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Director’s MessageTo Our Employees, Veterans, and Stakeholders:Table of ContentsSince March 2020, VA Southern Nevada Healthcare System (VASNHS) has been one ofthe busiest Department of Veterans Afairs facilities in the battle against COVID-19.As I refect upon what we accomplished locally in 2021, the word resiliency comesto mind. COVID-19 has been a marathon, but at times we’ve asked our 3,000-plusstaf members to run various legs of this journey as a sprint. And they havenever let us down, working tirelessly to provide vaccinations, deal withnew variants, care for inpatients, and provide testing.While all of that was a monumental undertaking, our staf also set severalrecords beyond COVID in 2021, serving an all-time high of more than 70,340unique Veterans, surpassing 930,000 outpatient visits, and expanding accessto critical care and services via in-person and virtual modalities.Our people continue to be our strength and the word “no” is not in theirlexicon. They are all winners in this long race and this year’s annual reporthighlights their numerous achievements.As we begin 2022, we will continue to support COVID contingency operationsas needed, but our focus will be transitioning to a “new normal” as we work toexpand access to services and focus on improving the patient experience. We willalso look to the future and review services, capabilities and data to chart a course onhow to most-efectively deliver healthcare that is second to none in the years ahead.In closing, thank you to our staf, the Veterans Service Organizations,Congressional Delegation, federal, state, local, and nonproftpartners; and the Southern Nevada health care communityfor your continued support during this challenging time.We are fortunate to have some of the best Veteransupporters in the nation right here locally, and eachof you is pivotal to our success.- BillWilliam J. Caron, PT, MHA, FACHEDirector/CEOVA Southern Nevada Healthcare SystemExecutive Leadership .1- 2Vaccine POD Operations .3- 4Joint Partnership with Nellis .5- 6Showcasing our Veterans .7Improved Outreach .8Awards and Recognitions .9-10Women’s Health .11Fisher House .11Chaplain Service .12Voluntary Service / Community Contribution .12Employee Feature .13Veteran Feature .14Statistics .15Facilities and Locations .16VA Southern Nevada Healthcare System Director/CEO William J. “Bill” Caron, a U.S. Air Force Veteran,began his medical career as a physical therapist in 1993. He assumed his current duties in June 2019 aferserving as the Director of the Southern Arizona VA Healthcare System in Tucson, Ariz. Prior to that role, Mr.Caron served as VASNHS’ Associate Director. He also held several leadership roles during a 14-year privatesector career, where he managed multiple clinical services.
2021Executive LeadershipJames “Jim” Zeigler is the Deputy Director of the VA Southern Nevada HealthcareSystem. In this role, he serves as the facility’s chief operating ofcer, overseeingbusiness administration, fscal, biomedical engineering, prosthetics, strategicplanning, and facilities management. Mr. Zeigler has more than 20 yearsin healthcare administration, which includes 10 years in Veterans HealthAdministration leadership roles. Prior to joining VASNHS in March 2021,he served as the associate director of the Chillicothe (Ohio) VA Medical Center.He is a graduate of the VA Healthcare Leadership Development Program.He has a bachelor’s degree in speech-language pathology and a master’s degreein communication disorders – both from Northern Michigan University.Dr. Ramanujam Komanduri is the Chief of Staf at the VASouthern Nevada Healthcare System. He is a graduate of theUCLA School of Medicine and board certifed in Psychiatry.Dr. Komanduri has held various clinical and academicappointments throughout his career, and prior to his currentrole, he served as the unit chief for VASNHS’ AddictiveDisorders Treatment Program. He is actively involved inmedical resident and student teaching and has participatedin multiple clinical research projects. Dr. Komanduri is agraduate of Leadership VA, and he has received multipleawards for his distinguished public service in thelocal community.John Stelsel is VA Southern Nevada Healthcare System’s AssistantDirector and was detailed as Acting Associate Director for severalmonths during 2021. He has served at eight VA Medical Centers acrossthe country, acting in various roles throughout his VA career, includingservice chief of a broad range of administrative services. Mr. Stelselholds a bachelor’s and master’s degree in occupational safety. Heis a graduate of the Health Care Leadership Institute (HCLI) and is aFellow-Level Mentor in VA’s national mentor certifcation program.1Dr. Alex Isani was appointed as Deputy Chief of Staf inOctober 2018. He joined VA Southern Nevada Healthcare Systemin