VA Health Care

Inadequate Planning in the Chesapeake Network Gao ID: HEHS-95-6 December 22, 1994

The Department of Veterans Affairs (VA) requested $14.5 million in its fiscal year 1994 budget request to build a 120-bed nursing home on the site of its former Baltimore (Loch Raven) Medical Center. Although Congress authorized VA's request, it required VA to reconsider the location of the new nursing home in the context of the entire Chesapeake Network and to determine whether the nursing home at the Fort Howard, Maryland, Medical Center needed to be expanded and modernized. VA reported to Congress that it had chosen the Loch Raven site for construction of a new nursing home and that the Fort Howard nursing home needed replacing. This report discusses whether VA used sound planning criteria in its choosing Loch Raven as a new nursing home site and in its plans to replace the Fort Howard hospital building and its nursing home.

GAO found that: (1) VA did not soundly plan its construction projects partly because it failed to provide adequate guidance to its regional offices and medical centers on how to change its facility-by-facility construction process into an integrated network planning process; (2) the VA Eastern Region did not provide an integrated plan to develop the Chesapeake Network into a competitive managed care system as VA envisioned; (3) VA inadequately surveyed the future availability of community nursing home beds, misallocated the availability of state nursing home beds, and did not thoroughly explore the option of renovating excess hospital space in determining the need for a new VA nursing home; (4) VA may have overstated its need to build additional extended-care capacity in the Chesapeake Network; (5) the VA construction plan may not be the best approach to improving veterans' extended-care services in the Chesapeake Network service area; and (6) the proposed site may not be the best location for a new VA nursing home in light of the misallocation of state nursing home beds.


Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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