Watchdog.org has a new article up today about the VA. This time, they’re questioning some activities at the 111-bed VA Overton Brooks Medical Center in Shreveport, LA. At first glance, it certainly seems that the activities in question need questioning.
Seems the VA Medical Center there has some problems. The article lists several. But the one that got my attention most was the fact that it has been running out of things lately.
What kind of things, you ask? Well, things like toiletries – toothbrushes, toothpaste, stuff like that – for patients.
Well, that’s not so bad, you say? True. But they’ve been running out of other stuff, too. Like clean sheets. And serviceable blankets. And clean pajamas.
However, it also seems like the facility has plenty of money. They recently spent just under $74,500 on flat screen TVs. No, not new TVs for each of the 115 patient rooms. New 42″ (and one 50″) flat-screen TVs to be placed in hallways at elevators. The VA issued a statement saying that these TVs were
. . . procured to serve as an electronic bulletin board that “offers an easy way to spread information to a wide audience in a short amount of time. It also provides a way to inform … (about) Medical Center activities, future events and specific health-related topics,” . . .
Hmm. Yeah, that’s a great way to use our tax money instead using it to support basic facility operations. I can’t see why anybody would complain.
They also bought new furniture – at least some of which was made in Canada, not the US – to the tune of just over $134,000. And they spent $3M on solar cells for the facility.
Hey, sometimes you need to replace furniture, and the facility was built in 1950. So maybe the furniture buy was legit – though given employee accounts that much of the furniture previously on hand was in “great shape”, I kinda doubt it.
I also don’t have any data on the payback period for the solar cells, so I won’t dispute that purchase either. Based on previous idiocy we’ve seen from this Administration regarding other so-called “green energy” products (like that $24/gallon biodiesel the Navy purchased), I have my doubts. I’d guess it’s likely a waste, and will never pay for itself. But maybe not.
Further: this hospital is currently sending their soiled items over 100miles to another VA facility to be laundered so that job can be performed by VA employees. (And no, I’m not joking; that’s really their stated reason for periodically running out of bedding and pajamas.) So I think I can recommend an easier and simpler way to save even more energy than spending $3M on solar cells – and one that has a real short payback period.
But the hallway TV procurement for use as an “electronic bulletin board” really bothers the sh!t out of me.
Why? Well, for starters: $74,000 for 24 TVs works out to over $3,080 each. That probably includes the broadcast source, cabling, and installation. But still: close to $3,100 a screen? Damn, that seems pretty excessive for something used to display the weather, inspirational sayings, quotations from modern poets, and healthy lifestyle exhortations at the facility’s elevators – which is what one employee says is all that is routinely displayed on them.
But that’s not what torques me the worst. What galls me most is that I took a few minutes, looked up a few prices for hospital bedding (here) and blankets (here), and did a little math. And the results (and implications of same) were, well, disgusting.
Per those price sources, purchased in case lots (60 each) a set of sheets plus a pillowcase runs somewhere about $20. A decent cover/blanket runs about the same. So a set of hospital bedding runs about $40.
That’s commercial pricing. I’m guessing the government could negotiate a substantially better price – but let’s use those numbers anyway.
$74,000 / $40 = 1,850. That means the money spent on those flat-screen TVs could have bought 1,850 complete sets of bedding for the facility (set of sheets, pillowcase, blanket).
The facility has 111 beds. Assuming a daily change of sheets for each bed, that’s over 2 weeks worth of linen for every hospital room in the facility. Even if each bed needs a 2nd change once a week (due to sickness, accidents, spills, etc . . . ), that’s still nearly 2 weeks worth of linen. Cut back the furniture buy by about 33% and you’re talking about purchasing around 3 weeks worth.
Seems to me that 2 weeks is more than enough time to get the laundry done and returned. And it seems that having a 3-week supply of new bedding on-hand would fix the current problem of periodically running out. But apparently having those damned TVs and that new furniture was more important than making sure patients had clean linen when needed.