October 2014 as the Chief of Pain Medicine. Prior to joiningVASNHS, Dr. Isani was the Director of the Anesthesia Pain Serviceat the VA Salt Lake City Healthcare System for seven years.He graduated with a Bachelor of Science in biochemistryfrom the University of Nevada, Reno and a medical degree fromRoss University School of Medicine. Additionally, Dr. Isani is agraduate of the VA Health Care Leadership Development Program.Dr. Desiree Crawford is Associate Director ofPatient Care Services and Nurse Executive for theVA Southern Nevada Healthcare System. She previously served asVASNHS’ Deputy Nurse Executive and Associate Nurse Executive ofNursing Professional Services prior to assuming her current dutiesin 2021. Before joining VA, Dr. Crawford held progressive leadershippositions in Education, Critical Care and Medical Surgical clinical areasand was a staf nurse in Critical Care. She graduated from A.T. StillUniversity, Kirksville, MO. with a Doctorate in Health Care Education. Sheis a graduate of VA’s Health Care Leadership Development Program andVA’s Executive Career Development Program.Antoinette Pretto-Sparkuhl is Chief Ofcer, Quality,Safety Value for the VA Southern Nevada Healthcare System.Ms. Pretto-Sparkuhl has been an RN for over 30 years. Prior to joining VA,she was Senior Director of Clinical Excellence for HCA Healthcare’s FarWest Division Ofce, responsible for driving key quality and performanceimprovement metrics for eight acute care hospitals in Nevada andCalifornia. She also served as Vice President of Quality at Mountain ViewHospital in Las Vegas. Ms. Pretto-Sparkuhl received her Bachelor of Sciencedegree in Nursing from UNLV and has two master’s degrees, one in HealthCare Administration and one in Business Administration -- both fromUniversity of Saint Francis in Joliet, Ill.Joseph M. Scotchlas was temporarily detailed to the VA SouthernNevada Healthcare System as the acting associate director,from the Bay Pines (Fla.) VA Healthcare System in late 2021.He holds a Master of Healthcare Administration and a Bachelor ofScience in Political Science from The University of Scranton(Penn.). He is an active member of the American College of HealthcareExecutives (ACHE) and is board certifed in health care management.2
Vaccine POD OperationsIn order to ensure the safety of Veterans living outside of Las Vegas, VASNHS made efortsto provide vaccine clinics in Pahrump and Laughlin. Dozens of VASNHS staf made the driveto these locations every weekend throughout March and April to make sure that our ruralVeterans had equal opportunity to receive the vaccine.The approval of the Johnson & Johnson single-dose COVID-19 vaccine allowed VASNHSto expand its vaccination eforts to Veterans who were not able to attend a normal clinic.The Housing and Urban Development (HUD) Veterans Afairs Supportive Housing(HUD-VASH) program worked tirelessly to connect with homeless Veterans to ensurethey had access to a vaccine, which was made easier with the more portable J&Jvaccine. The home-based care program was also able to bring the vaccine toVeterans unable to leave their homes.By the end of the year, VASNHS had given nearly 70,000 dosesof COVID-19 vaccine.As 2021 began, VA Southern Nevada Healthcare System was one of 37initial sites to receive the Pfzer-BioNTech COVID-19 Vaccine. In order to meetthe demand and “put shots in arms,” VASNHS Emergency Management mobilizedthe largest Point-of-Dispensing (POD) operation in its history. In accordance withCDC guidelines, vaccines were ofered to the most elderly and at-risk Veterans initially,followed by more age groups. By the end of January, VASNHS had given over 10,000 dosesof COVID-19 vaccine.At frst, vaccines were only available at the North Las Vegas VA Medical Center because ofconcerns with refrigeration and transportation of the Pfzer-BioNTech vaccine. To accommodateas many Veterans as possible, VASNHS held weekend clinics throughout the frst quarter of theyear, providing hundreds of vaccines per day. These clinics allowed VASNHS to outpace communitynumbers in vaccination rates.34
Joint Partnership With NellisVASHNS maintains an active joint venture with the Department of Defense, 99th Medical Group,at the Mike O’Callaghan Military Medical Center (MOMMC), located at Nellis Air Force Base.The MOMMC is VASNHS’s preferred frst choice for sending Veterans to the community whenpossible. VASNHS and DoD maintain an active Joint Venture Executive Council and havechartered a number of Joint Venture Workgroups to refne VA/DoD systems and operationalizefuture joint venture sharing opportunities. Both facilities partner in weekly huddles and VASNHSand MOMMC are one of three VHA locations nationwide identifed to pilot DoD VeteranCommunity Care referrals. In 2021, VASNHS and MOMMC renewed their resource sharingagreement to continue collaboration on providing care and services to Veterans andactive-duty service members in Southern Nevada.The two facilities also collaborate on preparednessexercises on a regular basis. VASNHS supported a mutual aidexercise in partnership with Nellis Air Force Base. As part of theexercise, a simulated event forced MOMMC to send patients to theNorth Las Vegas VA Medical Center. VASNHS Emergency Departmentstaf admitted the patients and nursing staf was on hand to ensureproper handof of care. This event showcased the interoperability betweenVASNHS and MOMMC and the efectiveness of the joint sharing agreementbetween the two agencies.56
