The Government Accountability Office (GAO) announced it has recommended that the Department of Veterans Affairs (VA) under Secretary for Health 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. The VA concurred with GAO’s recommendation in principle.
About 9,000 veterans a day receive nursing home care in 134 VA community living centers (CLCs). GAO reviewed the data VA has on COVID-19 cases and deaths at these facilities. Since November 2020, the five highest case rates at these facilities ranged from 38% to 59% of residents. The five highest death rates ranged from 6% to 11% of residents.
The VA has been compiling and reviewing resident COVID-19 data by facility since November, but it hasn't been doing the same for facility staff. GAO has recommended that VA regularly compile and review staff COVID-19 data by facility.
VA provides or pays for nursing home care for approximately 9,000 veterans per day in three nursing home settings, including in 134 VA-owned and -operated CLCs. The health and safety of the nation's nursing home residents—often in frail health and living in close proximity to one another—has been of particular concern since the emergence of COVID-19, a new and highly contagious respiratory disease causing severe illness and death, particularly among the elderly. VA has issued guidance on national surveillance (data collection and reporting) of COVID-19 case growth across the VA health care system to inform resource allocation, maximize clinical care, and predict future trends in the pandemic.
The CARES Act includes a provision that GAO monitor the federal response to the pandemic. In this report, GAO examined 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.
Since November 2020, the Department of Veterans Affairs (VA) has had facility-specific data on COVID-19 cases and deaths among residents in CLCs, which are VA-owned and -operated nursing homes. According to officials, VA compiles and reviews these data on at least a monthly basis. Officials stated that they report these data to VA leadership if they determine that the data indicate a change to current policy or practice related to the response to the pandemic in CLCs is needed.
While VA has facility-specific data on COVID-19 cases and deaths among CLC residents, the agency does not have such data for CLC staff. Officials indicated it is challenging to identify staff who worked in a CLC in existing employee data on COVID-19. However, Centers for Disease Control and Prevention guidance recommends that officials should have data on public health emergencies by specific populations and by locality to develop appropriate responses. GAO's prior work also identified the importance of reporting COVID-19 data by demographic group and geographic location.
