A commission that reviewed a Bush administration proposal to overhaul Veterans Affairs (search) health care facilities wants the government to close hospitals in Pennsylvania, Ohio and Mississippi and scale back most operations at a Texas facility.

The panel rejected the VA's proposal to close hospitals in Canandaigua, N.Y., Lexington, Ky. and Livermore, Calif., according to a copy of the commission's report obtained by The Associated Press.

The 16-member panel agreed that a new hospital should be opened in Orlando, Fla., but disagreed with opening a new hospital in Las Vegas. Instead, the commission recommended the VA continue partnering with Nellis Air Force Base (search) for care.

The commission accepted or rejected a number of other proposals affecting dozens of VA facilities across the country. In some cases, the VA had not provided enough data to support changes in the mission of the facilities, the commission said.

The VA also proposed converting some facilities to Critical Access Hospitals (search), but the commission said the agency did not clearly define what that is and so rejected those proposals.

It recommended closing hospitals in Pittsburgh, Cleveland and Gulfport, Miss., and transferring large portions of care away from the Waco, Texas, hospital.

The commission found that money the VA was spending to maintain unused or underused buildings and excess land could be used to provide direct medical care to veterans.

"The commission believes that change is necessary to prepare the system for a new veteran demographic reality and a rapidly evolving approach to health care delivery," the panel members said in their report.

Veterans have shifted from northern cities such as Chicago, Detroit, Boston and New York to Sun Belt states like Florida, Texas and Arizona.

The recommendations are not final. VA Secretary Anthony Principi, who received the report Thursday afternoon, now gets to review the report and decide whether to approve, reject or change some of the recommendations.

The VA said Principi would not comment on the report until it is final.

The VA launched the massive restructuring after government auditors in 1999 predicted that the VA would spend billions of dollars to operate unneeded buildings and that as much as one in every four VA health care dollars would be devoted to maintenance and operation of facilities.