Second, VA expects to improve the geographic accessibility of VA hospital beds for as many veterans as possible. The planners concluded that these beds were needed to make VA health care more geographically accessible to veterans in East Central Florida. Using Existing Capacity to Provide Medical and Psychiatric Beds Appears Prudent

VA has a large supply of unused beds in its three hospitals now serving Central Florida veterans and the number of unused beds is expected to increase substantially. To achieve the most prudent and economical use of resources, VA’s hospital planning should be guided by two objectives. Veterans’ Past Use of VA Hospitals Inadequately Considered

VA’s decision to build 470 medical, surgical, and psychiatric beds in the Brevard hospital is based on the assumption that East Central Florida veterans’ demand for care will equal veterans’ use of VA hospitals nationwide. VA’s use of lower-cost alternatives could meet its service delivery goals and would also avoid the unneeded expenditure of government resources. For example, using available beds at the former Orlando Naval Hospital and converting unused beds at existing VA hospitals for psychiatric or nursing home care will reduce the risk of large unused bed capacity at the proposed Brevard hospital, which appears likely because of expected decreases in the veteran population and VA’s increased reliance on outpatient care to serve veterans. The officials disagreed with our overall conclusion that there is a more prudent and economical way to achieve VA’s service delivery goals in Central Florida than building a new 470-bed hospital and 120-bed nursing home in Brevard County and converting the former Naval Hospital in Orlando to a nursing home. More specifically, he questioned whether the conversion of the former Naval Hospital to a nursing home is the most economical and prudent use of resources. Also, he asked us to explore available options and, if possible, suggest a more prudent and economical way for VA to meet its service delivery goals for Florida veterans. VA makes its construction decisions based on a comparison of veterans’ projected use and the potential availability of beds in community and state homes. Furthermore, most of the inpatient psychiatric services planned for the hospital in Brevard are comparable to existing VA services or are planned at VA’s three facilities in Central Florida.
Why GAO Did This Study

Pursuant to a congressional request, GAO reviewed the Department of Veterans Affairs' (VA) plans to provide accessible medical and other services to veterans in East Central Florida, focusing on: (1) VA acquisition of the former Orlando Naval Hospital; (2) whether the conversion of the hospital to a nursing home is the most economical use of VA resources; and (3) whether more prudent and economical options exist to meet VA service delivery goals for Florida veterans.

What GAO Found

GAO found that: (1) VA conversion of the former Naval hospital to a nursing home and the construction of a hospital and nursing home in Brevard County are not a prudent and economical use of VA resources; (2) VA planning assumptions are questionable, particularly those regarding the availability of community nursing home beds and unused VA hospital beds, and the potential decrease in future demand for VA hospital beds; (3) VA could meet its service delivery goals by using existing capacity, which would result in lower costs and greater convenience for the veterans; (4) preserving the Orlando hospital as a hospital would improve the geographic accessibility of VA medical and psychiatric services at a lower cost; (5) the number of unused VA hospital beds is expected to increase because of the projected decline in the veteran population; (6) VA could convert some of the unused medical and surgical beds in the three central Florida hospitals to psychiatric beds to make those beds more geographically accessible to all Florida veterans rather than concentrating them at the new hospital in Brevard County; (7) construction of the Brevard hospital is not justified, since VA greatly overestimated veterans' potential use of Florida VA facilities; and (8) VA needs to focus its strategy on the most prudent and economical use of its limited resources and avoid unnecessary expenditures while meeting its service delivery goals in a more timely manner.