Healthcare Inspection Alleged Quality of Care Issues Martinez Outpatient Clinic and Center for Rehabilitation and Extended Care, Martinez, California

The VA Office of Inspector General Office of Healthcare Inspections conducted an inspection to determine the validity of allegations regarding quality of care issues at the Martinez Outpatient Clinic (OPC) and Center for Rehabilitation and Extended Care (CREC). The complainant alleged that six patients received inadequate care as observation patients, the CREC lacked the infrastructure for quality observation care, and the OPC placed surgical outpatients in a contracted community setting with no nursing care after their procedures. We substantiated the allegations regarding inadequate care for two of the six patients reviewed. We also substantiated the allegation that the CREC lacked the infrastructure in which to provide quality care for observation patients. We determined that system managers took appropriate actions. Therefore, we did not make any recommendations regarding these allegations. We did not substantiate the allegation that surgical outpatients were inappropriately placed in a contracted community setting without adequate care after their procedures. We concluded that policies need to be developed for the local temporary lodging or Hoptel Program, employees need to be educated about the program, and Gains and Losses sheets should document lodger check-ins and check-outs. We recommended that the System Director ensure that local temporary lodging or Hoptel Program policies and procedures are developed, implemented, and monitored to ensure compliance with Veterans Health Administration policy.