Healthcare Inspection —Alleged Program Mismanagement and Other Concerns at the VA Southern Oregon Rehabilitation Center and Clinics, White City, Oregon

OIG conducted a healthcare inspection in response to allegations regarding program mismanagement and other concerns at the VA Southern Oregon Rehabilitation Center and Clinics (SORCC), White City, OR. Specifically, the complainant alleged that: Home Based Primary Care (HBPC), the Transitional Care Unit (TCU), the Non-Institutional Purchased Care program (specifically, the Homemaker and/or Home Health Aide services (H/HHA)), and the Housing and Urban Development Veterans Affairs Supported Housing (HUD-VASH) program were mismanaged and lacked appropriate oversight; Services, such as occupational therapy, physical therapy, case management, discharge planning, and mental health, were unavailable; Services were denied to patients as a result of other patients receiving services inappropriately; TCU patients’ lengths of stay (LOS) were based on need for reimbursement rather than clinical criteria; H/HHA service hours were inflated; Patients were harmed at the SORCC; Training and educational resources were unavailable for staff. We initially substantiated that H/HHA and HUD-VASH programs lacked appropriate oversight as the Community Care Oversight Committee (H/HHA oversight) and the HUD-VASH program committee did not have required attendance or documentation of relevant program issues as described in Veterans Health Administration (VHA) and SORCC policy. However, based on updated information we received in 2016, we noted new committee leadership, required attendance, and discussion of relevant program issues. We did not substantiate the other allegations. We found the HBPC program and the TCU complied with selected VHA requirements; oversight committees were in place; members attended meetings; and action items were identified, addressed, and resolved. We reviewed selected services and found the patients we reviewed had received required services. We did not receive the names of any patients, and we did not identify any patients, who were denied services. We identified and reviewed the EHRs of 11 TCU patients whose LOS were over 90 days. We found the LOS were appropriate based on the inability of the patients to be fully successful in the traditional SORCC setting or in the community. We did not find an inflation of care needs without clinical justification for H/HHA patients. We found various educational resources were available to staff and that management supported necessary clinical training. We made no recommendations.