Hospitals run by the VA are graded on a 5-point system. Up until now, those grades have been kept private. USA TODAY's Donovan Slack shares what she learned while uncovering them.
USA TODAY NETWORK

WASHINGTON — The Department of Veterans Affairs has quietly released quality-of-care ratings for its medical centers across the country, despite years of refusing to share them with the public.

The move follows a USA TODAY investigation that revealed ratings for 146 VA medical centers for the first time earlier this month. VA Secretary Bob McDonald complained at the time that their publication across the USA TODAY Network caused “unwarranted distress” to veterans and could dissuade them from getting care.

But last week, according to an internal memo obtained by USA TODAY, the agency posted updated ratings on its website and also included indicators of whether hospitals were improving or declining, allowing members of the public to see for the first time how their local VA medical centers have been faring over time.

The VA rates centers on a scale of one to five stars, with five being the best and one being the worst, and bases the ratings on dozens of factors, including death and infection rates and wait times.

The newly posted ratings show VA hospitals in Albuquerque, Detroit and Los Angeles received one star as of June 30, 2016, down from two stars on Dec. 31, 2015.

At the same time, the VA medical center in Fayetteville, Ark., jumped from three stars to five, and the VA in Orlando, Fla., went from two stars to four.

“I am glad to see these ratings finally made public,” said Rep. Martha Roby, R-Ala., who has been pushing for the release of more detailed VA quality data for more than a year. “This not only helps veterans know basic information about their health care options, it allows stakeholders in the community and members of Congress to demand better of the VA when improvement is needed.”

Rep. Debbie Dingell, D-Mich., who wrote to the VA demanding the release of five years’ worth of ratings following USA TODAY’s story, said “it shouldn’t take news reports and public pressure for the VA to make these ratings available to the public.”

“These are important tools for veterans and the community to see quality of care at the hospitals they depend on, and I hope this transparency continues,” she said.

Until USA TODAY’s story, Dingell did not know that the Detroit VA — which is named after her husband, former congressman John Dingell — was among the worst-rated in the country. She is now “working with leadership at the Detroit VA to ensure the issues that led to the facility’s poor star ratings are addressed and that our veterans are receiving the best possible care they deserve.”

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The VA did not respond to a message seeking comment Tuesday. VA officials have previously said the star ratings were an internal improvement tool and not intended for the public because they worried hospitals with one star would be unfairly tarnished.

“To be clear, no VA medical facility is bad or failing,” McDonald wrote in a letter to the editor of USA TODAY.

In addition to star comparisons with other VA medical centers, the newly posted data show whether centers have improved compared with their own performance a year earlier. Five hospitals had a "large decline" in the year ending June 30, 2016. They are facilities in El Paso and Hot Springs, Texas; Fargo, N.D; San Diego, Calif.; and Tomah, Wis.

The VA says on the new ratings web page that overall, 120 of the 146 medical centers showed improvement since 2015.

Sen. Ron Johnson, R-Wis., chairman of the Senate Homeland Security and Governmental Affairs Committee, has been investigating the VA for nearly two years — ever since the revelation in January 2015 that a veteran had died after doctors at the Tomah VA prescribed him a fatal cocktail of narcotics.

“Let’s face it, none of this, none of these abuses — the wait times, the opioids, these types of things — none of this would be known were it not for a free press, people like yourself digging and publicizing it,” Johnson said. “The natural tendency of any government bureaucracy, probably I think any organization, any human being, quite honestly, is not to be forthcoming, not to be transparent. Nobody wants to air their dirty linen.”

Johnson said he plans to continue in his committee to push for more transparency to identify problems and then hopefully solve them. “It’s a target-rich environment of things we have to deal with, the problems, it’s like a mosquito in a nudist colony.”

Rep. Jeff Miller, R-Fla., chairman of the House Veterans' Affairs Committee, said the VA's release of quality data is a "positive development" crucial for improvement, but the agency should have released it long ago.

"Imagine the hassle the department could have saved veterans, employees and taxpayers if it would have just done the right thing and made these ratings public from the start,” Miller said.

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