Federal Manager's Daily Report

The VA has not followed through on issues raised in its own reviews of its system for rating its Veterans Health Administration facilities, GAO has said, adding that in its own work it found that agency officials at various levels continue to have those same concerns.

The VA uses the Strategic Analytics for Improvement and Learning, or SAIL, measure to assign ratings of between one and five stars to its 146 medical centers to identify areas of needed improvement and to promote accountability; evaluations of facility leaders are partly based on those ratings. For the 2018 ratings, 6 percent received 1 star; 24 percent 2 stars; 38 percent 3 stars; 19 percent 4 stars; and 12 percent 5 stars. That was little changed over five years, GAO noted, with only 9 having decreased by two or more stars during that time and only eight having increased by that much.


The VA’s assessments of the system in 2014 and 2015 “found issues related to the validity and reliability” of SAIL and included more than 40 recommendations, GAO said, but those evaluations were not widely distributed within VHA due to leadership turnover, as well as attention that was diverted to other concerns such as extensive wait times for medical appointments.”

“Without ensuring that the recommendations resulting from these previous evaluations are assessed and implemented as appropriate, the identified deficiencies may not be adequately resolved, and VHA’s ability to hold officials accountable for taking the necessary actions may be diminished,” it said.