New Veterans Hospital

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Coyote
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Re: New Veterans Hospital

Post by Coyote »

EXCLUSIVE: VA policy prevents Omaha veterans from getting new hospital
KETV wrote:Terry is going public with a plan that could break ground sooner than if the VA were to finance the project. In fact, Terry estimates if the VA doesn't adopt this way of constructing government buildings, it could be a decade or more before Omaha sees a new VA hospital.
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Brad
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Re: New Veterans Hospital

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From that same article...
KETV wrote:Janssen's assessment is a far cry from what's currently happening at four VA hospital construction sites. According to the Government Accounting Office, in 2013, the four sites were each an average of 35 months behind schedule and $366 million over budget.
I don't see why we need a VA. Give them health care (which we already do) and let them choose what hospital they go to. From most people I have talked to, I think they would choose Bergan or UNMC over the VA any day of the week...

Between these cost/construction issues, the issues with the VA police that came out last week, and then all the national stories that have come out this summer, I think the VA has serious issues from top to bottom...
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GetUrban
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Re: New Veterans Hospital

Post by GetUrban »

Once upon a time, it must have been less expensive to offer more advanced high-quality care and take wounded servicemen and servicewomen to government-run hospitals oversees and back home, and also offer general medical care to veterans. But the VA became another bloated, redundant-ridden bureaucracy. Now it seems logical to just have the government pay for Veteran's care at regular hospitals. But I guess that would be seen as cutting veteran's benefits, and not politically palatable.
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Re: New Veterans Hospital

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I used to work for PRC a few years back and sometimes would have to do perception surveys about various hospitals in regions of the country; sometimes including VA hospitals. I can confidently say that VA hospitals received some of the most negative perceptions out of all the hospitals and health systems surveyed.
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Re: New Veterans Hospital

Post by ricko »

Brad wrote:From that same article...
KETV wrote:Janssen's assessment is a far cry from what's currently happening at four VA hospital construction sites. According to the Government Accounting Office, in 2013, the four sites were each an average of 35 months behind schedule and $366 million over budget.
I don't see why we need a VA.  Give them health care (which we already do) and let them choose what hospital they go to.  From most people I have talked to, I think they would choose Bergan or UNMC over the VA any day of the week...

Between these cost/construction issues, the issues with the VA police that came out last week, and then all the national stories that have come out this summer, I think the VA has serious issues from top to bottom...
That would seem to me the most reasonable solution, and the one that I've been suggesting since this became an issue. Just put them all on Medicaid, but it would never pass the current Congress, it makes too much sense. Heck, even increased funding for medical care for returning veterans got the boot.
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Re: New Veterans Hospital

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At one time building on UNMC's campus was an option, given their history..., I wonder why this wasn't taken up.
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Re: New Veterans Hospital

Post by Garrett »

Yeah... Just let UNMC build a hospital specializing in Veteran's care. Boom. Done.
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Re: New Veterans Hospital

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Coyote wrote:At one time building on UNMC's campus was an option, given their history..., I wonder why this wasn't taken up.
They would have had to take out JP Lord School. The VA wouldn't let them expand TNMC, they had to build duplicate ORs and everything. Thus the need for the JP Lord site. Then the VA funding started to get shakey and then stall. It would have been a good combo if done correctly.

Frankly, they need to end the VA. The idea behind it was to care for service members injured in war. It morphed into free medical care for anyone that ever wore a uniform. The people that were dealing with real war related issues were squeezed out. The work environment got toxic and destructively unionized. The place became a shameful betrayal of basic moral justice. We broke the war injured. We should fix them. We didn't force someone to sit on their |expletive| drinking their life away. We didn't force some guy to play touch football on his day off in basic only to tear up his knee and get a "service connected" card. These users plug up the system. The bureaucrats that run the place are interested in moving out of patient care ASAP. They just buff their numbers to move up.

