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Investigators said 13 percent of scheduling staff had been instructed by a supervisor to enter a date other than the veteran’s requested appointment into the “desired date” field, substantiating the claims that employees were cooking the books.

“This behavior runs counter to our core values,” the report said. “The overarching environment and culture which allowed this state of practice to take root must be confronted head-on.”

The VA allows patients to give a desired appointment date, which may have led to some of the problems. The audit said that practice was “difficult to reconcile against more accepted practices such as negotiating a specific appointment date based on provider availability.”

Auditors also questioned the VA’s self-imposed deadline of 14 days to begin providing care. Investigators said the number of doctors or appointment slots may not be sufficient to achieve that goal.

Officials have blamed the 14-day deadline and other performance goals for some of the problems. They said some facilities began to treat the deadline as a goal in itself, not as a tool to ensure better care.

Former VA Secretary Eric K. Shinseki, who resigned late last month as the internal audit was being prepared, said department executives wouldn’t be getting bonuses this year.

A bipartisan group of 21 senators said the matter is more serious than that. Led by Sens. John McCain, Arizona Republican, and Richard Blumenthal, Connecticut Democrat, the senators demanded that the Department of Justice take over a criminal investigation into the situation.

“The spreading and growing scale of apparent criminal wrongdoing is fast outpacing the criminal investigative resources of the IG, and the revelations in the interim report only highlight the urgency of involvement by the Department of Justice,” the senators wrote last week in a letter to Attorney General Eric H. Holder Jr. “There is a need for prompt results from the IG — not by August, as the IG has publicly said, but within the next few weeks.”

• Dave Boyer contributed to this report.