There were 96 medical centers that showed improvement compared to one year earlier. Dayton was one of 50 that showed no improvement or declined in its performance, according to the ranking.

The Dayton VA’s nursing home earned one out of five stars in its most recent quality rating as did Chillicothe’s. Nursing homes in Cleveland and Cincinnati each received two stars in that June report.

The VA has several clinics throughout Ohio, including locations in Springfield and Hamilton but only medical centers are included in the year-end rating.

The VA’s rating, called the Strategic Analytics for Improvement and Learning, takes into account metrics that measure access to care, quality of mental health, employee perception, nursing turnover and efficiency and capacity. Each medical center receives a rating based on the performance of other facilities, meaning there will always be VA medical centers with a rating of just one start as well as hospitals with a rating of five starts.

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Due to the comparative way the rating system works, Dayton’s medical center would have to show significant improvement to be moved up to a four or five star rating, said spokesman Ted Froats.

“It’s not enough just to improve,” Froats said. “If everybody Is improving then we need to improve faster than everybody else.”

Dayton has historically received three stars through the SAIL rating, which until 2016 was used only internally. But, improving the SAIL rating has become a prime focus for the Dayton VA’s new director Jill Dietrich, said Wilson.

Dietrich, who was appointed in March, is the first woman to hold the director’s job in the Dayton VA’s more than 150-year history.

Wilson said Dietrich has taken a “very aggressive” approach to improving the hospital’s SAIL metrics by creating a “multidisciplinary team” to take a close look the factors considered by the VA. Some of the changes have already been implemented and may take a year or more to show in the SAIL rating, Wilson said.

The Dayton medical center’s highest performing metric is its “ambulatory care,” which Wilson said is the rate for which the hospital handles conditions that should be treated though outpatient means. The Dayton VA is the No. 16 medical center in the country for that measure.

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An area where the Dayton medical center lags behind others is its “adjusted length of stay” or the number of days a patient is expected to be in a hospital compared to how long their stay ends up being, Wilson said. While the medical center is trying to solve that issue it’s a difficult and complex one to address because it means that a patient may not be leaving because they don’t have the care they need outside of the hospital.

“What we’re trying to do is create a process internally where we can monitor our progress more regularly,” Wilson said. “Were trying to get ahead of the ball and flag those areas that seem to be trending in the wrong direction.”

When asked about the rating, Rep. Mike Turner, R-Dayton, said ensuring health care for vets is a “commitment of honor.”

“I have worked diligently to hold accountable those responsible for providing quality care to our veterans and to improve funding and facilities for our VA health care. I have met with our new Dayton director and I believe she is absolutely committed to improving the quality of care here locally,” Turner said via email.

Turner is running for re-election this fall and his opponent in Ohio’s 10th congressional district is Democrat Theresa Gasper. Vets should be able to count having their health care needs met when they return home, Gasper said.

“Given these rankings, we need to do better by them,” she said in a prepared statement.

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