The VA should end. Guys who were injured by actual service should be kept at active duty hospitals or managed through TriCare in the private sector. The football injuries would not turn into free healthcare for life. We would not have the crowd issues. The guys with real injuries would get treated. The condensation of patients would allow for treatment protocol and research to process more efficiently. Time for it to go.
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Re: New Veterans Hospital

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It is definitely redundant to provide completely separate heath care for veterans. Maybe if the govt was efficient at even one thing it would be better, but this shows clearly that they are not. My dad surprisingly has always been fairly satisfied with VA care, but perhaps its because he hasn't been able to go other places.
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Re: New Veterans Hospital

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cdub wrote:It is definitely redundant to provide completely separate heath care for veterans.  Maybe if the govt was efficient at even one thing it would be better, but this shows clearly that they are not.  My dad surprisingly has always been fairly satisfied with VA care, but perhaps its because he hasn't been able to go other places.
The problem with the VA is that at some level, they do well. When I was in med school, their surgical ICU was the best in the city. Their Emergency Department now is a competent level 2 ED. Is it as good as UNMC? Not by a long shot. Is it as good as Midwest Minor Medical? Better. The problem is the lack of consistency. When the surgical ICU was great, the surgical specialty floor was a disaster. The MICU was at best OK, but fading fast. The surgical floor run by Creighton was semi-functional and the one run by UNMC was good, but nothing special. There is a tolerance for marginal performance. There is a fear of the unions that choke that place. There is a fear of going up against the bureaucrats that choke the budgets. Something that fails never gets fixed for fear of a union labor action or the lack of funding to do anything.

If you have the right leaders and the right staff with a good attitude, the VA can do good medicine. Our VA was a leader in nuclear medicine back in the 50's and 60's. It had a reactor and was capable of making therapeutic isotopes and doing advanced imaging long before the civilian market had this. The damage done to it by politicians that lower the bar for VA medical care to buy votes, unions that chase away anyone that wants a career instead of a job, and bureaucrats who are only interested in their next promotion has accumulated too long, and the damage done is now lethal and incurable. Time to stop.
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Re: New Veterans Hospital

Post by frankt »

cdub wrote:It is definitely redundant to provide completely separate heath care for veterans.  Maybe if the govt was efficient at even one thing it would be better, but this shows clearly that they are not.  My dad surprisingly has always been fairly satisfied with VA care, but perhaps its because he hasn't been able to go other places.
It's not really surprising since most veterans are, in fact, pretty satisfied with their care from the VA.
http://www.militarytimes.com/article/20 ... tisfaction" onclick="window.open(this.href);return false;
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Re: New Veterans Hospital

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http://www.ketv.com/news/creighton-hosp ... y/28211802
Option 1 would partner with Omaha-area businesses to finance construction of a new VA medical center.

Option 2 would use the "soon to be vacant" space in the CHI-Creighton Medical Center facility in midtown Omaha. The 1,000,000 square feet is nearly the size needed by the VA. Renovations to the building would cost an estimated $250 million.

Option 3 would split VA Medical Center services. A new building would provide ambulatory care for veterans in a hospital smaller than the current building. Other VA services would be placed in other area medical facilities.
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Re: New Veterans Hospital

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I like options 2 and 3, but 3 a little more. If they can equip and staff and work out government reimbursement stuff with other hospitals, that sounds like a nice idea.
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Re: New Veterans Hospital

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Option two would be nice since it would make use of the Creighton Medical Center, but three would seem like a big win in the long run
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Re: New Veterans Hospital

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I always thought building on the UNMC campus and combining services would have been the best option.
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Re: New Veterans Hospital

Post by Ben »

As much asI would love to see the CUMC space reused, I don't get how the government thinks they can cost-effectively rehab the space if CHI couldn't.... Plus, what the VA needs is primarily outpatient services, not a large inpatient facility, like what the CUMC building is...

I agree with the shared services, and smaller VA campus line of thinking. It'd benefit everyone if the current facilities are better utilized....
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Re: New Veterans Hospital

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New Omaha VA hospital moves up to No. 10 on agency's priority list
In budget request documents released this week, the U.S. Department of Veterans Affairs has a replacement Omaha facility at No. 10 on its priority list, up from No. 28 a year ago.
In a potentially more ominous change, the cost of the project also has risen. It’s now listed as a $616 million undertaking, up 10 percent from its previous price tag of $560 million.
The same budget documents indicate that demolition of the existing Omaha facility is slated for 2019.

One idea was to have the Omaha VA operation move into the Creighton University Medical Center after it closes in 2017, but Ashford has suggested that VA officials don’t seem very keen on that option.
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Re: New Veterans Hospital

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With the recent track record of the VA building hospitals, I don't see much chance of Omaha getting a new one in this decade.
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Re: New Veterans Hospital

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skinzfan23 wrote:New Omaha VA hospital moves up to No. 10 on agency's priority list
In budget request documents released this week, the U.S. Department of Veterans Affairs has a replacement Omaha facility at No. 10 on its priority list, up from No. 28 a year ago.
In a potentially more ominous change, the cost of the project also has risen. It’s now listed as a $616 million undertaking, up 10 percent from its previous price tag of $560 million.
The same budget documents indicate that demolition of the existing Omaha facility is slated for 2019.

