GAO: VA oversight of state veterans homes improved but lacks enforcement tools, GAO and VA witnesses say

Chairwoman Miller Meeks opened the House Veterans' Affairs Subcommittee on Health hearing by emphasizing the committee’s oversight role for long-term care for aging veterans and the role of state veterans homes in that system. “Every veteran deserves independence and dignity with age,” she told members and witnesses.

The Government Accountability Office (GAO) told the subcommittee that state veterans homes provide important long-term care for aging veterans but that VA enforcement tools are limited. GAO witness Ms. Silas summarized the agency’s November 2022 review, noting persistent deficiencies: “In our review, we cite an example of a state administrator that noted they were more concerned with CMS's inspections because of the civil penalties.” GAO reported 766 deficiencies across a sample of 53 state homes and said 40% of homes were cited for the same deficiency in both 2019 and 2021; 21% of corrective action plans were past their due date.

GAO recommended that VA identify additional enforcement actions scaled to the scope and severity of deficiencies and seek legislative authority to implement them. Ms. Silas said VA had proposed a legislative option in the past and that GAO still considers an expanded range of penalties—such as civil fines or…