Vets home wants to junk troublesome computer

Wednesday, Sept. 14, 2005 | 11:14 a.m.

Although it was only two years ago that $50,000 was spent on computer software for the Southern Nevada Veterans Home in Boulder City, state officials now are prepared to scrap that software and spend $250,227 more to buy a new computer system.

Officials at the veterans home, where long-term nursing care is provided to 160 ex-military members and/or their spouses, say the existing computer system has become unreliable and causes errors in medical and billing files of patients.

The officials complain that they have tried for two years to get the bugs worked out of the Accu-Care software system from Ohio-based Accu-Med Services, but have failed. It's not that the software doesn't work, they say. The problem is that it does not integrate billing with clinical or inventory operations, creating a situation in which three employees have to input the same data that one worker ordinarily would do, facility officials said.

Tired of working around that glitch, veterans home officials will appear before the Legislative Interim Finance Committee, which meets 8:30 a.m. Thursday in Carson City, to seek approval to spend $250,227 from its budget to get a state-of-the-art integrated system.

The Accu-Med system was purchased off a Veterans Administration supply schedule, a pact that allows the veterans home to piggyback on existing federal contracts instead of putting the matter out to bid and contracting with the low responsible bidder.

Gary Bermeosolo, the director of the veterans home, said that the deal to purchase the Accu-Care software in 2003 seemed like a good move at the time because it had a good working history.

"Accu-Med's system was the one the VA was using, so we thought it would work for us," Bermeosolo said.

He said prior to that the facility had sent out requests for proposals for a software system. The bids that came back were comparable in price with Accu-Med's product, so that company's software was purchase off of the facility's national contract sharing agreement with the VA, he said.

However, Bermeosolo said, because the VA doesn't bill patients and utilizes only the clinical portion of the software, veterans home officials did not learn of the system integration problems between the billing and clinical components until it was too late.

Bermeosolo said that the use of the increased VA patient care per diem to purchase the new software will not adversely affect patient care.

"We would not take away from patient care because that is our first priority," he said. "If the purchase of software would result in lower care, we would not be pursuing it."

Initially veterans home officials were going to ask the committee for the money. But because the VA has decided to increase the facility's per diem for patients from $59.36 per day to $63.40 beginning Oct. 1, they now want the OK to instead spend the increased revenue on the new computer system, Bermeosolo said.

Bermeosolo said he is required to spend multiple sources of income, such as VA contribution increases, before spending general fund dollars, and that any unspent general fund dollars at year's end are returned to the state's coffers.

He said that if the extra $4 a day is not used to buy the new software it would be used for continuing operation costs such as utilities and salaries.

The veterans home, which has a 180-patient capacity, opened Aug. 12, 2001, amid a myriad of problems with construction and issues over whether adequate medical staffing could be obtained.

Lawsuits have been filed over construction defects that have included large cracks in the walls. The staffing has "been stabilized," Bermeosolo said.

Nevertheless, state lawmakers say they will have to take a close look at the facility's latest request given its well-documented history of problems.

"At this point there are lots of questions," said state Sen. Bob Beers, R-Las Vegas, a member of the interim finance committee. "It's frustrating because this is not the first symptom of bad management. We've already change the manager. There is little more we can do."

Beers said the facility's rocky start, which included replacing its original director before the home opened, "probably will play into the decision," though he believes "ultimately the request probably will be approved."

"It doesn't sound like we have another choice," Beers said. "There is more harm ahead if we do nothing to address the problem. Hopefully, we'll see less and less of these legacy problems as the months role by."

Sen. Bob Coffin, D-Nev., another committee member, says the rocky history should not play so much of a role in determining whether the veterans home gets either the funds or the approval to spend the VA's patient funding increase.

"As long as the problems with the computer software are not resulting from mismanagement, but rather because of outside sources, we should not hold it against the institution," Coffin said.

Bermeosolo said that he has attempted to fix the software glitches internally and has received cooperation from the vendor, Accu-Med, a division of the Omnicare pharmaceutical company.

Accu-Med stopped charging its monthly $550 maintenance fees, yet continues to provide support, including removing the faulty integration gateway system, Bermeosolo said.

"The vendor offered to take the software back and give us a refund," Bermeosolo said. "But, if I had taken that deal, what would I have used to bill patients, monitor inventory and run the clinical operations?

"To drop the current system, you have to have another software system in its place. That's what we are in the process of doing."

Tom Deutsch, spokesman for Accu-Med System, which is based in Milford, Ohio, said that while it is his company's policy not to comment on relationships with clients, he confirmed that his company is continuing to work on any problems.

"We are working actively with this client and we have made significant concessions," Deutsch said, referring to discontinuing the monthly maintenance charge. "We are working on the software every day. We will continue to work to find ways to resolve this."

Deutsch, said his company has several thousand clients, including VA facilities, and that the situation with the local veterans home involves "a very complex piece of software."

Bermeosolo said suing the vendor did not seem like a cost-effective alternative.

"To sue them would mean spending far more than the $50,000 the system cost," Bermeosolo said. "By the time we change the system it will have cost us about $17,000 a year to use. We would have spent more than that to lease a system. In the end, we will have gotten our money's worth out of it."

Coffin, however, said members of the interim finance committee might question at Thursday's hearing why the agency did not take a more aggressive stand against the company for not delivering what it allegedly promised.

"Sometimes you have to do it (sue) and, when you prevail, you get your expenses (court costs) back," Coffin said.

Despite the computer problems, Bermeosolo said there "has not been a huge problem of sending out bad bills." To prevent that from happening, Bermeosolo said, his employees have had to spend more work hours doing what the computer software should automatically have done.

"We've had to double and triple entry the data," he said. "As a result our system is more staff intensive. With a new system, the savings in manpower also will help the new software pay for itself."

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