One idea was to have the Omaha VA operation move into the Creighton University Medical Center after it closes in 2017, but Ashford has suggested that VA officials don’t seem very keen on that option.
The St. Joe's building is very problematic for revision into a modern hospital. Two cardinal issues: 1. it was built facing backward. The front is actually the rear of the building. This forces an unnatural flow and utilization pattern. When the building was built in the 1970's, there was a fad in hospital design called "Nursing Pods" where a single team of a couple of nurses and assistants could manage a whole group of patients from a single location. The problem is that this forces the overall hospital to commit to an entire pod or nothing. If you need 7 beds and you have two pods of 5, you have to open and staff all 10 beds. This architectural style rapidly faded after it's shortcomings were noted.

I would have to think that the VA wants to have no part of that. Additionally, they don't want to be on a medical school campus. They have been burned elsewhere and even when they were considering UNMC property, the idea was to build a new tower with floors for the VA and floors for UNMC. This was shot down fast by the VA who wanted their own building totally (even HVAC had to be theirs.)
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Re: New Veterans Hospital

Post by GetUrban »

I agree, with all of the requirements VA has created for itself, there is no way St. Joe could meet its needs. It's hard enough designing a new hospital from the ground up that meets all of their regulations.

A more fundamental question is "Why does the VA need it's own hospitals in the first place?" Why can't veterans choose to be treated in other hospitals and simply have VA coverage to pick up the bills? Would the billing get too complicated with all of the pricing differences in place now? Sorry if we've already touch on this point.
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Re: New Veterans Hospital

Post by iamjacobm »

It will also be interesting to see how VA facilities react to the shrinking number of veterans in America. Projections show that numbers could drop by as many as 10 million over the next 30 years. So even if they still have their own facilities a lot of them will be way over sized for the next generation.
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Re: New Veterans Hospital

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GetUrban wrote:A more fundamental question is "Why does the VA need it's own hospitals in the first place?" Why can't veterans choose to be treated in other hospitals and simply have VA coverage to pick up the bills? Would the billing get too complicated with all of the pricing differences in place now? Sorry if we've already touch on this point.
I wonder how much of that happens already. My grandfather has surgery at the Med Center a couple years back and was given the choice to be transfered to the VA after of stay at NMC. Obviously he stayed put and they just sent the bill into whoever they needed to.
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Re: New Veterans Hospital

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iamjacobm wrote:My grandfather has surgery at the Med Center a couple years back and was given the choice to be transfered to the VA after of stay at NMC.  Obviously he stayed put and they just sent the bill into whoever they needed to.
It seems to me like it's logical to outsource medical care to private facilities that can handle it. While I have a problem with people thinking the private sector can handle everything better than the public without question, I firmly believe it's pointless to duplicate services that are available, effective and reasonable.
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Re: New Veterans Hospital

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Veterans need discrete facilities that specialize in military medicine as the needs of service members are often specialized. For example, most of us will not have been exposed to agent orange or have shrapnel in us.

If you compare this group to other special groups you can see a way to improve things. Survivors of childhood cancer have the same needs as other adults, and some others. We need to see these kids forever, due to the toxicities they experience. Same with these kind of vets. You get a rare disease or injury, you may be seen in a special clinic, but without putting all the patients possible on study, you don't figure it out fast enough.
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Re: New Veterans Hospital

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bigredmed wrote:Veterans need discrete facilities that specialize in military medicine as the needs of service members are often specialized.  For example, most of us will not have been exposed to agent orange or have shrapnel in us.

If you compare this group to other special groups you can see a way to improve things.  Survivors of childhood cancer have the same needs as other adults, and some others.  We need to see these kids forever, due to the toxicities they experience.  Same with these kind of vets.  You get a rare disease or injury, you may be seen in a special clinic, but without putting all the patients possible on study, you don't figure it out fast enough.
Could they have some VA specific staff at hospitals that would be familiar with treating those unique situations? Or would it require more than that?
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Re: New Veterans Hospital

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Louie wrote:
bigredmed wrote:Veterans need discrete facilities that specialize in military medicine as the needs of service members are often specialized.  For example, most of us will not have been exposed to agent orange or have shrapnel in us.