Showcasing our VeteransImproved OutreachConnecting our Veterans with easier access to care is one of our chief priorities, and 2021saw several innovations to bring simple solutions right to the fngertips of our Veterans.VA Southern Nevada Healthcare System launched its new and improved website inconjunction with VA networks across the country. Through a user-friendly interface,streamlined navigation tools, and a centralized design, Veterans can make appointments,access secure messaging, and fnd local information in a faster, more intuitive manner.VASNHS has also been listening to what Veterans want. Through surveys like SHEP andVSignals, VASNHS closely monitors the patient experience and has made strides to improvepatient satisfaction. VASNHS has resumed the Red Coat Ambassador Program, Own the Moment Training and We Care Rounding to assist in getting real-time feedback and assist withimproving Veteran’s perceptions of quality of care and services. VASNHS currently hasthe highest inpatient satisfaction scores in HCAHPS of 22 facilities in Southern Nevada.Additionally, plans are underway for a new Welcome Center located near theentrance, where Veterans can fnd out what services the VA can ofer them.VA Southern Nevada Healthcare System is home to incredibly talented,creative, and inspirational Veterans. Our dedicated Recreational Therapy teambrings Veterans out to participate in various physical, mental, and spiritual healingactivities. Creative Arts Therapies such as art, writing, dance, drama, and music areevidence-based treatments that provide Veterans with healing from mental scars resultingfrom PTSD. VASNHS will be co-hosting the frst ever Southern Nevada Veterans Creative ArtsCompetition in 2022 to showcase some of the most talented Veteran artists and musiciansand send them on to compete nationally with top Veteran artists from around the country.Other events, like the Writers of the Storm, give Veterans a venue to debut their written worksamong peers, providing an outlet for mental, spiritual, and emotional healing.Recreational sports like cycling, archery, bowling, golf, and racquetball are adapted to ftVeterans of all skill and ability levels and build confdence and comradery while encouraginghealthy living. VASNHS Recreational Therapy also has a wide-range of mindfulness andspiritual activities like reiki and yoga at beginner, intermediate, and master levels led bycertifed instructors.78
Awards and RecognitionsEmergency Department (ED) Nurse Maria VanHart was one of six selected to receive the 2021Secretary’s Award for Excellence in Nursing and Advancement of Nursing Programs. VanHart wasrecognized by Veterans Afairs Secretary Denis McDonough for demonstrating leadership, selfessdedication to Veterans, and providing patient-centered care in a safe, efcient, and cost-efectivemanner. Each year the Secretary’s Award for Excellence in Nursing and Advancement of NursingPrograms is given to individuals who have been nominated by their colleagues for outstandingservice to our Veterans and the Department of Veterans Afairs. They have demonstrated excellenceand the highest level of dedication to their profession. Chosen from individual medical centers, thenominees go through a rigorous review before the fnal selection is made.In her role as an ED Nurse, VanHart performs comprehensive physical, psychological and spiritualassessments to a wide variety of patient populations with complex medical and surgical conditionsrequiring emergency care. She applies the nursing process to systems at the unit, team, andworkgroup level to improve the care Veterans receive.