Community Nursing Home Program Oversight: Can the VA Meet Increased Demand for Community-Based Care?

Limitations

Limitations include the unique relationship between VA and CNH staff overseeing the quality of care provided to veterans in CNHs, which is not replicated in other models of care. Data collection was interrupted following the passage of the MISSION Act in 2018 until guidance on changes to practice resulting from the law were clarified in 2020. Interviews were also interrupted at the onset of the COVID-19 pandemic.

Conclusions

The current quality of the CNH care oversight structure will require adaptation as demand for CNH care increases. While the VA CNH program is one of the longest-standing programs collaborating with non-VA community care partners, it is now only one of many following the MISSION Act. The success of this and other programs will depend on matching available CNH resources to the complex medical and psychological needs of veterans. At a time when strategies to ease the burden on NHs and VA CNH coordinators are desperately needed, Veterans Health Information Exchange capabilities need to improve. Evidence is needed to guide the scaling of the program to meet the needs of the rapidly expanding veteran population who are eligible for CNH care.

Acknowledgments

The authors acknowledge Amy Mochel of the Providence Veterans Affairs Medical Center for project management support of this project.