MADISON – Today, the nonpartisan Legislative Audit Bureau (LAB) released the second phase of its evaluation (report 17‑14) of the Wisconsin Veterans Home at King, which is located in Waupaca County and operated by the Wisconsin Department of Veterans Affairs (DVA). In 2016, King provided skilled nursing care to an average of 685 veterans and their spouses each day.
Overall, LAB found that the care needs of residents at King increased from 2007 through 2016 based on several measures. Although King was authorized more than 80 additional nursing positions by 2013 Wisconsin Act 20, LAB found King has not been able to keep many of the additional positions filled, and in fiscal year (FY) 2015-16, King’s use of overtime for nursing staff exceeded the amount it used immediately prior to the creation of the additional positions. The number of overtime hours worked by nursing staff increased from 36,800 in FY 2013-14 to 65,100 in FY 2015-16, or by 76.9 percent.
“I am encouraged that the audit found, generally, the Veterans Home at King is running well, however I think the findings in the audit raise an important issue about the healthcare workforce shortage in Wisconsin. It is my hope that future work regarding this audit will contribute valuable information about the long-term health needs of our veterans and necessary staffing levels to provide them quality healthcare” Said Senator Robert Cowles (R-Green Bay).
From 2012 through 2016, LAB found that, on average, the Department of Health Services (DHS) issued King fewer citations for violations of federal nursing facility regulations than it issued to other skilled nursing facilities in Wisconsin. Similarly, based on a federal five-star rating system, LAB found that the combined overall rating for King’s four residence facilities exceeded the average ratings for other skilled nursing facilities in Wisconsin.
LAB conducted an anonymous survey of all King employees. Of the 956 employees to whom the survey was sent, 449 (47.0 percent) completed at least a portion of it. Those King employees who responded generally indicated that the overall care provided at King was good, but raised concerns with issues such as the manner in which overtime is assigned, employee morale, and management responsiveness to employee concerns.
“I appreciate the quality of care that King staff is dedicated to providing,” said Rep. Kerkman (R-Salem Lakes). “However there is more work to be done with regards to staffing issues, including overtime and morale. Workforce issues are challenging throughout the long-term care sector and I look forward to listening to DVA’s plans to address these issues, as well as receiving their subsequent follow-up report in a few months.”
LAB recommends that DVA report to the Joint Legislative Audit Committee in January 2018 on its progress in filling vacation nursing positions, reducing the use of overtime, assessing training needs, and ensuring steps are taken to encourage employees at King to report concerns regarding resident abuse, neglect, and misappropriation of resident property.
In the first phase of the evaluation (report 17-8), LAB evaluated revenues, expenditures, and capital projects at King. LAB found King generated operating revenue of more than $8.0 million in excess of its expenditures each year from FY 2011-12 through FY 2015‑16. At the end of FY 2015-16, the cash balance in King’s institutional operations account totaled $35.2 million. From FY 2003-04 through FY 2015-16, a total of $55.0 million was transferred from King’s institutional operations account to other accounts that do not directly benefit King.
Copies of report 17-14 and 17-8 may be obtained from LAB’s website at www.legis.wisconsin.gov/lab or by calling (608) 266-2818. Report concerns related to state government activities to LAB by calling the toll-free hotline at 1‑877‑FRAUD‑17.