The basic article goes on to discuss a number of other problems at that VA Medical Center. Disgusting – there’s really no other word.
. . .
I’ve said it before, but I’ll repeat myself here. IMO, the VA doesn’t have a resource problem. The VA has a leadership, culture, and priorities problem.
The new VA Secretary there needs to f**king clean house among his agency’s management.
Question: Do we know that the technology and/or furniture purchases came from the same pot of money as what is authorized for bedding and laundry? I ask this because it is ILLEGAL to spend money designated for a TV on something like bedding, even if it makes more fiscal sense to do so. I’m not saying it’s not mismanagement, but we need to know if it’s budget personnel, congressional appropriators, or administrators that are responsible for this wasteful spending.
That is not clear, but the possibility you raise is potentially valid – at least in part.
VA funding is apparently managed quite differently than that of DoD – there are a number of different one-year, multi-year, and no-year accounts, not the relatively neat 5 you normally find in DoD (O&M, Proc, R&D, Construction, and MILPERS). Because of that, I can’t really hazard anything but a guess on that point. Or, more precisely, two guesses.
Disclaimer: while I’m relatively familiar with how DoD manages it’s money, I’m not terribly familiar with the VA’s process. What follows is based on what I could find quickly, and may well be in error.
VA Hospitals fall under the Veteran’s Health Administration (VHA). Presumably the funding involved was therefore either VHA funding or central, VA Departmental-level funding (these types of funds at the VA also appear to be separate accounts).
IT funding for the VA appears to be a centrally-funded Departmental account (0167). Therefore, if the funding used for the TV purchase was IT funding, there may indeed be a “color of money” problem in using it to support other aspects of the hospital’s operation. (That’s very unlikely to be the case for the furniture, though, since using IT funding to buy reception-area or hospital-room furniture would seem to be problematic.)
However, if the items were procured with VHA funding (as appears very likely the case for the furniture and may also be the case for the TVs), the case for a “color of money” issue becomes less defensible.
Per this document, unlike DoD’s 5 “colors” of funding, there appear to be a relatively large number of different appropriated funds accounts and types for the VHA. However, most of them are clearly not legitimate sources for the money used here. Three are, however: 0152, Medical Support and Compliance; 0160, Medical Services; and 0162, Medical Facilities. Each of these funding accounts have both one-year and multi-year variants – “colors”, if you like.
Like most Federal appropriations, the one-year and multi-year funds at the VA have expiration dates. And like other Federal entities, the VA has internal reprogramming authority for (by government standards) relatively small amounts like $150k. (Other documents I’ve seen lead me to believe the reprogramming limit for the VA withing a funding type is at least $1M, and may be higher – but I could be wrong about that.)
My guess here is that the funds used for the furniture and TVs in question were very likely expiring VHA funds from one of the 3 above accounts (0152, 0160, or 0162) that were “swept” and reprogrammed near the end of a FY to prevent loss (“spend it or lose it”). If so, my guess is the local Hospital Director (or someone working for him/her) likely authorized or arranged the authorization of repurposing those funds to support these buys.
Alternately, it’s possible the items could have been planned purchases all along, likely IMO in either the 0152 or 0160 accounts – or the TVs in question could have been centrally funded using Departmental IT funds. In the latter case (IT funding), this may indeed be a case of a coincidence looking bad. In the former case, IMO it appears someone either screwed up or put “pleasing the boss” ahead of patient care.
Given what we’ve seen from the VA recently concerning being a “good steward” of public funds, I’m not exactly inclined to give them the benefit of the doubt.
Having worked in a VA Contracted assisted-living/nursing/rehabilitation facility, I know a thing or two about laundry.
Bedding requirements are 4×number of beds. So, 444 sets of bedding.
Every three months, the worse bedding get thrown out (holes, etc.) and a count is done. enough packs are purchased to bring the total up to the minimum number.
On top of this, laundry is to be done DAILY at the very minimum. IF they are an actual hospital without a laundry department on-site, then they must have some loose-arse state regulations. Any build-up of more then three days of linen is actually an OSHA violation.
