Wednesday, August 27, 2014
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IG: Phoenix VA hospital missed care for 1,700 vets

By
From page A12 | May 29, 2014 |

WASHINGTON — About 1,700 veterans in need of care were “at risk of being lost or forgotten” after being kept off the official waiting list at the troubled Phoenix veterans hospital, the Veterans Affairs watchdog said Wednesday in a scathing report that increases pressure on Secretary Eric Shinseki to resign.

The investigation, initially focused on the Phoenix hospital, found systemic problems in the VA’s sprawling nationwide system, which provides medical care to about 6.5 million veterans each year. The interim report confirmed allegations of excessive waiting time for care in Phoenix, with an average 115-day wait for a first appointment for those on the waiting list.

“While our work is not complete, we have substantiated that significant delays in access to care negatively impacted the quality of care at this medical facility,” Richard J. Griffin, the department’s acting inspector general, wrote in the 35-page report. It found that “inappropriate scheduling practices are systemic throughout” the VA’s 1,700 health facilities nationwide, including 150 hospitals and 820 clinics.

Griffin said 42 centers are under investigation, up from 26.

Three Senate Democrats facing tough election campaigns — Colorado’s Mark Udall, Montana’s John Walsh and Kay Hagan of North Carolina — called for Shinseki to leave. “We need new leadership who will demand accountability to fix these problems,” Udall said in a statement.

Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee; Rep. Howard “Buck” McKeon, R-Calif., chairman of the House Armed Services Committee, and Arizona’s two Republican senators, John McCain and Jeff Flake, also called for Shinseki to step down. Miller and McCain also said Attorney General Eric Holder should launch a criminal investigation into the VA.

Miller said the report confirmed that “wait time schemes and data manipulation are systemic throughout VA and are putting veterans at risk in Phoenix and across the country.”

Shinseki called the IG’s findings “reprehensible to me, to this department and to veterans.” He said he was directing the Phoenix VA to immediately address each of the 1,700 veterans waiting for appointments.

Reports that VA employees have been “cooking the books” have exploded since allegations arose that as many as 40 patients may have died at the Phoenix VA hospital while awaiting care. Griffin said he’s found no evidence so far that any of those deaths were caused by delays.

VA guidelines say veterans should be seen within 14 days of their desired date for a primary care appointment. Lawmakers have called that target unrealistic and said basing employee bonuses and pay raises on it is outrageous. The 14-day waiting period encourages employees to “game” the appointment system in order to collect bonuses based on on-time performance, the IG report said.

The inspector general described a process in which schedulers ignored the date that a provider or veteran wanted for an appointment. Instead, the scheduler selected the next available appointment and used that as the purported desired date.

“This results in a false 0-day wait time,” the report said.

The IG’s report said problems identified by investigators were not new. The IG’s office has issued 18 reports to George W. Bush and Obama administrations as well as Congress since 2005.

Griffin said investigators’ next steps include determining whether names of veterans awaiting care were purposely omitted from electronic waiting lists and at whose direction and whether any deaths were related to delays in care.

He said investigators at some of the 42 facilities “have identified instances of manipulation of VA data that distort the legitimacy of reported waiting times.” The IG said investigators are making surprise visits, a step that could reduce “the risk of destruction of evidence, manipulation of data, and coaching staff on how to respond to our interview questions.”

Justice Department officials have already been brought into cases where there is evidence of a criminal or civil violation, Griffin said.

Dr. Samuel Foote, a former clinic director for the VA in Phoenix who was the first to bring the allegations to light, said the findings were no surprise.

“I knew about all of this all along,” Foote told The Associated Press in an interview. “The only thing I can say is you can’t celebrate the fact that vets were being denied care.”

Foote took issue with the finding by the inspector general that patients had, on average, waited 115 days for their first medical appointment.

“I don’t think that number is correct. It was much longer,” he said. “It seemed to us to be about six months.”

Still, Foote said it is good that the VA finally appears to be addressing some long-standing problems.

