Almost three years after long waits for medical appointments for veterans exploded into a nationwide scandal, the Phoenix VA hospital at the center of the crisis still is not providing timely care, a watchdog group documented Monday.

Special Counsel Carolyn Lerner, whose office represents whistleblowers and investigates their claims, wrote in a letter to President Obama that two independent reviews have confirmed many allegations brought by a doctor at the Phoenix facility.

One review, by the inspector general for the Department of Veterans Affairs, said a veteran with heart trouble died last year while waiting for cardiology tests that could have saved him. Investigators also found that on a given day, 1,100 veterans in Phoenix have a longer-than-30-day wait to see a doctor. And during the period reviewed by investigators, 215 veterans died while waiting to see a specialist.

“In case after case since 2014, Phoenix VA whistleblowers have exposed and helped to correct serious problems with veterans’ care,” Lerner said in a statement. She thanked the whistleblower, Kuauhtemoc Rodriguez, chief of specialty care clinics in Phoenix, for his “courage” in coming forward.

The findings are likely to present challenges for President-elect Donald Trump’s incoming administration, which has made improving care for veterans a priority. Continuing delays in care could bolster the case of agency critics, who say the government alone cannot meet the medical needs of all veterans, who should be able to turn to private doctors when they want.

Trump has not yet named a secretary to replace Robert McDonald, a former Procter & Gamble chief executive brought in by President Obama in 2014 after the wait-times scandal forced out retired Army general Eric Shinseki.

“Although [Veterans Health Administration] has made efforts to improve the care provided at [the Phoenix hospital], these issues remain,” Larry Reinkemeyer, assistant inspector general for audits and evaluations, wrote in its review of Rodriguez’s claims. While some of the claims were not substantiated, investigators for the inspector general and VA’s Office of Medical Inspector corroborated others.

A VA spokesperson did not respond to requests for comment.

Among the problems investigators found:

  • A veteran who died of cardiovascular disease did not receive a cardiology exam his VA physician ordered. The agency determined that had he received the exam when he should have, further testing and interventions could have prevented his death.
  • During a week in October 2015, nearly 3,900 medical appointments in Phoenix were canceled. Of those, 59 should have been rescheduled and were not. Of those 59 patients, 12 may have experienced harm that could have been prevented without the delay in care.
  • On an average day, the Phoenix VA has 1,100 patients waiting longer than 30 days for appointments.
  • Patients needing to see a psychotherapist wait an average of 75 days.
  • Out of a sample of 215 veterans with 295 consults who died while waiting for care, 62 of their consults (21 percent) were delayed. The delayed consults did not contribute to their deaths, the inspector general’s office concluded.
  • In one case, a veteran “waited in excess of 300 days for vascular care” following a consult request from another doctor.
  • Out of a sample of 30 inappropriately canceled chiropractic consults, 28 veterans did not receive the appointment they requested.

McDonald has said that on his watch, the agency has added thousands of appointments throughout the system, and that continuing problems like those in reported in Phoenix are isolated.

When the scandal broke in 2014, senior managers there and at other VA facilities were found to have instructed their staffs to deliberately cover up long waits for appointments. The reviews released Monday did not find intentional mistakes, but rather, bureaucratic confusion: “Staff were generally unclear about specific consult management procedures, and services varied in their procedures and consult management responsibilities,” the inspector general’s office wrote.

The reviews released Monday did not directly address Rodriguez, who said in an email that VA is now retaliating against him and threatening to fire him by falsely accusing him of discrimination in hiring. He said he has not been the deciding official in any hiring decisions.

“This is straight out of the VA playbook on how to deal with whistleblowers,” Rodriguez wrote. “This is a gross injustice and a gross violation of my civil rights.”

Sen. Charles E. Grassley, (R-Iowa) chairman of the Senate Judiciary Committee, praised Rodriguez.

“Sometimes whistleblowers expose matters of life and death, other times they expose harm against the taxpayers, and sometimes they expose all of the above,” he wrote in a release. “Kuauhtemoc Rodriguez of the Phoenix VA deserves praise and gratitude for coming forward about problems that cover all of the above.”