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SORCC receives lowest rating by VA Saturday Dec 17, 2016 at 2:08 PM Dec 17, 2016 at 10:50 PM Teresa Thomas Mail Tribune @teresathomas_MT The Southern Oregon Rehabilitation Center and Clinics was rated a one-star facility by the Department of Veterans Affairs, according to internal documents obtained by USA TODAY. Earlier this month, the newspaper published recent star ratings for 146 VA medical centers nationwide. The White City facility was one of 10 to receive only one of five possible stars on June 30, 2016. While local VA officials see areas for improvement, they say the rating doesn't tell the full story and is partially based on perception as some of the data is acquired through surveys. The five-star system is part of the Strategic Analytics for Improvement and Learning model used by the VA to monitor and improve the quality of care, said Dr. Shawkat Dhanani, SORCC’s chief of staff. “What it does is compare the quality of care amongst all VAs and rank them against each other,” he said. The department has been using the internal rating system for the last four to five years. However, the SORCC received its first star rating last December, Dhanani said. VA medical centers are rated for a number of factors depending on their level of care. The SORCC is evaluated for care transition, patient satisfaction, access to care, employee satisfaction, mental health services and preventive measures, Dhanani said. The facility scored above average for care transition and many of its mental health services, about average in employee satisfaction and below average in the areas of access to care, patient satisfaction and preventive measures, he said. Access to care and patient satisfaction account for about 38 percent of the SORCC’s overall score and are both determined by a survey sent to veterans. Veterans dissatisfied with the care they received at SORCC gave U.S. Rep. Greg Walden an earful during a September visit in Medford. They complained of appointments being canceled or changed without proper notification, rarely seeing the same care provider twice and layers of bureaucracy that required a trip out of state to meet with a psychiatrist in order to obtain a prescription. Staff acknowledge that access to care is a problem, which is primarily due a lack of primary care providers. “It’s not just a VA problem,” said SORCC spokeswoman Rhonda Haney, adding that the shortage is communitywide. In the last year, the SORCC has lost about two-thirds of its primary care providers due to retirements, resignations and interdepartmental moves. “We originally had 18 teams — 12 at this facility and three at each of our community-based outpatient clinics in Grants Pass and Klamath Falls,” Dhanani said. Now there are only 10 teams working at the center and two teams at each of the clinics. Five of those teams are telehealth providers, based in Boise, Idaho, who video conference with patients here. “(The telehealth providers) have access to our charts, and nurses on our end assess the veteran, and the provider will see the patient through video conferencing,” Dhanani said. The center hired a clinical recruiter three weeks ago to help hire more staff, and it eased the administrative and clerical burden of its existing primary care providers so they can see more patients. “We’ve also significantly increased the salary of those doing primary care (to attract more doctors),” Dhanani said. “On average, we’ve increased it by about 15 percent for full-time primary care providers.” To meet the demand until it can fill positions, the SORCC is relying on community doctors participating in the Veterans Choice Program, temporary doctors who work for a contracting agency, and telehealth providers. In the first quarter of the fiscal year, the average wait time for a mental health patient was 3.03 days from the date recommended by their doctor (the clinically indicated date) or their preferred date. This quarter, the average wait time is 2.65 days from the clinically indicated or preferred date, said SORCC facility planner Michael Schmidt. In specialty care, the average wait time increased from 6.25 days from the clinically-indicated or preferred date in the first quarter to 6.49 days this quarter. As of this week, 90.2 percent of pending mental health, primary and specialty care appointments are scheduled for within 30 days of their clinically indicated or preferred date, and 7.4 percent are scheduled for within 60 days of that date, Schmidt said. Specialty care wait times are generally longer and, therefore, can skew the overall numbers, Schmidt said. Staff are working hard to improve veterans’ experience and the center’s SAIL rating, Dhanani said. In the last 14 months, SORCC has hired a new director, Philip Dionne, and chief of staff, Dhanani. And, more recently, it formed a SAIL workgroup composed of members from all levels who track and report on various systems and processes. Recent improvements include a call center so veterans aren’t left on hold if the clerk is with another patient and a flu vaccine clinic near the mental health clinic. “We offered drive-thru flu vaccines (earlier this month) where people drove up, rolled down their window, rolled up their sleeves and got their shot,” Dhanani said, adding that 60 veterans received flu vaccines and 14 received pneumonia vaccines this way. SORCC staff also are making an effort to reach out to veterans to schedule appointments for preventive care, Dhanani said. “However, it’s an unfortunate fact that many of our veterans don’t have a home so it’s hard to establish that contact with them,” he said. Because the star rating system is a relative scale, the SORCC will need to outperform other VA medical centers nationwide in order to improve its rating. “We certainly expect that by the third quarter of fiscal year 2017 we will be a two-star facility,” Dhanani said. “I would say to the veterans out there: Give us some time and try us out, and I think we’ll be able to match their expectations.” SORCC provides primary, mental health and limited specialty care services, as well as residential care to veterans with a mental health or substances abuse diagnosis. Last year, it served nearly 18,000 veterans. Physicians, nurses, dentists and pharmacists interested in applying for a job at the SORCC can send their resume or CV to Clinical Recruiter Margarita Weld at [email protected]. Reach education reporter Teresa Thomas at 541-776-4497 or [email protected]. Follow her at www.twitter.com/teresathomas_mt.