BRISTOL — A study commission is recommending that the “antiquated and dilapidated” Rhode Island Veterans Home facility be rebuilt and that it establish new policies to guide its patient care.

In a final report released Monday, the five-member Special House Commission to Study Potential Administrative and Functional Improvements reports that it discovered “hostile and antagonistic” treatment of families by veterans home officials; “inconsistent and dysfunctional” policies and procedures; cronyism; and inappropriate use of restricted funds.

“I think over time we need to build a new veterans center on the site that is more modern and equally comfortable, and it needs to start to address a slightly younger and female population,” said H. Reed Cosper, the state’s mental health advocate, who heads the commission.

While the commission commends the hiring of a new veterans home administrator — Rick Baccus, the former head of the U.S. detention camp at Guantanamo Bay, Cuba — it criticizes officials for “clumsily” disseminating news of his appointment and raps the home’s administration.

Cosper said the veterans home needs “really, really skilled” leadership and must stop its “culture of people acting like people.”

“There’s too much authoritarian rule, too much favoritism, too much inside dealing,” Cosper said.

In its report, the commission outlines a number of recommendations, including a call for the creation of a new cabinet-level office, headed by an official with a military background, to handle veterans affairs. Oversight is now concentrated within the state Department of Human Services.

The commission suggests that a compliance hot line be established to receive complaints, and that the home establish better policies on releasing patient information.

The commission is also urging that the veterans home remain a public facility.

“The RI Veterans Home serves as the ‘facility of last resort’ for many members of Rhode Island’s population of veterans,” the report says. “It should not be ‘privatized.’ Such a development will simply leave veterans with no ‘last resort’ option.”

The final report follows the commission’s interim study from July 2007, which found low staff morale and antagonism toward some residents or family members who complain about their care. Critics called that report unreliable and anecdotal.

The commission encountered some roadblocks in its latest review. The veterans home administration and the state Department of Human Services has criticized the commission’s work as “one-sided” and denied it access to some records, the latest report claims.

All but two veterans home physicians refused to speak with the commission. The state Department of Human Services named a team to conduct its own investigation in August 2007, but the House commission claims the department refused to discuss the team or its internal investigation.

“It appears that the ‘group think’ consensus on our work is that we went ‘off the reservation’ or got involved in ‘personalities,’ or are just plain wrong,” the report says. “The truth is when the Commission asked questions, the answers often invoked ‘personalities’… It is a fact that in the world of a disabled, elderly resident of a facility, ‘personality’ matters a lot. What might look like very high quality of care on the surface diminishes greatly when it is delivered by an administration that is self-absorbed, nepotistic, authoritarian and selfish, and by a staff that is unhappy and intimidated.”

The special commission held 13 open meetings in the last year. The commission is scheduled to review its findings before the House Veterans Affairs Committee on Wednesday at 5 p.m. in Room 35 at the State House.

The final report emphasizes that the veterans home is still a good nursing facility despite any deficiencies.

“While the Veterans Home needs administrative improvement, we believe that it continues to provide high quality care,” the report says.

The veterans home opened in 1891 and was rebuilt in 1955. Any Rhode Island veteran who has served during a time of war and was honorably discharged can apply to stay there. Residents pay a monthly fee that’s equal to 80 percent of their income.

mwims@projo.com