“Everybody has been gaming the system for a long time,” he said. “Phoenix just took it to another level. … The magnitude of the problem nationwide is just so huge, so it’s hard for most people to get a grasp on it.”

The report Wednesday said 84 percent of a statistical sample of 226 veterans at the Phoenix hospital waited more than 14 days to get a primary care appointment. A fourth of the 226 received some level of care during the interim, such as in the emergency room or at a walk-in clinic, the report said.

In a related matter, Griffin said investigators have received numerous allegations of mismanagement, inappropriate hiring decisions, sexual harassment and bullying behavior by mid- and senior-level managers at the Phoenix hospital. Investigators were assessing the validity of the complaints and their effect, if any, on patients’ access to care, he said.

The House passed three bills related to veterans’ care late Wednesday, including one that extends counseling for National Guard and Reserve members who were sexually assaulted during training or other inactive duty. Those veterans currently receive care for assaults that occur during active duty. Another bill is intended to improve research of Gulf War Illness.

The bills now go to the Senate.

The Associated Press

The Associated Press

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Discussion | 9 comments

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  • MadelineMay 29, 2014 - 8:50 am

    This is a new low in how we treat our wounded soldiers. First they're sent out then when they come back broken, they're made to wait 115 days to 6 months for a first appointment! Illegal immegrants get better treatment! I'm furious over this article. It's disgraceful, shameful and points to an oversight in the government that is letting our men die here on our own home turf. This makes me want to scream! A LOVE FILLED SHOUT OUT TO ALL YOU VETS YOU DESERVE SO MUCH BETTER!

    Reply | Report abusive comment
  • Rick WoodMay 29, 2014 - 10:14 am

    Right! Now are you willing to pay for it? I am. And please don't say there is enough waste in government spending that we could do the right thing by our veterans without raising taxes or cutting something we--or at least somebody--thinks is important.

    Reply | Report abusive comment
  • Dave ShreeveMay 29, 2014 - 9:38 am

    And the reason this was not on the front page was what......? Super Soaker ride in Vallejo was more important than this?

    Reply | Report abusive comment
  • Rick WoodMay 29, 2014 - 10:21 am

    DS: You'd have to ask the DR about that, which is I guess what you're doing. But this is what transparency looks like. Full and public disclosure of bad news. We can't make people pay attention or be responsible with the information; sometimes transparency elicits a yawn, especially if there is a lot of it. The message here is we're not spending enough to fix the problems in the VA or there is mismanagement or corrupt management, systemic/organizational/cultural problems that even good management would have a tough time cracking, or some combination of all the above.

    Reply | Report abusive comment
  • Mr. SmithMay 29, 2014 - 10:40 am

    Take a good look at it folks. This is most likely what our nation's healthcare system will look like in a very short time thanks to Obamacare.

    Reply | Report abusive comment
  • rlw895May 29, 2014 - 12:50 pm

    Not exactly. VA is a single-payer system that's messed up because the people being served are a minority without enough political power to get it fixed. That may change now. And don't compare the VA to ObamaCare or it with NEVER get fixed. We need to shame the Republicans to getting off their do-nothing duffs.

    Reply | Report abusive comment
  • JagMay 29, 2014 - 5:18 pm

    It`s more like your do nothing president sitting on his ash

    Reply | Report abusive comment
  • rlw895May 30, 2014 - 10:54 pm

    Jag: That's what I mean. It's attitudes like that that give the Republicans a pass to do nothing. "It's the president's fault, and he can fix it by himself." Falsification of records and gaming the numbers to hide poor service and get a bonus go from unacceptable to outrageous. We are finding those practices to be a systemic problem that has existed over administrations of both parties. The investigations the president has ordered is what he should be doing. What else do you suggest? How does he get Republicans off their anti-Obama train long enough to do something?

    Reply | Report abusive comment
  • General Fadi BasemMay 29, 2014 - 2:47 pm

    Our military vets are the people who should get the first call on health care funds. The illegal immigrants can wait. Maybe their country of origin can pay for their health care needs.

    Reply | Report abusive comment
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