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Two VA hospitals forced to turn away patients

ST. PETERSBURG, Fla. — Two Tampa Bay veterans hospitals turn away critically ill patients for huge chunks of the year because of an overloaded veterans’ health care system.

James A. Haley VA Medical Center in Tampa and Bay Pines VA Medical Center in St. Petersburg are the nation’s busiest and fourth-busiest Veterans Affairs hospitals, respectively.

Haley has been on “divert” status for critical patients 27 percent of the time since Jan. 1, 2006, or the equivalent of about 170 days, VA figures reviewed by the St. Petersburg Times show. The hospital diverts all patients regardless of condition 16 percent of the time.

Since 2000, Bay Pines has diverted patients far more frequently than any other hospital in Pinellas County. Last year, it diverted veterans during 1,150 hours about 48 days, or 13 percent of the time, Pinellas paramedic records show.

“There’s no intent to deny veterans care,” said Dr. George Van Buskirk, chief of staff at Bay Pines. “I like to think we’re as compassionate as possible. We’d rather send them out to a place that can take care of them than have them languish on a gurney in the hallway.”

But some question the VA’s resources.

“The VA has never dealt with its capacity issues seriously,” said Bill Geden, district director in west-central Florida for the Blinded Veterans Association. “They’re underfunded, undermanned and overloaded.”

In one instance, Bay Pines said it “made a rare mistake” last June when it turned away a non-veteran who suffered a fatal heart attack 200 feet from its emergency room.

The VA says it cannot assess how the Florida hospitals’ diversion rates compare to others nationally. But officials at both Haley and Bay Pines say they are making it a priority to achieve better performance.

In 2003, for example, Bay Pines diverted paramedics 2,464 hours or 28 percent of the time. Similar statistics were posted in 2004.

This year, Bay Pines is diverting about 7 percent of the time, roughly 500 hours so far.

Haley’s diversion numbers have not improved in recent years, though it also has expanded its emergency care and hired three “bed czars.”

Meanwhile, the number of patients treated at both hospitals is on the rise.

“It’s like putting your finger in a dike, actually,” said Dr. Edward Cutolo, Haley’s chief of staff.

Bay Pines treated 49,800 patients in 2000 and tallied 516,000 outpatient visits. In 2006, the numbers increased to 95,000 and 1.1 million.

“It doesn’t seem right that a veterans hospital can ever be filled up,” said Dick Shockey, 77, an Army veteran who was turned away from Bay Pines three years ago. “But veterans end up with a big surprise.”

The problem is not specific to VA hospitals. About 36 percent of all hospitals reported going on diversion, a survey by the American Hospital Association shows.

“It’s a crisis across America, not just the VA,” said Michael O’Rourke, assistant director of veterans health policy at the Veterans of Foreign Wars. “There’s a shortage of emergency room physicians, and there’s a shortage of beds, and there’s a shortage of nursing staff.”