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HRD-82-114 1 (1982-09-30)

handle is hein.gao/gaobabmpt0001 and id is 1 raw text is: 


                  UNITED STATES GENERAL ACCOUNTING OFFICE
                             WASHINGTON, D.C. 20648

HUMAN RESOURCES
   DIVISION                                     September 30, 1982


   B-208538


   The Honorable Robert P. Nimmo                            H B

   Administrator of Veterans Affairs                           119622

   Dear Mr. Nimmo:

         Subject: VA Should Consider Less Costly Alternatives Before
                    Constructing New Nursing Homes (GAO/HRD-82-114)

         We are evaluating the Veterans Administration's (VA's) readi-
    ness and plans to provide health care to the rapidly increasing
    aging veteran population. As part of that effort, we examined VA's
    nursing home care programs and the processes it uses to plan for
    meeting future nursing home care needs. Upon reviewing the plan-
    ning criteria and processes used to justify proposed nursing home
    construction projects, we have concluded that they do not adequately
    consider local conditions or less costly alternatives.

         Specifically:

         --VA justified new nursing home construction using national
           demographic and needs projections with little input about
           the characteristics and resources of the medical districts
           or the medical centers' primary service areas.

           --VA did not adequately consider the option of providing
           more nursing home care in community nursing homes by
           expanding its use of existing legislative authority to
           contract for care.

           --VA did not adequately consider converting, renovating,
           or changing the mission of its existing VA facilities
           to help meet the need for more nursing home beds.

           The cost of new VA nursing home construction is much higher
    'than that in the private sector, and the average operating costs
    of VA nursing care units far exceed the average operating costs
    of community nursing homes, making new construction an expensive
    alternative. We are reporting on these matters now so that
    (A) VA's medical districts can consider our recommendations as
    they prepare new planning documents, due in November 1982,

                                                               (401922)


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