VINDICATION at last! Now lets see what they will DO with it.

From MLive.com's website, the following article, in full:
(Here is the full article.)

By Zane McMillin | zmcmilli@mlive.com
Follow on Twitter
on May 01, 2013 at 11:23 AM, updated May 01, 2013 at 1:09 PM


GRAND RAPIDS, MI — The Grand Rapids Home for Veterans' lack of an on-site, board-certified

psychiatrist jeopardizes its residents' access to timely care and might skirt federal regulations, Michigan's auditor general has found.

In a report released this week that mainly centered on the home's handling of its finances, Auditor General Thomas McTavish faulted the home in multiple areas and found it was overall "moderately effective" at delivering select services.

The audit was conducted between March and September 2012, and covered a span from October 2009 to September 2012.
It was published on the auditor general's website this week. According to its contents, the state Department of Military and Veterans Affairs already was addressing the issues.

The lack of an on-site, board-certified psychiatrist was among the more prominent findings in the report, which painted a somewhat unflattering image of a home struggling to adequately safeguard against financial waste.

The home spent $50.3 million in the fiscal year that ended Sept. 30, 2012, the report found. This year more than 140 unionized, state-paid caregivers were pink-slipped and replaced with contracted caregivers after a bruising fight against privatization.

State officials have estimated that move will save $4.3 million. McTavish's report found no reportable incidents with regard to nursing care, but his office is constitutionally empowered to solely examine state agencies' finances.

The audit did find, however, a reportable incident as it related to psychiatric care, or lack thereof. The home's contracted, in-house psychiatric services provider pulled out in August 2012, citing other clients' needs, which left the facility without on-site mental care.

When the audit was conducted, nearly 41 percent of the home's 502 residents required antipsychotic medication. Because it lacks an on-site psychiatrist, the home had turned away prospective residents with mental health issues, the report found.

Now, the home's four in-house physicians administer, monitor and occasionally amend dosages instead of an on-site psychiatrist.

Federal regulations require "appropriate treatment and services" for mental health patients at veterans home, and the report found an on-site psychiatrist would be better equipped in this regard than in-house physicians.
The DMVA had tried recruiting an in-house psychiatrist in spring 2012, the audit found, but was unsuccessful in finding a qualified candidate.

Among its other findings were ineffective safeguards over food and maintenance and medical supplies, and "moderately effective" safeguards over its pharmaceutical inventories.

The report found the "moderately effective" pharmaceutical safeguards meant the home could not ensure medication would not be misused, lost or wasted. It valued the annual value of pharmaceuticals discarded because of scant inventory procedures at $103,800.

The home also was found to have insufficient controls over monetary and other gifts received by outside parties, and could not sufficiently account for monthly member fees and disbursal of its residents' personal funds.

Auditors surveyed 44 residents about the level and quality of care in the facility, and found 84.1 percent were satisfied. Other interviews were conducted with nurses and other staff.

The DMVA had taken steps to address some of the issues prior to the report's release. Below are some notable summaries of its findings:
• The home has been without a board-certified, on-site psychiatrist since August 2011, when a Grand Rapids-area mental health services provider pulled out of a five-year contract inked in 2010 to meet obligations to its other clients.
Home leaders last solicited help from the DMVA in finding a contracted psychiatrist in June 2012, but as of April 2013, a request for bids had not gone out.
The auditor general noted the DMVA insisted the four in-house physicians that now attend mentally unstable residents are capable of providing adequate care, but conceded that it would "make great clinical sense" to have an on-site psychiatrist.
• Residents' access to timely medical care also was jeopardized by the home's inability to ensure effective creation and execution of comprehensive care plans.
Such plans are conducted on an annual basis to identify each resident's personal "physical, mental and psychosocial needs" and pinpoint potential future problem spots.
A random sampling of 36 assessments found some were not completed within 14 days of a resident's admission, and not all "periodic narratives necessary for consistent monitoring of care plan goals and interventions" were carried out.
The DMVA said it was addressing the issue, and would be implementing an electronic records system within the next two years in an effort to more effectively monitor patients' care.
• Between Oct. 2009 and May 2012, the home spent $7.5 million on food, maintenance supplies and medical supplies, but did not have an inventory system to properly account for all purchases.
The report found employees' duties with respect to food and medical supplies were not adequately defined, and that many employees had unsupervised access to "all areas where the home received and maintained food, maintenance supplies and medical supplies.
According to the report, the DMVA already has authorized an assessment of security measures at the home, and will examine various inventory software and other systems for implementation.
• The home discards roughly $103,800 worth of pharmaceuticals each year, a symptom of the home's inability to safeguard its pharmaceutical inventories.
This allowed for possible abuse, loss or waste, according to the report. Employees' duties with regard to pharmaceuticals was not clearly defined, and there was no tracking system in place for lost or discarded prescriptions, the report found.
Still, the home implemented new policies governing inventory and tracking of prescription medication in February this year, according to the DMVA.
• The home spends more each month on resident care than it gathers in fees to help pay for such services.
It cost $24,381 per month in the 2012 fiscal year to provide care, but the home only collected $15,260 in fees from residents, per levels approved by the home's board.
By Sept. 30, 2012, only a fraction of residents at the home were capable of paying monthly fees in full, the report found.

There were 502 residents when the report was conducted in 2012, down from 693 in 2009. As of Sept. 30 last year, only 43 residents paid their monthly fees in full.

The audit noted home leaders could increase the monthly assessment, but that members who are able to pay current rates might have insufficient additional money to pay.

A full copy of the report, and its summary, may be viewed here.

 END of News,

Start of Comments:

Moderately effective - in other words, a  "C" Grade  - average.
OMG, here I was concerned over the cost being charged to Dorm unit people and I find out from this report that medical unit people can be charged up to 24,000 a month.. If that is not a criminal act in progress, I don't know what is..

I do know that Governor Snyder wants to get more bang for the buck.. well, find out why its costing 2100 a month to house dorm unit people, when it should be less than 800..


Find out why they are charging up to 24 thousand a month for nursing care, and find ways to do the same, cheaper..