No Surprise: VA Probe Confirms Scheduling Manipulations

  Words by Bridget Foster.

The VA’s Office of Inspector General released a preliminary report on Wednesday that confirmed allegations that VA hospitals and clinics were delaying medical care to veterans and manipulating scheduling records to hide those delays. The report called the manipulations “systemic throughout” the VA healthcare system and investigators say the problems uncovered during the probe are not new.

Thomas Lynch, an assistant deputy undersecretary, testified before a congressional committee on Wednesday night, stating that investigators from the VA Office of Inspector General had, for years, reported scheduling manipulations, but that VA officials discounted those reports as the exception rather than the rule. “We could and should have challenged those assumptions,” Lynch testified.

Prompted by allegations that 40 veterans in the Phoenix VA Healthcare System died while waiting for appointments and that schedulers had created “secret” waiting lists, the investigators reported that “multiple lists” had been created at that facility but they could not yet determine whether any patients actually had died as a result of the delayed care.  An investigation will continue to look at death certificates and medical records at the facility to see if patients died or were otherwise harmed as a result of waiting for care. Investigators have expanded their probe to 42 other VA medical facilities in connection with delays in providing health care.

The report stated that in 2013, [Phoenix VA] hospital administrators “significantly understated the time new patients waited for their primary care appointments.” Administrators had reported an average wait time of 24 days; in a random sample of 226 appointments, the investigators found the average wait time to be 115 days, with 84% of veterans in the system waiting more than the VA-set goal of 14 days.  The hospital director, Sharon Helman, had received a bonus of over $9000 in 2013 based partially on the reported wait time. She was placed on administrative leave by VA Secretary Eric Shinseki earlier this month as the allegations against the Phoenix hospital surfaced.

During his congressional testimony, Lynch, the assistant deputy undersecretary, was asked if bonuses were the motivation for administrators to manipulate wait time records, to which he replied “I think that is possible.” He went on to indicate that the focus of the VA has been misguided, paying more attention to meeting performance standards rather than treating patients.

The probe of the Phoenix hospital also found that even though they need to see doctors, 1700 patients at the facility are not on any official list awaiting appointments.  “These veterans were and continue to be at risk of being forgotten or lost in the [Phoenix hospital’s] convoluted scheduling process,” the report stated.

In the ongoing and expanded investigation, the IG’s office described some of the schemes used to hide delayed wait times, including deleting the appointments of veterans who had been sent to see a specialist if those appointments were pending for too long.

Naturally, the release of the report has increased lawmakers’ demands for VA Secretary Eric Shinseki to step down. But House Speaker John Boehner described that action as “the easy way out.”

I agree; getting rid of Shinseki would not address the crux of the problem: an antiquated system overwhelmed by the surge in patients eligible for care with a greater range of injuries and illnesses requiring treatment, while at the same time continually being underfunded by the same people currently calling for heads to roll. As the report stated, the findings are not new; going back to 2005, the VA Office of Inspector General has issued 18 reports to Congress and the VA Secretary detailing problems with long wait times for appointments and the negative impact those wait times were having on patient care. What did they do? Shinseki has been the secretary for what, five years?  Yes, changes are needed and changes are needed NOW but once he’s gone, what will be different?