Sen. Charles Grassley

The Department of Veterans Affairs has three weeks to deliver an accounting of the inspection and quality control processes it uses to assess a network of more than 150 state-run veterans homes.

Sen. Charles Grassley (R-IA) this week sent a letter to Veteran Affairs Secretary Denis R. McDonough asking a wide series of questions about its oversight capabilities and reported inconsistencies.

Grassley’s letter demanding more transparency follows a two-year period during which the Government Accountability Office called out the VA for its lax standards, and more than 1,400 residents died of COVID-19 at residential facilities supervised directly by state officials.

“Unfortunately, it appears that the standard of care and quality controls at many state veterans homes falls well short of those required by other government supported nursing homes,” Grassley said in a press release issued late Monday. “Americans deserve answers and our veterans deserve better.”

The senator cited a damning report published by Politico last month, as well as commentary published by McKnight’s Long-Term Care News, in questioning why state-run facilities for veterans aren’t subject to the same standards as federally run veterans facilities or the 15,000-plus nursing homes in the Medicare and Medicaid systems. 

While the VA has addressed some concerns raised by the GAO in 2019, the government watchdog reported this May that 28 recommendations it had made to the agency remained open. They include a suggestion to collect timely data on COVID-19 cases and deaths in its state veterans homes to improve its ongoing pandemic response.

“The VA regularly provides well over $1 billion annually to State Veterans Homes, to cover all or part of the care for veterans in need,” Grassley wrote in his letter. “Based on recent media reports and a report by the U.S. Government Accountability Office (GAO) on these state-owned and operated facilities, I strongly question the adequacy of the VA’s oversight of this federal spending.”

Among other questions, Grassley asked McDonough: If (and how) the VA consults with other agencies, such as the Centers for Medicare & Medicaid Services, that have an extensive system for oversight of civilian nursing homes; whether the VA has now fully implemented the GAO’s latest recommendations with respect to State Veterans Homes; if the VA intends to make additional reforms beyond those recommended by the GAO; and if the VA will make any changes to its website to ensure quality of care information is publicly accessible.

Grassley also asked whether Congress should provide statutory authority to facilitate the adoption of additional reforms to the oversight system for state veterans homes receiving Federal resources.