Anited States Senate WASHINGTON, DC 20510 June 26, 2018, Mr. J. Ronald Johnson Ms. Rebecca J. Stackhouse rector Director Hampton VA Medical Center Salem VA Medical Center 100 Emaneipation Drive 1970 Roanoke Boulevard Hampton, VA 23667 Salem, VA 24153 Mr. John A. Brandecker Dr. Adam M. Robinson, Jr. Director Acting Director Hunter Holmes McGuire VA Medical Center Washington DC VA Medical Center 1201 Broad Rock Boulevard 50 Irving Street NW hmond, VA 23249 Washington, DC 20422 Dear Mr. Johnson, Mr. Brandecker, Ms. Stackhouse & Dr. Robinson: We are writing to express our deep concer over recent reports in the media of inadequate care provided in nursing homes overseen by the Department of Veterans Affairs (VA), including those located in Virginia and Washington, D.C. Specifically, an investigation by US4 Today and the Boston Globe revealed unacceptable conditions for patients in VA-run nursing homes across the country. Detailed data on VA nursing homes previously undisclosed by the Department indicate that nursing homes in Hampton, Richmond, Salem, and Washington, D.C. have outcome metrics far ‘worse than private facilities. According to the VA’s tracking system, the VA faci average, below private nursing homes on 9 of 11 indicators. The following metries for facilities in the Commonwealth and in Washington are deeply alarming: Residents reporting serious pain in the past five days Hampton ~ 25.8% (VA) vs. 5.6% (private) Richmond — 22.1% (VA) vs. 5.6% (private) Salem ~ 32.4% (VA) vs. 5.6% (private) Washington, D.C. ~ 25.67% (VA) vs. 5.6% (private) Short-stay residents in serious pain in past five days Hampton ~ 25.8% (VA) vs. 13.3% (private) Richmond ~ 44.2% (VA) vs. 13.3% (private) Salem ~ 19.0% (VA) vs. 13.3% (private) Washington, D.C. ~ 37.45% (VA) vs. 1 32% (private) Residents with serious bed sores Hampton ~ 11.5% (VA) vs. 5.6% (private) Salem — 17.3% (VA) vs. 5.6% (private) Washington, D.C. — 16.4% (VA) vs. 5.6% (private)Residents with catheter left in the bladder Hampton ~ 12.8% (VA) vs. 1.8% (private) Richmond ~ 13.7% (VA) vs. 1.8% (private) Salem ~ 13.6% (VA) vs. 1.8% (private) Washington, D.C. — 11.6% (VA) vs. 1.8% (private) Although we are disturbed that the VA did not voluntarily share this data, we are pleased that an amendment was added to the FY 2019 Military Construction and Veterans Affairs Appropriations bill, which recently passed the Senate. This legislation will ensure that this information becomes public in the future. It is critical for the VA to be transparent about the quality of care provided to our nation’s veterans. Stakeholders, patients, and their families deserve to have a clear understanding of potential deficiencies. We are particularly interested in understanding what steps each of your facilities are taking to address and mitigate these serious problems, as shown by the data. Our nation’s veterans deserve the best care we have to offer. We must renew our commitment to ‘ensuring that veterans have the high quality of care that is worthy of their service and sacrifice. It is imperative that you determine a plan to alleviate these issues in the coming weeks. Thank you for your attention to this matter. We look forward to your timely response. Sincerely, oon MARK R. WARNER TIMKAINE United States Senator United States Senator