Administration asks for $2 million more for Vermont Veterans’ Home deficit

Vermont Veterans' Home

Vermont Veterans’ Home in Bennington has a capacity for 171 patients; last year its daily census dropped to 112. Photo by Andrew Stein/VTDigger

Budget woes are far from over at the Vermont Veterans’ Home.

The Bennington-based facility, which provides nursing home services for veterans, has an ongoing operating deficit of $2 million this year. Last week the Shumlin administration asked lawmakers on the powerful Joint Fiscal Committee to make up that difference in a budget adjustment after the Legislature already ponied up $1.5 million this year to help the home cover the shortfall.

The $3.5 million annual shortfall at the Vermont Veterans’ Home is in the foreground at the moment. Looming in the background is the specter of much deeper federal cuts.

The Centers for Medicare and Medicaid Services has set a termination date for Medicaid funding of Aug. 26 if the home can’t remedy standard of care problems at the facility. Inspectors for CMS will be conducting an unannounced survey of the facility in the intervening period.

A loss of Medicaid funding would cost the state roughly $7.1 million a year more, according to Jim Reardon, the commissioner of the Department of Finance and Management. CMS first threatened to pull support last fall for alleged violations ranging from insufficient staffing and mistreatment, abuse and neglect of patients, to failure to provide a safe, sanitary and comfortable environment. Shortly after CMS began an investigation last September, a nurse punched a patient.

The current enforcement cycle has “nothing to do with that at all,” according to Melissa Jackson, the director of the home. CMS most recently cited the facility for expired medication on nursing carts, she said. The federal regulators have also want to see better supervision of patients with dementia. The Vermont Veterans’ Home has one of the best-regarded dementia units in the country.

Jeb Spaulding, secretary of the Agency of Administration, told lawmakers that the administrators and staff are working hard to satisfy CMS standards and training requirements. There is “reason for optimism,” he says.

The daily census for the facility, which has a maximum capacity of 171 patients, has dropped to just 112 last year. Fewer patients means less revenue for the home from private payers and the federal government. Forty percent of the home’s patients are eligible for Medicaid.

The current patient census is 127, and about 240 people work at the facility. The annual operating cost for the home is $21 million.

Other states have managed to make their nursing homes for veterans not only solvent, but profitable.

Spaulding hopes the Bennington home, which is near the state border, will attract some of the 450 veterans who are on a waiting list for Massachusetts facilities. The governor’s office is working with Sen. Bernie Sanders to pursue a licensing agreement that would make it possible for the Vermont Veterans Home to take Medicaid patients from Massachusetts, he said.

“The governor wants to do what we can to make the veterans home sustainable,” Spaulding said.

The Legislature authorized an independent study of the management practices and costs associated with the Bennington home, the results of which should be available later this summer.

The employees of the home are state workers. Personnel makes up 80 percent of the costs associated with operating the facility.

CORRECTION: This article originally stated that the CMS investigation of the Vermont Veterans Home began after a nurse punched a patient. The probe began before that incident.

Follow Anne on Twitter @GallowayVTD

Anne GallowayAnne Galloway

Comments

  1. It is not correct that CMS inspections were initiated as a result of an incident with a nurse and an altercation with a patient. In fact, VVH had already been cited and failed to comply with its plan of correction by the time the incident you write about occurred. Incidentally, the nurse you write about reacted after a patient caused him severe pain when the patient essentially grabbed his genitalia. Adult protective services found no evidence of abuse and after 26 years of caring for our veteran’s the nurse was returned to employment having received many letters of support for his exemplary service.

    The crisis at the Vermont Veteran’s Home is a result of a failure of leadership and poor choices by the Board of Trustees. Please don’t repeat false claims. Please dont’ falsely blame the nurses and caregivers for management’s failed policies.

  2. Winifred Rose :

    I have worked at the Vermont Veterans Home for 15 years and never has the facility been at risk of loosing funding and yet this has happened twice under the current management. We have received multiple citations as a direct result of the poor decisions of management. The frontline workers care for the veterans and perform their jobs well. Management continually states that we can’t get admissions because of the bad publicity,,,funny the facility being at risk of loosing CMS funding twice and the multiple citations that are the fault of the management wouldn’t have anything to do with it. The management takes no responsibility for their actions, even when it is in black and white…the citations speak for their selves and are public knowledge. Though many of the staff have met with many representatives, legislators, Senators, and other administration, we can only had out packets of facts, we cannot force people to read them. The Frontline workers stand and advocate for high quality care and it’s difficulty if the managements has a different perspective. We shouldn’t have to battle to care for our veterans. Your title does not make you an honest person and the staff has the right to be heard.