“In line with VA’s vision of quality care and service, Maria VanHart works tirelessly as a Registered Nursein our Emergency Department to ensure our team and the Veterans who depend upon us for care havethe very best experience,” said William Caron, VASNHS director/CEO. “We are so proud of her and of allour nurses who have performed with selfess dedication during this pandemic.”VanHart was also recognized in June 2020 for providing life-saving care while of duty whenshe was a frst responder to an overturned passenger van containing 10 people. Local policeand emergency personnel noted that her triage, trauma care, and calling for helicoptermedivac likely saved the lives of several of the critically injured.Designated a “Leader in LGBTQ Healthcare Equality” for the fourth year in a row bythe Human Rights Campaign in their 2021 Health Equality Index. This award recognizeshealth care facilities that are committed to providing inclusive care to their LGBTQ patients.By providing inclusive non-discrimination policies, these health care facilities are adoptingbest practices in the areas of LGBTQ patient care and support, employee policies and benefts,and LGBTQ patient and community engagement. VASNHS is one of only two (VA Sierra NevadaHealth Care System) medical facilities in the entire State of Nevada with this designation for 2021.VASNHS was designated as a “Pathway to Excellence” facility by the American Nurses CredentialingCenter. An ANCC Pathways to Excellence designation is highly-selective and recognizes health careorganizations which are committed to creating and maintaining a positive practice and collaborativeenvironment that empowers and engages staf to practice at the top of their profession, while drivingimprovements in safety and quality in the delivery of care. VASNHS was the frst health care facility inSouthern Nevada and frst VA facility in the Southwestern United States with this designation.910
Women’s HealthFemale Veterans are the largest growingdemographic of Veterans that we serve.At VASNHS in 2021, we have 7,303 uniquefemale Veterans accessing services. That representsa 10.4 percent increase since 2019. VASNHS has dedicated care forWomen Veterans at four of our Primary Care Clinics, as well as dedicatedWomen Veteran exam rooms at both Pahrump andLaughlin Outreach Clinics. We have developed anintegrated mental health program in primary care forWomen Veterans. In addition, VASNHS has fosterededucation and outreach programs for pregnant andnew mother Veterans. VASNHS has an active WomenVeterans Program with activities throughout the year.VASNHS hosted its frst Women Veterans Townhall,connecting female Veterans virtually with clinicalresources as well as community support and guestChaplain ServiceVA Southern Nevada Healthcare System’sSpiritual and Pastoral Care has grown toserve the diverse and increasing needs ofthe Veteran community. Whether in personor virtually, the VASNHS Chaplain corpsis available to meet the spiritual needs ofVeterans and VASNHS staf. Led byDr. Dwight Webster, VASNHS chaplains helppatients and family members throughoutpatient treatment, hospital stays, andextended care. If needed, they will contact aVeteran’s personal clergy or spiritual careprovider in the community. These clinical pastoral care specialistsprovide religious and non-religious people with services such as funerals,bereavement, and comfort and counseling.speakers. Finally, VASNHS has been approved fordesign of a stand-alone Women’s Health Center with constructionexpected in the coming years.Fisher HouseVoluntary Service/Community ContributionsThe volunteers that work at VASNHS play acrucial role in the operation of our health carefacility. Our team of 210 volunteers donateThe Las Vegas Fisher House is a comfort home whereapproximately 20,468 hours of their time inmilitary and Veterans’ families can stay at no cost while a2021 to navigate, inform, and ensure that ourloved one is receiving treatment at the VASNHS MedicalVeterans have the best experience at every visit.Center and the Mike O’Callaghan Military MedicalCenter. This house is 13,500 square feet, with 16 privateVoluntary Service also works with communityguest suites, and has provided a healing environmentpartners and private donors to accept donationsfor more than 4,400 families since it was frst built inof money and goods like hygiene products,2016. The facility operates with donations from theblankets, or food.Fisher House Foundation and generous volunteers11who help with day-to-day operations.12
Employee FeatureVeteran FeatureDonia Till, a direct care nurse on thespecial procedures unit at VA SouthernNevada Healthcare System is the direct carenurse winner of the Pathway Nurse of the Year Award.This distinction recognizes the outstanding contributionsof nurses globally from a Pathway organization, as chosen by American NursesCredentialing Center (ANCC).Till is recognized for her exemplary contributions and commitment to shareddecision-making and the organization’s shared governance structure, leadership,and professional development.Till was nominated for being the driving force behind VASNHS’ pursuit of Pathwaydesignation. She put together a cadre of nurses who rounded from unit to unit,informing staf about the Pathway to Excellence framework and its benefts,including why it’s suitable for the organization.Till is an advocate for direct care nurses and, as a certifed nurse, was directlyinvolved in writing the Pathway Standards Document. She was instrumentalin the organization’s “Let’s Get Certifed” campaign by providing educationand leading the shared governance education team and steering committee asco-chair and chair. And with her pursuitof advanced education, Till fosters thefoundation of leadership and providessafe and efective patient outcomes.