WASHINGTON — The Department of Veterans Affairs has for years assigned star ratings for each of its medical centers based on the quality of care and service they provide, but the agency has repeatedly refused to make them public, saying they are meant for internal use only.
USA TODAY has obtained internal documents detailing the ratings, and they show the lowest-performing medical centers are clustered in Texas and Tennessee.
VA hospitals in Dallas, El Paso, Nashville, Memphis and Murfreesboro all received one star out of five for performance as of June 30, the most recent ratings period available.
Many of highest-rated facilities are in the Northeast — in Massachusetts and New York — and the upper Midwest, including in South Dakota and Minnesota. Those medical centers scored five out of five stars.
The VA determines the ratings for 146 of its medical centers each quarter and bases them on dozens of factors, including death and infection rates, instances of avoidable complications and wait times.
USA TODAY Network is publishing the ratings in full for the first time so that members of the public — including patients and their families — can see how their local VA medical centers stack up against others across the country.
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The documents obtained by USA TODAY detail those averages, and when asked about them, VA officials agreed to provide updated statistics. Overall, the data show something of a mixed bag, with improvements in some areas and declines in others.
On average, veterans are dying at lower rates and contracting fewer staph and urinary tract infections from catheters in VA medical centers since 2014. Veterans are not staying as long in VA hospitals and they are being readmitted within 30 days at lower rates.
At the same time, veterans are experiencing higher rates of preventable complications during hospital stays, on average, than they did in 2014. Those on ventilators suffered more problems, such as catching pneumonia, and the rate of turnover for nurses has increased.
The VA has also seen increases in the percentage of veterans who have to wait longer than 30 days for appointments when they are new patients. Overall, more than 500,000 veterans were still waiting longer than 30 days to be seen as of Nov. 15. More than 125,000 of them were waiting longer than two months, and 46,000 were waiting more than six months.
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