  3. Rachael Fields :

    In April of last year, several members of VVH administration and Nursing Leadership were found by the investigating state surveyor to have knowingly broke federal and state regulations by making the decision to have an unlicensed employee administer medication to a resident at an appointment. We were cited for that. The management made a plan of correction and failed to follow through on it making a very similar decision and causing another citation. CMS threatened to pull our funding then and that was long before the incident mentioned above with the nurse. However, as usual, rather than take responsibility, they decided to play it off in the media like they had nothing to do with it. This is all public record. Read the citations online. Yet nobody in administration is willing to address the real issues. A budget shortfall?! VVH administration presented for next year a budget that was missing several million dollars worth of necessary expenditures. The legislators (thankfully) caught on to this and provided some of that money. The VVH Board and Administration purposely stopped admissions when we nearly lost our funding last year so we could supposedly get a better handle on things. That means that the home was paying much more than it was (is) bringing in. This intentional admissions stall was reported on at the time in at least the Bennington Banner. And do you want to know what the absolute most appalling and horrid thing about this is? Nobody has bothered to tell the staff, the veterans or their families that we are in this very serious situation that threatens the Veterans Home’s very ability to remain open. WE FIND OUT BY READING IT ON VT DIGGER. The veterans deserve better and the employees who work endlessly to serve the states veterans, deserve better!!!! When is someone going to listen to the frontline workers and stop this nonsense?!

  4. joanie maclay :

    We, the citizens who have enjoyed the many freedoms
    today that have been fought for by our men & women
    of the various military forces…owe to each of these men & women not only our thanks, but our gratitude. We can show this by always providing them with a safe and caring haven known as the Vermont Veteran’s Home. Many of these Veterans do need skilled care in a setting such as that provided at VVH. We have another Veteran’s facility located in Vermont. Has thought been given to these working in concert? Not becoming one, but working to
    provide the type of care needed. One might provide
    excellent medical care while the other might provide
    another type of care. We owe it to our Veterans to find a
    way to keep the VVH open and viable. ..doing what it does
    best..excellent care for our Veterans. We are obligated to do this.

    But perhaps when a Veteran has needs for elder car, perhaps not strictly medical care. Might be worth a thought.in the meantime, please come together to keep our Vermont Veteran’s Hone viable and doing what it dies best…caring for our Veterans.

  5. Heather Elwell :

    I have worked at VVH for just a couple months short of 2 years. The staff works hard, yet are forced to work harder. This article claims to have 240 employees to the 127 vets residing there, yet I dont see the numbers on a divided basis as far as how many make up dietary, activities, vcas, housekeeping, laundry, department heads, etc. Not all of the 240 employees are allowed to provide hands on care and its illegal for such unlicensed employees to do so. We are so short of funding, yet, there are monies found to contract out employment to a travelling nursing agency to cover these supposed call outs and vacations. Some of it may be as such, but this is not entirely the reason. I do recall that the last time we contracted out with this same company last year for a mere 2 months give or take, I was told out of the administrators mouth it costed the facility $25,000! It would be so much cheaper for them to actually hire new employees to fill in the positions that are clearly needed to be filled. The only issue now with hiring new employees is, who is seriously going to want to be employed here with all the goings on? This is an outrage and these veterans deserve better than this. And I like how it always boils down to being nursing departments fault! We are continually busting our humps daily to provide the best care possible with what we have. We are not even meeting minimum requirements at this time for staffing. Everytime I called our supervisor today, she was busy trying to call people to come in early, because we werent at the minimum. All these things that are “nursings” fault come right down to the lack of time we have. CCCs delegate their jobs to us, work gets added to us, we help out with hands on care as needed which is on a daily basis and nurses are being utilized to work as LNAs for full shiftbecause they are needed, but it also adds so much more to the workload of the nurses that arent

