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Inspector general’s report confirms allegations at Phoenix VA hospital

An independent report from the Department of Veterans Affairs inspector general’s office substantiates recent allegations that VA health clinics used inappropriate scheduling practices that concealed treatment delays — lasting an average of 115 days in a sampling of patients — and boosted performance measures that help determine whether bonuses are deserved.

The report said 1,700 veterans using a Phoenix VA hospital were kept on unofficial wait lists, adding that “these veterans were and continue to be at risk of being forgotten or lost in Phoenix HCS’s convoluted scheduling process.”

Auditors determined that the hospital’s leadership “significantly understated the time new patients waited for their primary care appointment in their FY 2013 performance appraisal accomplishments, which is one of the factors considered for awards and salary increases.”

Official VA data showed that 226 patients in a sampling from the Phoenix clinic had waited just 24 days on average for their first primary care appointments. But the inspector general’s office determined that those veterans had actually waited an average of 115 days.

The unofficial wait lists may represent the “secret” list that whistleblowers claim the Phoenix clinic used to cover up treatment delays, according to the report.

The inspector general’s office said that “significant delays in access to care negatively impacted the quality of care” at the Phoenix clinic.

The report focused largely on the Phoenix clinic, where recent allegations of records manipulation prompted official investigations and calls for VA Secretary Eric Shinseki to resign. But it said that the inappropriate scheduling practices are “systemic throughout [the Veterans Health Administration.]”

House Veterans Affairs Committee Chairman Jeff Miller (R-Fla.) on Wednesday called for Shinseki to resign immediately, issuing the request less than two hours after the IG released the report. He previously refrained from demanding the secretary’s removal.

Miller also called on Attorney General Eric Holder to launch a criminal investigation of “widespread scheduling corruption.”

Shinseki said in a statement: “I have reviewed the interim report, and the findings are reprehensible to me, to this department, and to veterans. I am directing that the Phoenix VA Health Care System immediately triage each of the 1,700 Veterans identified by the [inspector general] to bring them timely care.”

The secretary also noted that he launched a new initiative to expand capacity at VA clinics where possible and allow more veterans to obtain health care at private health centers if they incur substantial treatment delays.

Veterans groups expressed outrage over the findings on Wednesday.

“The VA’s problems are broad and deep — and President Obama and his team haven’t demonstrated they can fix it,” said Iraq and Afghanistan Veterans of America chief executive Paul Rieckhoff. He added: “Today’s report makes it painfully clear that the VA does not always have our veterans’ backs.”

The American Legion stands alone among veterans organizations calling on Shinseki to resign over the scheduling issues, as well as other problems at the VA, including a longstanding backlog of disability claims. The  department has reduced the inventory by more than 44 percent since it reached a high of more than 600,000 cases last year.

The Veterans of Foreign Wars has opposed the Legion’s calls for Shinseki’s removal, saying the secretary needs to take strong action in response to the allegations and that Congress needs to exercise better oversight of the VA.

The findings released Wednesday are part of an interim report outlining substantiated allegations and recommendations for immediate action by the VA. The inspector general’s office is continuing a comprehensive review of scheduling practices at VA health clinics nationwide.

The inspector general’s office is deploying “rapid response teams” that make unannounced visits to VA medical facilities to address existing and new allegations of inappropriate scheduling practices, according to the report.

Despite the recent uproar over VA records manipulation, the department has known about the problems for years. In 2010, a top VA official issued a memo to the agency’s medical centers listing 17 schemes some of them were known to be using and warning that the practices would “not be tolerated.”

Since 2005, the inspector general’s office has issued 18 reports on scheduling issues that resulted in lengthy wait times and negative impacts on patient care, according to the report.

The House Veterans Affairs Committee has scheduled a hearing for Wednesday evening to hear testimony from three VA officials about the destruction of scheduling documents from the Phoenix clinic.

On Tuesday, Sen. Pat Toomey (R-Pa.) said he plans to introduce legislation that would allow VA patients to sue employees who falsify or destroy health records, in addition to giving the department authority to fire employees who engage in such activities.

In response to the recent allegations, Shinseki placed three of the VA’s Phoenix executives on administrative leave, in addition to requesting the inspector general’s investigation and ordering face-to-face audits of scheduling practices throughout the VA health system.

Shinseki indicated Wednesday that he would not make a decision about possible personnel actions until the inspector general’s office has finished its review. “It is important to allow OIG’s independent and objective review to proceed until completion,” he said.

President Obama has dispatched top White House aide Rob Nabors to assist VA investigators with their examination of the allegations in Phoenix and at other clinics.

The inspector general’s office recommended that the VA take steps to ensure appropriate care for the 1,700 veterans who were not on the official wait list, in addition to identifying all patients at the greatest risk because of treatment delays and ensuring that all patients appear on the official wait list when appropriate.

Shinseki said the VA will “aggressively and fully implement” the recommendations.

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