VA Health Care

The Department of Veterans Affairs (VA) spent about $429 million to provide food services at 172 of its 175 inpatient health care locations in fiscal year 1998. Although some of this money went for nutrition needs assessments, counseling, and other patient-related activities, most--$337 million--was spent on preparing and distributing meals. Production and delivery costs averaged $24.50 per patient; daily costs at individual locations ranged from $8 to $51. The differences reflect the different requirements of, for example, hospitals and nursing homes. In the same year, 27 VA locations raised $739,000 by using excess food capacity to provide food services for 44 non-VA organizations, including nonprofit groups and federal, state, and local government agencies.

GAO noted that: (1) VA provides a variety of food services to meet the widely varying needs of patients; (2) for example, patients frequently need specialized food services, such as diet-restricted meals, snacks for special conditions like diabetes, and liquid nourishment for those unable to eat solid food; (3) most hospital patients need food delivery to their bedside; (4) many nursing home residents also require food service in their rooms, although a larger portion of nursing home patients eat in congregate dining areas; (5) the volume of food service at individual locations also varies, with most locations serving between 100 and 400 patients a day, although 25 percent serve less than 100 patients a day; (6) in fiscal year (FY) 1998, VA employees provided food services at 172 of 175 VA inpatient locations; private contractors provided food services at the 3 remaining locations; (7) VA-operated food service locations buy most of their food supplies from prime vendors who provide discounts for high-volume purchases; (8) VA-furnished meals and snacks include food cooked from scratch; pre-prepared foods that are purchased; and food cooked in advance and chilled for later use; (9) VA locations also use traditional and advanced food delivery methods to maintain proper temperatures when food is distributed; (10) the mix of these methods varies by location; (11) VA spent about $429 million on inpatient food services in FY 1998; (12) of this amount, VA spent about $337 million to produce and distribute inpatient food and nourishments, with the rest for patient-related activities such as nutrition needs assessment and counseling; (13) about 72 percent of production and distribution costs were for the wages and benefits of about 7,348 full-time-equivalent wage-rate employees; (14) VA's daily food service production and delivery costs averaged about $24.50 per patient, with individual locations' daily costs ranging between $8 to $51 per patient; (15) the range in costs partly reflects the range in nutritional needs, which are generally less in domiciliaries than in hospital and nursing home settings; (16) in FY 1998, 27 VA locations generated modest revenues of $739,000 by using excess food capacity to produce food service for 44 non-VA organizations; and (17) most sales were to private, nonprofit organizations; the other VA sales were primarily to federal, state, and local government agencies.