residents, given the close and personal day-to-day contact they have with these veterans. Although VA now has facility-specific data on the number of COVID-19 cases and deaths among CLC residents, the agency does not have these data for CLC staff. These facility-specific staff data would provide a more complete picture of the COVID-19 situation in CLCs, which VA could use to better inform the agency’s response to the COVID-19 pandemic—or to future infectious disease outbreaks—and target its response effectively.”

Recommendations for Executive Action

“We are making the following recommendation to VA:The Department of Veterans Affairs Under Secretary for Health should compile and review facility-specific COVID-19 data on Community Living Center staff cases and deaths on a regular basis to inform the agency’s response to the pandemic or future infectious disease outbreaks…”

Read the full 21-page report here.

Source: VA Health Care: Additional Data Needed to Inform the COVID-19 Response in Community Living Centers – June 10, 2021. GAO.

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