Community Care Departments Need Reliable Staffing Data to Help Address Challenges in Recruiting and Retaining Staff

The Veterans Health Administration (VHA) uses staffing data to assess whether medical facilities have the necessary resources to manage community care needs. Accurate staffing data are critical for decision-making and funding allocation to support veterans’ access to community care. The VA Office of Inspector General (OIG) assessed whether medical facility leaders identified, authorized, recruited, and retained nurses and medical support assistants (MSAs) to meet increased demand for community care. The OIG found that VHA does not have reliable data or sufficient tools to assess community care staffing levels and needs at the network or national level. Facility leaders do not use consistent organizational codes to identify community care staff across VA medical facilities. Additionally, VA’s staffing assessment tool relies on self-reported data that are not effectively verified. Due to data entry errors and a lack of consistent validation or quality review, VHA included inaccurate information in congressionally mandated reports. Despite these limitations, facility community care leaders generally identified local staffing needs, and their resource management committees authorized the requested staff. Although most facilities could adequately recruit and retain community care nurses, many could not recruit and retain MSAs. To compensate for the lack of MSAs, some facilities used innovative strategies such as hiring incentives or consolidated community care units to help process community care referrals. The under secretary for health concurred or concurred in principle with the OIG’s five recommendations to improve the reliability of community care staffing data and recruitment and retention of MSAs.