“As a direct care nurse, ‘Living Pathway’is the ability to make a diference at thelowest level that impacts practice andoutcomes and be the change agent toimprove processes,” said Till. “The VASNHSleadership team was an inspiration in myindividual journey and encouraged me togo above what I thought was obtainable.The journey doesn’t stop; it improves andendures as nurses continue to strive tomake a diference.”13Jay Cambridge has embraced many changes on his life journey. He is a Veteran,a yoga instructor and he is transgender. Each of those transitions have helpedshape him into the person he is today.Cambridge enlisted in the Air Force in 2008 and spentsix years serving as a security forces airman. “When Ijoined the military, I joined as female,” he said. “I wasfemale assigned at birth and so my entire militaryexperience was as a woman.”As someone who describes himself as outgoing andexpressive, Cambridge struggled with having to keeppart of his life a secret. “Serving in the military as afemale, I identifed as a lesbian and served duringthe last few years of Don’t Ask Don’t Tell,” he said.“That was a difcult time for me as I was not allowedto truly be myself.”While serving in the Air Force, Cambridge began to associate himself with amore “masculine energy” and eventually realized that he identifed as transgender.During the six years that Cambridge served in the Air Force, he faced incredibleadversity. “I endured discrimination and military sexual trauma,” he added. “I livedin a lot of fear. It was extremely difcult. I faced depression, anxiety and suicidalideations.”Throughout his transformation, Cambridge still struggled with depression andanxiety, and looked for something to help him heal mentally, physically andspiritually. Cambridge receives most of his care through VASNHS. “When I wasin treatment, they presented yoga to me,” he said. “That was the frst time thatI ever really felt connected to my mind, my body and my spirit. It becamemy frst healthy addiction.”Cambridge believes the lessons he has learned can apply to anyone. “We’re all in atransition. It doesn’t matter if it’s a transition with your gender, your career, or yourlife,” he said. “What can we do to smooth that transition? Be kind to one another.Build a more supportive community. Maybe it’s just saying hello or giving someonea smile because you don’t know what that person may be going through.”That sense of community is one of the reasons that Cambridge feels comfortablegetting his care at VA. “VA has come a really long way in caring for transgenderVeterans,” he said.14
VA Southern NevadaStatisticsFacilities and LocationsVASNHS BY THE NUMBERS IN FISCAL 2021. 70,342 unique patients served in FY2021North Las Vegas VA Medical Center6900 North Pecos RoadNorth Las Vegas, NV 89086702-791-9000 1-888-633-7554Women’s Health Center(VA Medical Center)6900 North Pecos Road, 3rd Floor, Room 3A-333North Las Vegas, NV 89086702-791-9176 7,303 of women Veterans served 930,667 total outpatient visits 58,733 total COVID-19 vaccinations administered in FY2021Mike O’CallaghanMilitary Medical Center4700 North Las Vegas Boulevard,Nellis AFB, NV 89191702-653-3040Northeast Las Vegas VA Clinic4461 East Charleston BoulevardLas Vegas, NV 89104*** Includes Community Resourceand Referral Center (CRRC) Services702-791-9050 CRRC: 702-791-9077Northwest Las Vegas VA Clinic3968 North Rancho DriveLas Vegas, NV 89130702-791-9020Southeast Las Vegas VA Clinic1020 South Boulder HighwayHenderson, NV 89015702-791-9030Southwest Las Vegas VA Clinic7235 South Bufalo DriveLas Vegas, NV 89113702-791-9040West Cheyenne VA Clinic (VRC/PRRC)3525 W. Cheyenne AvenueNorth Las Vegas, NV 89032702-791-9060Vet Center - Las Vegas7455 W. Washington Ave.Suite 240Las Vegas, NV 89128702-791-9170Vet Center - Henderson400 North Stephanie Street, Suite 180Henderson, NV 89014702-791-9100Pahrump VA Clinic220 South Lola LanePahrump, NV 89048775-727-7535MCPO Jesse Dean VA Clinic(Laughlin Professional Plaza)3650 South Point Circle, Bldg. D,2nd Floor, Suite 200Laughlin, NV 89029702-298-1100 2,963 total FTE 791,065,928 total operating budget for FY2021VASNHS vs Las Vegas CommunityOverall Rating of Hospital (Global Measure)Patients who gave their local hospital a rating of 9 or 10 on a scale from 0 (lowest) to 10 (highest).1516
Nevada Healthcare System as the acting associate director, from the Bay Pines (Fla.) VA Healthcare System in late 2021. He holds a Master of Healthcare Administration and a Bachelor of Science in Political Science from The University of Scranton (Penn.). He is an active member of the American College of Healthcare
