When Van Zandt VA Medical Center spokesman John Harlow first thought of applying for health care services through the VA, he hesitated, not wanting to take for himself assistance that other veterans might need more.

When he first actually inquired about enrollment, in Massachusetts, Harlow was ineligible, because he earned too much at the time.

Eventually, due to Army-connected disabilities, Harlow became eligible, and ultimately learned that VA health care services aren’t zero-sum, but the opposite — the more veterans who enroll, the more funding becomes available to provide more kinds of help for all potential beneficiaries, said Harlow and Van Zandt Director Derek Coughenour, summarizing the hospital’s 2024 annual report Tuesday in a meeting with the Mirror.

The theme was growth: Both enrollment and number of services.

In 2018, when Coughenour started working at Van Zandt under then-new Director Sigrid Andrew, the hospital focused on “lumps and bumps and primary care,” he said.

By the time Andrew retired in mid-2023, Van Zandt had added or expanded 50 services at the main hospital in Altoona and its five outreach clinics, and since then, under Coughenour, it has increased by about 20 more, officials said.

Last year alone, the additions have included radiofrequency ablation, transesophageal echocardiograms, diagnostic laparoscopy, dilation and curettage, Fulkerson allografts and bilateral tubal ligations, according to Coughenour.

Since 2018, staff size has increased by 63%, to the current 1,374.

Also since 2018, the number of patients served by Van Zandt has swollen 27% to 28,000.

Last year, the hospital and its clinics handled 485,000 outpatient visits — up 26% from the prior year — along with 34,000 telehealth visits.

Harlow’s department has labored for the increases: holding three major enrollment events and numerous minor ones in fiscal 2024 — including visits to VFW and American Legion posts in the organization’s 14-county territory.

The VA encourages all veterans to ask about eligibility.

That is complicated, although it’s generally based on factors that can include having 24 months of active duty without a dishonorable discharge, a level of disability, financial need, medals earned and presumed exposure to harmful substances, based on where the veteran served, according to Ashley Keller, Coughenour’s executive assistant.

Most of the staff wishes that all veterans were eligible, they all said.

The total Van Zandt operating budget for last year, including payments made for care in the community for services not available at Van Zandt, was $401 million.

All the expansions have been in response to patient demand, according to Coughenour.

That was expressed repeatedly in town halls held at the hospital, where many veterans recalled services offered previously, but no more.

The reluctance

Like Harlow, Coughenour’s father was reluctant at first to apply, despite the encouragement of his son, who is not a veteran.

When his father finally did apply and was enrolled, “he was floored” by the attentiveness with which he was treated, Coughenour said.

His father is a veteran of the Vietnam War, and the treatment he received contrasted with the reception he got when he came back from Southeast Asia, Coughenour said.

Van Zandt’s patient satisfaction is 97.5%, based on surveys all patients get after encounters with the system, Harlow said.

It’s hard to get 97% of people to agree “that the sun is yellow,” Harlow said.

The care is such that he wishes he could receive it himself, said Coughenour, the ineligible civilian.

“That is the best compliment I can give our team,” he said.

The success in keeping patients happy reflects the feeling among staffers that their work in the VA constitutes a mission, according to the officials.

As a civilian, Coughenour feels his part is payback for what his father did in the service.

As a veteran patient, the services he receives at the hospital is payback for having pledged his life in a “blank contract” to the nation at enlistment, said Harlow, one of the 217 veterans on the hospital payroll.

The staff at Van Zandt fulfilled that contract with Harlow by “digging deep” to detect cancer that is now under control and to find a non-cancerous tumor on his spine that was removed under the community care provisions of the VA, Harlow said.

Doctors in other states had misdiagnosed the tumor for years, according to Harlow.

The operation on his spine has made “all the difference” in his quality of life, he said.

Moreover, the staff has never made him feel like “a burden,” he added.

At Van Zandt, Coughenour urges all employees to take care of one other, so they can better fulfill their mission to help veterans, the director said.

That may “subliminally” reflect the military ethic under which service members are expected to rely on one another to fulfill their missions, he said.

The growth mode continues: Management is looking at the possibility of hiring a surgeon who could do hip and knee replacements during the current year, according to Coughenour.

“There’s no better mission,” the director said.

Mirror Staff Writer William Kibler is at 814-949-7038.