Inconsistent communication, evaluation and monitoring have hampered efforts by the Department of Veterans Affairs to update its facilities — including those providing assisted living and skilled nursing — so that they are better aligned with the current healthcare needs of veterans, causing existing buildings to be underused as the delivery of healthcare changes and veterans relocate to other parts of the country, according to a report released to the public on Friday by the Government Accountability Office.

The GAO recommended that the VA secretary take action to:

  • Address limitations to the process the VA uses to plan and prioritize capital projects;

  • Assess the value of a separate integrated planning process and either discontinue facility master plans or address their limitations;

  • Develop and distribute guidance for regional Veterans Integrated Service Networks, or VISNs, and facilities using best practices on how to effectively communicate with stakeholders about alignment change; and

  • Develop and implement a mechanism by which to evaluate VISN and facility communication with stakeholders to ensure that these efforts are working as intended and align with guidance and best practices.

The GAO’s recommendations, according to figures cited in the report, affect 168 VA medical centers, which can offer residential and institutional extended care as well as inpatient and outpatient care; 135 community living centers, which have nursing home beds; and 48 residential care sites, which offer domiciliary and assisted living.

Additionally, the recommendations apply to 737 community-based outpatient clinics, 22 healthcare centers and 305 other outpatient service sites such as mobile treatment facilities.

All of these sites are overseen by VISNs.