Changes may be coming to the Minneapolis Veterans Medical Center, one of five centers in the country that provide intensive rehabilitation to veterans and service members with severe injuries (including brain injuries).

Military operations in Iraq and Afghanistan have resulted in previously unseen patterns of injury. The use of improvised explosive devices (IEDs) and the sophistication of battlefield medicine that improved the survival rate have left many service members with multiple traumatic injuries, often to the head and brain.

In 2005, the VA was directed to develop a plan for dealing with these acute and multiple complexities. The polytrauma centers were created, including the center in Minneapolis.

But with the wars ending, fewer new cases are presenting themselves. A recent VA inspector general report suggests the time may have come to reassess whether all the resources are still needed.

VA inspectors found that the number of Iraq and Afghanistan veterans screened for traumatic brain injury dropped from a high nationwide of 11,110 in 2011 to 7,100 in 2012. The Minneapolis polytrauma center had 23 unique patients in 2012, and they stayed for an average of 43.26 days.

Minneapolis met or exceeded the required minimum staffing levels for rehabilitation physicians, nurses and outpatient social workers but fell below minimum staffing levels for inpatient social workers, the report showed. Inspectors said the workload among the five sites (San Antonio; Tampa; Palo Alto, Calif.; Richmond, Va.; and Minneapolis) appeared uneven.

"The resources expected to be dedicated to polytrauma inpatient care at Level 1 sites is extensive, and it may not be necessary to have five Level 1 sites to serve the decreasing population," the report concludes.

A spokesman for the Minneapolis VA referred all comment about the future of the center to the VA's response to the report. It said it plans to modify staffing and programming as appropriate.

Mark Brunswick • 612-673-4434