Vets home earns good marks
By Patrick McArdle

BENNINGTON — The good news received by the Vermont Veterans’ Home included another inspection that found no deficiencies and almost $800,000 that can be returned to the state because of funding received from the federal Veterans Administration.

Patricia Crossman, acting director of nursing for the veterans’ home in Bennington, which is the only state-run nursing home for veterans in Vermont, said the Centers for Medicare and Medicaid Services, or CMS, had inspected the home from July 17 through 19.

“They went through and talked to staff, made observations, went through all the clinical aspects of it,” she said Tuesday. “What really, I think had the biggest impact was the knowledge base of our staff and how they handle and care for our veterans here. Through education and just through our processes, they show confidence. No matter what day it is, you will always see that confidence.”

Melissa Jackson, administrator of the home, said she was especially proud of the staff because some of the other top administrators were out-of-state at the time for a national conference of nursing homes. But even without that oversight, the staff was able to use their training to show inspectors how well the home is run, she said.

Jackson said during an inspection, a team of six people from CMS will come to the home. State-run nursing homes have a window for the inspection but not the exact dates. Once the team arrives, they look at every area including food served, the medical care coming from the nurses’ stations and the activities provided by the home.

The deficiency-free survey is significant for several reasons. First, a deficiency-free survey doesn’t mean an adequate result or even a very good result but that no deficiencies at all were identified.

Second, the result is the fourth in a row with similar results. The CMS survey from 2015 and the CMS survey from 2016 found no deficiencies. Neither did inspections by the Veterans Administration in 2015 and this year.

Third, the home had a more difficult time just three years ago when two inspections found deficiencies which left the home within days of losing the ability to accept Medicare and Medicaid payments, which make up about 60 percent of the home’s income. The deficiency-free survey by CMS last year allowed the home to come off a special watch list it had been on for two years following the 2013 issues.

Fourth, the home works toward self-sufficiency through efforts to increase its “census,” or the number of residents living there, which Jackson said was easier when the home can advertise that inspectors from Medicare, Medicaid and the VA have found no problems.

On Tuesday, the home had 128 residents in a facility with 138 beds.

The veterans home receives funding from the state but Jackson said this year, the home will be able to give some back after receiving almost $800,000 for a project between 2012 and 2014 that removed mold.

The state provide $1.7 million toward the mold project.

For the home inspections, Crossman said she thought it was easier for the home’s staff to respond well to an inspection because the home has instituted electronic medical records in the last year. She said having those records easily accessible and organized could demonstrate to the inspectors that residents were getting the right care.

She added that the nurses weren’t just trying to maintain the status quo over the past year but were also working on new protocols to identify issues the residents may face in an effort to treat them before they rose the level that required transfer to a hospital.

In past years, the relationship between the home’s administrators and the staff, who are members of the Vermont State Employee Association, has sometimes been difficult, especially over nurse’s schedules but Jackson said efforts to find the right system continue and this week the home will try a type of “self-scheduling” by the nurses in each ward.

Crossman pointed out that despite any differences, the home’s whole staff comes together to care for the residents.

“Every day, not even just on survey day, every day, every staff member is on the bus, you know? They want to deliver excellent care and they’re very compassionate about their veterans,” she said.