If you compare this group to other special groups you can see a way to improve things.  Survivors of childhood cancer have the same needs as other adults, and some others.  We need to see these kids forever, due to the toxicities they experience.  Same with these kind of vets.  You get a rare disease or injury, you may be seen in a special clinic, but without putting all the patients possible on study, you don't figure it out fast enough.
Could they have some VA specific staff at hospitals that would be familiar with treating those unique situations? Or would it require more than that?

We could do it in the same way women's/children's hospitals work. Methodist or CHI could open their own Vet's hospital staffed by people who have experience with those unique health issues and the government can reimburse the hospital.
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Re: New Veterans Hospital

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Yes. The VA has several such activities going on. In ABQ, the VA and the USAF have a joint hospital. They tend to want their own shops. There needs to be tightly organized care with a learning mechanism built in so that vets with rare problems can get care where they are.
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Re: New Veterans Hospital

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bigredmed wrote:Veterans need discrete facilities that specialize in military medicine as the needs of service members are often specialized.  For example, most of us will not have been exposed to agent orange or have shrapnel in us.

If you compare this group to other special groups you can see a way to improve things.  Survivors of childhood cancer have the same needs as other adults, and some others.  We need to see these kids forever, due to the toxicities they experience.  Same with these kind of vets.  You get a rare disease or injury, you may be seen in a special clinic, but without putting all the patients possible on study, you don't figure it out fast enough.
That's very true, but that only represents a portion of VA patients. Many are just old men and women with the same diseases as the rest of the population (diabetes, heart disease, etc). It seems like there may be efficiencies in having the VA specialize in conditions that are unique to combat veterans (including those that bigredbed listed, as well as whole new class of injuries and disabilities that our post-9/11 vets have), while referring the run-of-the-mill patients to regular hospitals and clinics that are better-suited to treat them (without 6-month waits).
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Re: New Veterans Hospital

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Is there a point that they can no longer operate the facility? As in medicine can no not be conducted in a safe manner.. Or could they continue using the place even if the ceiling is crumbling in? It just seams like there isn't going to be a new VA hospital so plans for a post VA hosputal Omaha should start being drafted.
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Re: New Veterans Hospital

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As long as they don't encounter something serious enough that it can't be addressed with ongoing maintenance and repair, I don't imagine there is anything that would force the building to close. The maintenance gets more and more expensive with time, especially if they're continuing to nurse decrepit mechanical systems, but as long as water intrusion (roof, windows, flashing, masonry, etc) is maintained, there shouldn't be any structural worries.
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Re: New Veterans Hospital

Post by Garrett »

I used to take my grandpa here all the time and the facilities themselves were in pretty decent shape from what I could tell, but the layout was a confusing mess.
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Re: New Veterans Hospital

Post by iamjacobm »

So they might try a new funding source for Omaha's new facility. Build it with private funds with the government leasing it from the private developer. I guess they trust hat a developer won't allow insane cost overruns like what happened in Denver.
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Re: New Veterans Hospital

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http://www.livewellnebraska.com/health/ ... e4cdb.html

They are looking into moving the VA hospital into Creighton's facility, which will be vacated. $124 million after renovations vs. $616 million building a new hospital.
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Re: New Veterans Hospital

Post by nativeomahan »

That would be one practical use for St. Joe's hospital. There really aren't many other things one could do with that building.
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Re: New Veterans Hospital

Post by iamjacobm »

The VA site would be prime redevelopment property if they do end up moving.
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Re: New Veterans Hospital

Post by blueblood »

Any clue what effect the VA choosing the Creighton site has on CU or UNMC? I know nothing but I would assume this would be a huge get for Creighton and have no bearing on UNMC? Again, don't know anything but considering it would cost 1/2 as much as any other option why wouldn't they choose the Creighton site?
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Re: New Veterans Hospital

Post by iamjacobm »

Creighton's med school will be moving in a couple years so I don't think there will be much effect. If anything UNMC could be if it greatly by purchasing all the land that the VA is on and have the ability to create a huge corridor down 42nd over the next 50 years.
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Re: New Veterans Hospital

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Yeah I would suspect that UNMC would be very interested in the VA site. Even if they were not the ones who bought the land, there are many uses for that land.
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Re: New Veterans Hospital

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maybe if they close that site there will be renewed interest to close the street and have field club buy the land so they can make their course how it used to be.
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Re: New Veterans Hospital

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lmdramos wrote:maybe if they close that site there will be renewed interest to close the street and have field club buy the land so they can make their course how it used to be.
How did their golf course used to be?
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