This spring, Florida Gov. Rick Scott has been sending state inspectors unannounced to VA medical centers, including Riviera Beach, to demand access to records on patient deaths.
His interest in transparency from the VA is commendable. It’s well established that shining a light improves quality of care. But if transparency is good for the VA, it’s also good for Florida’s state-licensed hospitals.
Unfortunately, the Scott administration has just taken a giant step backwards in that arena.
In recent months, both CNN and CBS’ “60 Minutes” have uncovered problems throughout the VA, especially in Phoenix, where dozens of veterans apparently died while on secret waiting lists for appointments with scarce specialists. This week, Department of Veterans Affairs Secretary Eric Shinseki ordered face-to-face audits of scheduling at all VA clinics and medical centers, including those in Florida.
A spokeswoman for the VA in Riviera Beach notes that when the hospital was built, it anticipated serving about 30,000 veterans in the region. Today, over 60,000 veterans seek care from the hospital and its six clinics. Staff has increased by 60 percent, but the local VA is still having trouble meeting demand for dermatology, urology, optometry and orthopedics services.
Urgent cases are seen right away, but non-urgent and elective cases have the option of going to an outside provider in the community if an appointment can’t be made within 30 days, said spokeswoman Mary Goodman.
There have been five documented adverse events associated with appointment delays at the Riviera Beach VA since 1999, including two deaths, one not due to the delay, according to a VA report. Scott’s staff is demanding detailed records about those events. They should get them, just as the public should have easy access to documents on adverse events at other Florida hospitals.
It was 2003 when then-Gov. Jeb Bush launched a state website intended to open a transparent window to Florida’s health care system. The website, www.floridahealthfinder.gov, included not just information on the cost of care, but offered real documents about the quality of care. Today, consumers can still go to the bottom of the main Web page, and click on a link called “Inspection reports and final orders” to find out if a health facility has a clean bill of health.
But this spring, some of the most valuable records on that site were removed – the ones for hospitals, not for other health facilities.
These documents are important. They describe an inspector’s unannounced visit to a hospital, usually based on a complaint. Often the inspectors find no problems. But sometimes, they detail problems with infection control, nurse staffing, equipment maintenance or housekeeping.
A state Agency for Health Care Administration spokesperson says the hospital reports were removed from the website this spring after analysis found confidentiality and privacy could be compromised should the records be merged with other data sources. She notes they are still available through an official public records request. Some of the documents, the ones reported to the Centers for Medicare and Medicaid Services, can be seen elsewhere, she added.
It’s difficult to see the reports’ removal as anything other than a gift from Scott, the former CEO of HCA, the nation’s largest hospital chain, to his former hospital industry colleagues.
Ironically, the Department of Veterans Affairs is relying on the same excuse – worries about confidentiality and privacy – to block Scott’s access to records about adverse events at the VA.
Scott decries the VA’s lack of transparency in Washington. He needs to guarantee it at home.