Workers at the Veterans Affairs hospital in Aurora, Colo., in April. (David Zalubowski/AP)

The Army Corps of Engineers, brought in to rescue four floundering and vastly over-budget Veterans Affairs hospital projects, says that the VA needs more a “transformative change” of its construction process, and that the sites have been riddled with multiple design changes, conflicting lines of authority, slapdash planning and undisciplined VA leadership.

VA officials asked for the report, and the Army Corps of Engineers studied hospitals in Colorado, Florida, Louisiana and Nevada, all massively over budget and behind schedule and suffering from what the report called “mismanaged contracts” and “poor budget controls.”

The report states that the VA needs to make fundamental changes in the way it handles construction or it will suffer similar overruns and delays on future projects.

VA Deputy Secretary Sloan Gibson, who on Thursday visited the Denver construction site for the 10th time,  wrote on his blog that the “VA agrees with this assessment and has issued new policy that identifies roles and responsibilities for the development of needs, requirements and control of design and construction.”

The half-finished Colorado medical center, under construction outside Denver, is said to be one of the most expensive hospitals in the world and in VA’s history. It’s now estimated to cost up to $1.73 billion, more than three times initial budget estimates.

Congress has been pushing VA officials to put the Corp of Engineers in charge of all future projects and to fire those responsible for the Denver problems.

The report says that in Denver, the VA repeatedly changed the design and square footage of a new medical center and used a confusing contracting process that many employees didn’t understand, and adopted it too late, leading to infighting and a dizzying array of differing cost estimates, the report said.

VA asked Congress for an additional $625 million to finish a scaled-back version, on top of the $1 billion authorized to date.

Here are some highlights from the report:

The VA’s new medical center in New Orleans is being built to replace one damaged in 2005 by Hurricane Katrina. But cost estimates rose from $625 million in 2009 to $995 million today due to planning and environmental woes.

The Corps of Engineers report states that that the VA designed the hospital to meet hopes and dreams but never fit into the planning a budget.

The price tag for a new medical center in Orlando, Fla. — which has more than doubled from $254 million to around $600 million — was in part because the electrical design was flawed, the Corps said.