Exclusive: Internal documents detail secret VA quality ratings


Hospitals run by the VA are graded on a 5-point system. Up until now, those grades have been kept private. USA TODAY’s Donovan Slack shares what she learned while uncovering them.

The Department of Veterans Affairs has for years assigned star ratings for each of its medical centers based on the quality of care and service they provide, but the agency has repeatedly refused to make them public, saying they are meant for internal use only.

USA TODAY has obtained internal documents detailing the ratings, and they show the lowest-performing medical centers are clustered in Texas and Tennessee.

VA hospitals in Dallas, El Paso, Nashville, Memphis and Murfreesboro all received one star out of five for performance as of June 30, the most recent ratings period available.

Many of highest-rated facilities are in the Northeast — in Massachusetts and New York — and the upper Midwest, including in South Dakota and Minnesota. Those medical centers scored five out of five stars.

The VA determines the ratings for 146 of its medical centers each quarter and bases them on dozens of factors, including death and infection rates, instances of avoidable complications and wait times.

USA TODAY Network is publishing the ratings in full for the first time so that members of the public — including patients and their families — can see how their local VA medical centers stack up against others across the country.

Some lower-ranking medical centers have remained poor performers despite high-profile crises and years of attention and resources from Washington.

For instance, the Phoenix VA was a one-star medical center in 2014 when news broke that veterans had died awaiting care there while schedulers kept secret wait lists masking how long veterans were waiting for appointments. The revelations triggered a national scandal, hearings on Capitol Hill and the replacement of the VA secretary.

Phoenix remained a one-star facility in the most recent ratings.

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