Audit says vets had long care waits

Initial visits exceeded 90 days

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WASHINGTON — The first comprehensive review of the medical care system for veterans found widespread scheduling abuses, data falsification and long waiting times at dozens of hospitals and clinics across the country.

In its audit of 731 medical facilities, the Department of Veterans Affairs reported Monday that 57,436 veterans have been waiting more than 90 days for an initial medical appointment. Thirteen percent of schedulers told VA auditors that supervisors or other co-workers had instructed them to enter a different date in the appointment system than the one requested by a veteran.

“This audit is absolutely infuriating and underscores the depth of the scandal,” Paul Rieckhoff, founder of Iraq and Afghanistan Veterans of America, a New York City-based advocacy group, said in a statement. “Our vets demand action and answers.”

The medical facility with the longest average wait time for a new patient to see a primary-care physician was the VA medical center in Honolulu, at 145 days, while the VA hospital in Harlingen, Texas, topped the list for waits to see specialists, also at 145 days on average. The VA hospital in Durham, N.C., had the longest average wait for veterans seeking mental health care, at 104 days.

For an initial primary-care appointment in the VA Pittsburgh Healthcare System, 443 veterans waited more than 60 days, the nationwide audit showed. The audit comes less than two weeks after Western Pennsylvania’s Reps. Tim Murphy, R-Upper St. Clair, and Mike Doyle, D-Forest Hills, learned that 636 veterans were on a waiting list for primary-care appointments at the Pittsburgh VA — some since 2012. Since then, the Pittsburgh VA has pushed to contact those on the list and schedule appointments and has reduced the wait list to 240, Pittsburgh VA spokesman Mark Ray said.

The troubled Pittsburgh VA Healthcare System is already under review by an inspector general, Mr. Doyle said, and he and other lawmakers await that report to learn what needs to happen next. Mr. Murphy, who said he is still waiting for a report he requested from the VA in November 2013 on the Legionella outbreak, said the hospital system needs an independent audit to determine whether problems are systemic.

Mr. Murphy recommends that once the short-term backlog is resolved, local VA hospitals should be paired with “hospitals of excellence” in the region. For example, the Oakland VA Hospital could work with UPMC Presbyterian to increase their efficiency. “I think this is where you can look at other hospitals that run on a system that is based on customer satisfaction more than employee satisfaction,” he said.

Pittsburgh was not the only VA hospital system in Pennsylvania on the audit list requiring further review. Philadelphia VA Medical Center, which had 1,141 new enrollees awaiting an appointment for more than 60 days, is on the list, as well as hospitals in Altoona, Erie, Lebanon and Horsham/​Willow Grove.

Eight percent of schedulers said pressure had been placed on them to bypass the VA’s official Electronic Wait List system and maintain unofficial lists in order to make waiting times appear shorter than they actually were, according to VA interviews with 3,772 clinical and administrative staff.

Retired Army Gen. Eric Shinseki resigned May 31 as head of the Department of Veterans Affairs after acknowledging that inordinate wait times and scheduling data falsification were more widespread than he’d believed. Before his exit, Mr. Shinseki in mid-April directed the Veterans Health Administration to conduct the agencywide audit.

A key finding of the audit was that the 14-day target for waiting times that Mr. Shinseki established in 2011 was unrealistic and “not obtainable.” That problem was exacerbated by tying hospital managers’ bonuses to meeting the 14-day target. Setting such an unrealistic waiting-time target and linking it to performance bonuses created “an organizational leadership failure,” the audit found.

Sloan Gibson, named by President Barack Obama as acting VA secretary, said Monday that the agency is eliminating the 14-day scheduling goal and suspending all performance awards for senior executives of the Veterans Health Administration. Mr. Gibson said the VA also will deploy mobile medical units to provide care to some of the vets who have been waiting a long time for care.

Mr. Gibson said the VA has contacted 50,000 vets nationwide to get them off waiting lists.

The scandal erupted at the VA hospital in Phoenix, where Mr. Gibson acknowledged during a visit last week that 18 veterans had died while waiting for medical appointments.

A probe by the agency’s inspector general found that vets waited an average of 115 days for their first medical appointment at the Phoenix hospital, 91 days longer than the center reported in its logs. The new audit flagged 112 VA medical centers and clinics for further review.

White House spokesman Josh Earnest said Mr. Obama had tasked his deputy chief of staff, Rob Nabors, to work at the Veterans Affairs Department to assess the scope of the problem and propose more reforms. Mr. Earnest said Mr. Obama is focused on appointing a replacement for Mr. Shinseki soon.

“Clearly, having some new leadership in the VA is a top priority,” Mr. Earnest told reporters.

House Speaker John Boehner, R-Ohio, branded the audit results “a national disgrace.” He said the House is considering legislation to allow any vet who waits longer than 30 days for medical care to see private doctors with subsequent treatment covered by the government.

Iraq and Afghanistan Veterans of America, whose members include 177,000 vets who fought in one or both post-9/​11 wars, wants a criminal investigation of falsified VA wait-time data. The group is also pushing the Democratic-controlled Senate to pass the Veterans Affairs Management Accountability Act, which the GOP-ruled House approved May 21 by a wide bipartisan margin. The bill would give the new VA chief more power to swiftly remove hospital managers who falsify data and take other steps to sidestep civil service rules.

Senate Majority Leader Harry Reid, D-Nev., said Monday that Sens. Bernie Sanders, a Vermont independent, and John McCain, R-Ariz., had reached accord on bipartisan legislation to reduce VA hospital wait times and increase management accountability. That measure also would allow veterans facing long health care delays to seek care outside the VA.

United States government - Barack Obama - John Boehner - John McCain - Harry Reid - Josh Earnest - Bernie Sanders - Eric Shinseki - U.S. Department of Veterans Affairs

Post-Gazette staff writer Brett Sholtis contributed.


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