AUDIT’S FINDINGS
56,436
Veterans who have been waiting 90 days or more for an initial medical appointment at Veterans Affairs facilities.
145
Average wait time — the longest in the nation — for new VA enrollees to see a primary care physician at the VA hospital in Honolulu or a specialist at the VA hospital in Harlingen, Texas.
104 days
Longest average wait for veterans seeking mental health care, in Durham, N.C.
13%
Proportion of VA schedulers who said they had come under pressure to falsify information to make wait times look shorter.
More than 57,000 U.S. military veterans have been waiting 90 days or more for their first VA medical appointments, and an additional 64,000 appear to have fallen through the cracks, never getting appointments after enrolling, the government reported Monday in an audit of facilities nationwide.
It’s not just a backlog issue, the wide-ranging Veterans Affairs review indicated. Thirteen percent of schedulers in the facility-by-facility report on 731 hospitals and outpatient clinics reported being told by supervisors to falsify appointment schedules to make patient waits appear shorter.
The audit is the first look at the entire VA network since reports two months ago of patients dying while awaiting appointments and of cover-ups at the Phoenix VA center in Arizona. A preliminary review last month found that long patient waits and falsified records were “systemic” throughout the VA medical network, the nation’s largest single health care provider, but facility-by-facility details were not released until Monday.
“This behavior runs counter to our core values,” the full report said. “The overarching environment and culture which allowed this state of practice to take root must be confronted head-on.”
VA Secretary Eric Shinseki resigned amid the uproar May 30, taking the blame for what he decried as a “lack of integrity” through the network. A key finding of the audit was that the 14-day target for waiting times Shinseki established in 2011 was unrealistic and “not obtainable,” given poor planning and a growing demand for VA services as Vietnam-era vets age and younger veterans from the Iraq and Afghanistan wars enter the system.
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 goal and suspending all performance awards for senior executives of the Veterans Health Administration.
Gibson said the VA also will deploy mobile medical units to provide care to some of the vets who have been waiting for care.
Gibson ordered a hiring freeze at the Washington headquarters of the Veterans Health Administration and at 12 of its regional offices, except for critical positions to be approved by him on a case-by-case basis.
“This data shows the extent of the systemic problems we face, problems that demand immediate action,” Gibson said in a statement. “Veterans deserve to have full faith in their VA, and they will keep hearing from us until all our veterans receive the care they’ve earned.”
Gibson said the VA has contacted 50,000 vets nationwide to get them off waiting lists, and plans to contact thousands more.
Legislation is being drafted to allow more veterans denied timely VA appointments to see private doctors listed as providers under Medicare or the military’s TRICARE program. The proposals also would make it easier to fire senior VA regional officials and hospital administrators.
House Speaker John Boehner, who plans a vote on legislation this week in the House, said the report demonstrated that Congress must act immediately.
“The fact that more than 57,000 veterans are still waiting for their first doctor appointment from the VA is a national disgrace,” Boehner said.
The report came as the VA’s Office of Inspector General said it is investigating 56 VA medical facilities nationwide for possible wrongdoing, up from 42 two weeks ago.
A previous inspector general’s investigation into the Phoenix VA Health Care System found that about 1,700 veterans there were “at risk of being lost or forgotten” after being kept off an official, electronic waiting list.
The audit released Monday includes interviews with more than 3,772 employees nationwide between May 12 and June 3. Respondents at 14 sites reported having been sanctioned or punished over scheduling practices.
Wait times for new patients far exceeded the 14-day goal, the audit said — in the worst case, 145 days in Hawaii.
The report said 112 — or 15 percent — of the 731 VA facilities that auditors visited will require additional investigation, because of indications that data on patients’ appointment dates may have been falsified, or that workers may have been instructed to falsify lists, or other problems.
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