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VA Medical Centers Criticized for Shunting Patients to Other Hospitals

TAMPA BAY, Fla. -- The Bay Pines VA Medical Center called it a rare mistake in June when it turned away a non-veteran who suffered a fatal heart attack 200 feet from its emergency room.

In fact, care at the two Department of Veterans Affairs hospitals in the Tampa Bay area is hardly guaranteed, even for veterans.

For thousands of hours in recent years, Bay Pines in St. Petersburg and the James A. Haley VA Medical Center in Tampa have closed their doors to paramedics because the facilities were having patient overload, forcing veterans to other hospitals.

Diverting patients, usually from emergency rooms, has become a fact of life in American health care.

But some critics say the problem may be more acute at VA facilities because of the sheer pressure on the system. Haley is the nation's busiest VA facility, Bay Pines the fourth busiest.

Veterans Affairs says it cannot assess how local hospitals compare with others nationally. Officials at Haley and Bay Pines say they are making it a priority to perform better.

"There's no intent to deny veterans care," said Dr. George Van Buskirk, chief of staff at Bay Pines.

"I like to think we're as compassionate as possible. We'd rather send them out to a place that can take care of them than have them languish on a gurney in the hallway."

Some question the VA's resources, though.

"The VA has never dealt with its capacity issues seriously," said Bill Geden, district director in west-central Florida for the Blinded Veterans Association.

"They're underfunded, undermanned and overloaded."

Haley has been on "divert" status for critical patients 27 percent of the time since Jan. 1, 2006, or the equivalent of about 170 days, VA figures show.

The hospital diverts all patients, regardless of condition, 16 percent of the time.

The number of affected patients is unclear, though county emergency services officials say VA hospitals tend to have less emergency traffic than other facilities.

Since 2000, Bay Pines has diverted patients far more frequently than any other hospital in Pinellas County. Last year, it diverted veterans for 1,150 hours (about 48 days), or 13 percent of the time, Pinellas paramedic records show.

Those numbers are a sharp improvement. In 2003, for example, Bay Pines diverted paramedics 2,464 hours (about 102 days), or 28 percent of the time. Similar statistics were posted in 2004.

This year, Bay Pines is diverting about 7 percent of the time, roughly 500 hours so far.

Simple, brutal math works against both facilities.

Haley treated 133,000 veterans last year who visited the hospital as outpatients about 1.5 million times.That's up from 48,000 patients visiting about 1 million times in 2000.

"It's like putting your finger in a dike, actually," said Dr. Edward Cutolo, Haley's chief of staff.

Bay Pines treated 49,800 patients in 2000 and tallied 516,000 outpatient visits. In 2006, the numbers increased to 95,000 and 1.1 million, respectively.

"It doesn't seem right that a veterans hospital can ever be filled up," said Dick Shockey, 77, an Army veteran who was turned away from Bay Pines three years ago. "But veterans end up with a big surprise."

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