Audit finds increased overtime in King

By Robert Cloud

Overtime nearly doubled for nurses at the Wisconsin Veterans Home in King.

In 2016, nursing staff at King worked a total of 65,100 hours of overtime, according to a study released Aug. 25 by the state Legislative Audit Bureau (LAB).

In 2013, the staff worked a total of 36,800 hours of overtime.

LAB attributed the overtime to an ongoing nursing staff shortage.

“Although King was authorized over 80 additional nursing positions by 2013 Wisconsin Act 20, it has not been able to keep many of the additional positions filled,” the LAB study found. “As of June 2016, 46.8 full-time equivalent nursing positions (9.3 percent) were vacant.”

King employed 344 (FTE) certified nursing assistants, 81.6 registered nurses and 75.2 licensed practical nurses in 2016.

Including other staff, King employed a total of 884.3 people to provide services to 685 veterans and their spouses in 2016.

In addition to difficulties in filling vacant positions, King has also seen an increase in the amount of care a growing number of residents require.

There has been an increase in the percentage of residents with dementia and post-traumatic stress disorder, which means staff must spend more time caring for residents.

The percentage of residents requiring skilled nursing care increased from 65.8 percent to 88.2 percent between 2007 to 2016, the LAB audit revealed.

When LAB conducted a survey of employees in November 2016, 86.1 percent indicated they “disagree” or “strongly disagree” King has sufficient resident care staff to handle the workload.

The survey found 63.8 percent “disagree” or “strongly disagree” that management at King actively seeks input from employees on how operations and resident care can be improved, while 57.0 percent “disagree” or “strongly disagree” positions at King are filled through a fair and transparent process.

“In addition, while 66 percent of respondents indicated they are “satisfied” or “very satisfied” with King as a place of employment, 75.1 percent indicated the overall morale of employees at King was ‘poor’ or ‘very poor,’” the LAB report said.

The LAB study also found, “Among respondents providing direct care or interacting directly with residents, 97.5 percent described the overall care provided to residents at King as ‘good’ or ‘very good,’ and 95.7 percent ‘agree’ or ‘strongly agree’ that residents are treated with respect.”

LAB reported that from 2012-16, King generally received fewer citations than other nursing facilities in northeastern Wisconsin.

Of the 184 citations the Department of Health Services issued to King, one was in the highest severity category.

For this citation, the veterans home was fined $76,900 in June 2016.

State Sen. Luther Olsen, R-Ripon, requested the LAB study after reports surfaced of mistreatment of King residents and management issues within the Wisconsin Department of Veterans Affairs.

Noting LAB recommended the DVA report on its progress to reduce overtime and fill nursing vacancies at King by January 2018, Olsen said, “While many long-term care facilities face staffing issues, I want to hear from the department about their specific plans to address staffing concerns.”

“Let’s not get too comfortable,” said state Rep. Melissa Sargent, the ranking Democrat on the Joint Legislative Audit Committee. “While I’m cautiously optimistic about today’s (Aug. 23) performance audit results, there’s still plenty of work for us to do in the Legislature to ensure our veterans are receiving care with the dignity and respect they deserve.”

Sargent said there are still unanswered questions about King’s finances: “Why it continues to see understaffing and turnover, why it’s generating tens of millions in revenue, and whether it’s using the revenue it generates to put money back into services and programs to actually help our veterans.”

Sargent noted that the first half of the LAB’s study, released earlier, revealed $55 million has been transferred from King over the last decade to other programs.