So, 1,850 sets should last a 111-bed hospital a while – right?
I swore I would never post here again after the last fiasco, but I had to jump in on this. I’ll keep it short.
Hospital linens are an enormous expense. Changing linens twice a week? Try twice a SHIFT, in some cases more, where the patient is incontinent of urine or feces, or has suffered the loss of other bodily fluids / functions. Try burn units, where the sheets are sterile and have to be resterilized to be used again. Ditto in cases where the patient has anything that might be communicable and the linens are soiled to the point where they have to be destroyed (you pay for that, too, because they are a biohazard and need special handling.)
Linens that are sent for washing are put in water far hotter than most regular, or regular commerical units, produce. The detergents and bleaches are industrial grade. Some of those sheets are sterilized, sterile packed, and sent to surgical units and burn units.
That and more. All of it costs money. If hospitals are doing it the right way, those linens NEVER leave the hospital system unless they’re not coming back. The hospitals I used to work in had their own laundry, and I don’t know how it’s done now, but I guarantee it’s not cheap. And if they have found a way to do it cheaply, I’d put money on the fact it’s being done wrong.
The VA Hospital I work at has our own laundry Service, and we provide the service for several others. The cost is not cheap… They also go through a crap load (pun intended) of linnen. It gets changed a lot.
Other private hospitals I know of outsource their linnen/laundry to private companies. it just is not feasable for them to operate their own.
Someone else brought up budgeting, you cannot divert money from one service to another, it has to be spent on what it is budgeted for.
It is up to the individual services to submit what their budget needs are, and for the Hospital Director to ensure that things are running smoothly and efficiently.
I don’t know how efficient it is to send out dirty linnen to a facility 100 miles away, rather than outsource it to one of the many private vendors. I think we can all agree it is not being done efficiently though.
Um, Pinto Nag . . . what I said above is daily changes plus a second change one day a week – or 8x weekly. Not 2x weekly.
I dunno, I work at a DoD site with a hallway IPTV system, and I’d imagine it cost quite a bit more than $75k. These TV’s need to be installed and wired, then there has to be some kind of machine/machines for setting up and streaming their programming. I have no idea where those are located, but I probably should.
Of course we have the solar panels too, and all that BS. …and we’re in the same state… Maybe a coincidence or maybe some kind of buddy-buddy backscratching.
Sadly, it sounds like very normal spending in Federal LaLaLand to me…. but too, I’d like to see a top to bottom overhaul of the whole damn system. Doing so many things so badly should not be that expensive. NOBODY should need 5000 forms and 200 paperpushers to purchase a set of pencils.
Wow! Sounds to me like there’s a VA Hospital Administrator down in Shreveport in line for a promotion soon! We could be talking Washington DC for this one!
The real problem at many VA’s across CONUS is that VA senior staff at many hospitals, to include their Directors, are taking orders from VA attorneys at this point.
They are so far behind the 8-ball with respect to common sense and accountability, the larger VA legal team (General and Regional Counsels) are calling the shots to minimize communication and further damage.
Very much akin to a fan with no idea to the interworking’s of the game calling the plays.
Maggots.
“I’ve said it before, but I’ll repeat myself here. IMO, the VA doesn’t have a resource problem. The VA has a leadership, culture, and priorities problem.”
Umm, which is exactly what I was inferring years ago.
How’s that Shinseki firing doing so far?
Getting rid of one incompetent scapegoat isn’t going to ‘fix’ decades and decades of corruption, cronyism. The VA is a multi tentacled mess of a bureaucracy, so you’re dealing with a whole mess of different entities with their own rules.
100 miles? Dallas VA?
LA VAs have been a nightmare. Sad, I have friends and family vouch that Shreveport VA is the best of the bunch. Alexandria VA sucks, my friend worked there aand friend of family spent nearly 30 years getting his full disability.
I can’t even trust to send my VA paperwork to LA, so I just sent mine to Boston before I move. Louisiana VA will never get it right.