Recent cuts at hospital infuriate veterans council

Gerald Meager of Kingsland (left) , shown with his driver Bruce Swaringin, says he's always been well treated at the Kerrville VA hospital, and hasn't noticed at reductions in services during his infrequent visits there. Zeke MacCormack / zeke@express-news.net less Gerald Meager of Kingsland (left) , shown with his driver Bruce Swaringin, says he's always been well treated at the Kerrville VA hospital, and hasn't noticed at reductions in services during his infrequent ... more Photo: Zeke MacCormack, San Antonio Express-News Photo: Zeke MacCormack, San Antonio Express-News Image 1 of / 1 Caption Close Recent cuts at hospital infuriate veterans council 1 / 1 Back to Gallery

KERRVILLE — Opponents of service reductions at the Department of Veterans Affairs' facility here say it's a hospital in name only following the most recent cuts dictated by agency officials in San Antonio.

“We have no hospital beds as of July 2. Basically, what we have now is a nursing home and six clinics,” said Walter Schellhase, president of the Hill Country Veterans Council, which was formed two decades ago to safeguard services at the facility.

Besides closing the 20-bed acute care unit at the Kerrville VA Medical Center this month, the urgent care clinic's hours went from around-the-clock to weekdays only and after-hours lab and X-ray services were eliminated, he said.

The changes were sought by Marie Weldon, director of the South Texas Veterans Health Care System, who declined to be interviewed but provided written answers to some questions.

A proposal by Weldon to replace acute care beds with a short-term stay-services unit still was awaiting action last week by Robert A. Petzel, VA undersecretary for health, said William McLemore, spokesman for the VA's Heart of Texas Network, which covers most of the state and oversees the South Texas system.

McLemore said he thought inpatient care services still were available in Kerrville, noting, “You cannot close beds or change that acute care service without the undersecretary's approval.”

But an admissions clerk there Friday corroborated Schellhase's report that the only remaining in-patient care is in the 154-bed nursing home. “We don't have inpatient medical care any more,” the clerk said.

Vesta Cowen, president of the American Federation of Government Employees Local 2281, also confirmed the acute care unit's closure, saying, “We have stopped admitting acutely ill patients, except to long-term care.”

Her union's members fear that cuts eventually will result in the facility, which treated about 11,000 veterans last year, being shuttered.

“Their statement to us is that we're going to become a center for excellence of long-term care,” she said of VA officials in San Antonio. “Basically, we're going to be a glorified nursing home.”

Vets across the Hill Country who seek treatment here for serious illness or medical emergencies are now referred to Peterson Regional Medical Center in Kerrville or Audie Murphy VA Hospital in San Antonio, said Schellhase, a retired Army brigadier general.

While he contends the facility no longer qualifies as a hospital, Weldon said in written remarks that it “still meets the criteria to remain a VA hospital.”

She said her proposal to change “some beds” to short-stay services would “more accurately reflect treatments currently provided.”

The emotional conflict over the facility's services and future escaped the notice of ex-Coast Guard member Gerald Meager of Kingsland as he was treated there last week.

“I don't really see much change, but I don't go very often because I don't have many health problems,” said Meager, 67, who traveled 85 miles here rather than be seen at a closer VA clinic in Cedar Park.

“I prefer Kerrville over any other VA in Texas,” Meager said. “Every time I've been here, I've been treated very good.”

The changes enacted this month are merely the latest efficiency/cost-saving initiatives since the facility was brought into the South Texas system in 1996. At that time, it had 380 hospital beds to serve the roughly 16,000 veterans in its 14-county service area.

Members of The Hill Country Veterans Council feel excluded from the VA decision-making process, but Weldon said she meets quarterly with stakeholder groups, which include Schellhase's, and is open to feedback and suggestions.

Schellhase appealed directly to VA Secretary Eric Shinseki in a July 4 letter, saying, “We can't believe that you're aware that one of your finest facilities is being systematically downsized.”

That characterization was rejected by Weldon, who noted some services have been added in Kerrville since she took the San Antonio post in 2009.

“The long-term plan is to maintain or increase services available to veterans in all areas of South Texas VHCS,” Weldon said. “We make decisions which enhance patient safety and improve clinical outcomes based on utilization rates for several years.”

Despite the changes in Kerrville, McLemore asserted that Lawrence Biro, director of the VA Heart of Texas Network, has kept his promise to maintain or expand services in the district, that stretches from the Rio Grande Valley to the Oklahoma border, with more than one million veterans.

While the urgent care clinic in Kerrville is no longer open every day, McLemore said, veterans can still get after-hours care at the local hospital.

“This is about service delivery, not who is delivering the service and where,” he said.

It makes little fiscal sense to keep a doctor, nurse and clerk on duty 24/7 in the urgent care clinic, which saw very few patients at night, he said, adding, “Do you, as the taxpayer, want to see that? No. Can't the services be delivered another way? Yes.”

Retired Marine Corps Col. Vicki T. Marsh, 68, a member of Schellhase's group, says the South Texas system's website reflects its low regard for the Kerrville center.

Rather than appearing beside clinics in Victoria and San Antonio under the heading “Our Locations,” the “Kerrville VAMC” is in small type at the bottom of the page.

“They marginalize us,” Marsh said. “Last to know, first to go.”

Cowen said the under-utilized facility she now sees bears little resemblance to the thriving hospital where she began work 25 years ago.

“It's been a slow erosion of services in Kerrville,” she said. “Sometimes, we truly believe that they have set us up for failure.”

zeke@express-news.net