  6. Heather Elwell :

    I have worked at VVH for just a couple months short of 2 years. The staff works hard, yet are forced to work harder. This article claims to have 240 employees to the 127 vets residing there, yet I dont see the numbers on a divided basis as far as how many make up dietary, activities, vcas, housekeeping, laundry, department heads, etc. Not all of the 240 employees are allowed to provide hands on care and its illegal for such unlicensed employees to do so. We are so short of funding, yet, there are monies found to contract out employment to a travelling nursing agency to cover these supposed call outs and vacations. Some of it may be as such, but this is not entirely the reason. I do recall that the last time we contracted out with this same company last year for a mere 2 months give or take, I was told out of the administrators mouth it costed the facility $25,000! It would be so much cheaper for them to actually hire new employees to fill in the positions that are clearly needed to be filled. The only issue now with hiring new employees is, who is seriously going to want to be employed here with all the goings on? This is an outrage and these veterans deserve better than this. And I like how it always boils down to being nursing departments fault! We are continually busting our humps daily to provide the best care possible with what we have. and there are department heads there that have the gall to say that LNAs do nothing and dont even deserve to have breaks! We are not even meeting minimum requirements at this time for staffing. Everytime I called our supervisor today, she was busy trying to call people to come in early, because we werent at the minimum. All these things that are “nursings” fault come right down to the lack of time we have. CCCs delegate their jobs to us, work gets added to us, we help out with hands on care as needed which is on a daily basis and nurses are being utilized to work as LNAs for full shifts because they are needed, but it also adds so much more to the workload of the other nurses. And also, nurses are being paid overtime to work as LNAs as needed. Nurses working as LNAs is not really a huge deal when its only time to time, but they would not have to be paid the overtime for doing so if there were proper staffing levels not only based on the state minimums, but also the veterans acuity. Lets face it, some patients either demand more attention or really require more attention, which leaves the other ones that can obviously see the hustle and bustle going on not wanting to ask for more. I had a veteran who needed to use the toilet say to me “I dont want to be a bother to you. You’re all so busy…” i simply smiled and reassured him that I was more than happy to help and that he was in no way a bother and that it was my pleasure to help care for him. although smiling to him on the outside, my heart was breaking on the inside. this not an issue that they, the veterans, should be having to worry about. to feel like a bother or burden daily is beyond comprehension. they should feel comfortable knowing that their needs are going to be met in a timely fashion with a smile. Dont get me wrong, because we as the staff do our absolute best to meet these wonderful peoples needs, but there is always that feeling of doubt at the end of the day, like there was something you could have done more that time did not allow. there is so much more going on behind the scenes that people arent privy to, because of the fact that we as the frontline and hands on caregivers arent asked about, or are to afraid to talk about for fear of retaliation. The time for fear stops here. Enough is enough and something needs to be done. most of the staff employed there, have been there with longevity of at least 10 years plus. so if these issues and threat of loss of funding didnt occur then, why is it that they are all of a sudden occuring now?

  7. Dawn Keus :

    I have worked at the Vermont Veterans home for over 20 years and in all of my years of employment there have never felt so abused by administration. Let the facts speak for themselves. Management and management alone is what made the VVH a special focus facility as CMS calls it. That means everything we do is put under a magnifying glass to be inspected. Management earned us this title by their mistakes and wrongdoings over the past two years. Nobody is perfect and mistakes are only human, but it’s time to stop making scapegoats of the staff who work tirelessly everyday and have the leadership at the home take ownership of what they, themselves created. Read the citations for yourselves, they are public knowledge. Multiple citations alone for sending an unlicensed personnel wih a Veteran and having that person administer medication, perform care on and then send him out alone on an appt with no caregiver; but let’s not take ownership of that let’s blame the frontline workers “what do they have to lose except their dignity, self respect and let’s not forget their licenses.”

  8. Heather Elwell :

    my comment above was somehow cut short. but it adds more of a workload of the nurses that arent able to have that other nurses help. it would be nice to staffed not only based on the state minimums, but also the vets acuity. lets face it, some patients either demand more attention or truly require more time and attention. this leaves those who see the hustle and bustle going on not wanting to ask for more. There was a vet that needed to go to the bathroom today and he said to me ” I dont want to be a bother to you. You’re all so busy” I simply smiled and reassured him that he was in no way a bother and that it was a pleasure to help care for him. while i smiled in the outside to him, my heart was breaking on the inside. To feel like a bother or burden ins beyond comprehension. This is not something they, the vets, should have to be worrying about. The should feel confident that their needs are going to be met in a timely fashion and with a smile. dont get me wrong, we as the staff bustle o make sure their needs are met in such a way, yet at the end of the day, there is always that feeling that something more could have been done that time simply did not allow. There is so much more going on behinds the scenes that people arent privy to because we as the frontline workers and hands on caregiveres arent being asked, or they are too afraid to say something for fear of retaliation. The time for fear stops here. Enough is enough. We are either going to be retaliated against for standing up and saying something, or we are going to lose our jobs and the vets lose their homes because we said nothing. The staff that are employed here have been here with a longevity of at least 10 years plus, aside from the few newer employees. If there wasnt a threat to lose funding in the past, why is it happening now?

  9. Kathy Callaghan :

    Bravo to the VVH nurses and staff for speaking up and providing the public with detailed information about the disastrous conditions at the home.

    NOW will the VVH Board of Trustees and the Administration do something about the lack of competent leadership? Aren’t they the least bit embarrassed to ashamed to be allowing this mess to go on at the expense of our vets? Throwing more federal money at it isn’t the answer. Pay somebody whaevert it takes and get a competent director in there. The situation is shameful and totally unacceptable.

Comments

*

Comment policy Privacy policy
Thanks for reporting an error with the story, "Administration asks for $2 million more for Vermont Veterans’ H..."