- Associated Press - Monday, June 9, 2014

PHOENIX (AP) - One Veterans Affairs Department health care system in Arizona has been flagged for further review following a nationwide audit of the agency’s troubled appointment process, according to a report released Monday.

The internal VA audit of 731 of the agency’s hospitals and clinics around the nation found that a 14-day goal for seeing first-time patients was unattainable given increasing demand. The VA said Monday it was abandoning the scheduling objective as a basis for performance goals.

A preliminary review last month found that long waits and falsified records were “systemic” throughout the VA medical network, the nation’s largest single health care provider serving nearly 9 million veterans.

The report Monday found that new patients in the Prescott area were waiting an average of about 60 days for appointments with primary care doctors. The VA said that hospital system faces further investigation. New patients in the Phoenix area were waiting roughly 55 days for appointments.

Also in Arizona, the audit found that 1,715 new patients in the Phoenix area and 1,115 in Prescott’s Northern Arizona VA Health Care System have not had appointments scheduled within 90 days. In addition, 1,075 veterans who enrolled for VA health care over the past decade in Phoenix and 139 in the Prescott system have never been scheduled for appointments.

VA officials in Prescott said they have reduced wait times from the numbers reported in the audit and will fully cooperate with investigators probing the facility.

“At this point, we do not know the reasons and we do not know who will be doing the review,” spokeswoman Mary Dillinger said in an email Monday evening. “We welcome the opportunity to have these types of reviews as we feel we are doing the right things for our veterans.”

Phoenix VA officials declined comment.

While the probe began with allegations of misconduct and lengthy wait times in the Phoenix VA Health Care System, that facility did not make the VA’s list of the top 10 longest average wait times for primary care or specialist care appointments.

The Phoenix system also did not make the audit’s list of 112 locations nationwide, including Prescott, where the VA found further investigation into potential misconduct was merited.

The audit found that removing the 14-day target “will eliminate incentives to engage in inappropriate scheduling practices or behaviors.”

Vietnam veteran Dan Dominey says delayed care for his broken back at the Phoenix VA meant a quick surgical fix wasn’t possible, leaving him in prolonged pain. He was encouraged Monday that the VA seems to recognizing problems.

“But to tell you the truth, I will withhold judgment until I see some of these people who have done wrong fired,” said the 66-year-old retired Marine from Mesa, Arizona. “This is a big government bureaucracy. I want to see results. People need to held accountable.”

The audit is the first nationwide look at the VA network since reports emerged two months ago of patients dying while awaiting appointments and of cover-ups to falsify records making it appear as if patients were seeing doctors sooner than they actually were in the Phoenix area.

The audit indicates that accessing care is difficult for new patients, but that established patients within the VA generally had little trouble.

The audit released Monday said 13 percent of VA schedulers reported getting instructions to falsify appointment dates to meet performance goals. About 8 percent of schedulers said they used alternatives to an electronic waiting list.

The report found that nationwide more than 57,000 veterans have been waiting 90 days or more for medical appointments, while an additional 64,000 who enrolled for VA health care over the past decade have never been seen by a doctor.

The audit comes not long after a VA Inspector General’s preliminary report found 1,700 veterans in the Phoenix VA system were “at risk of being lost or forgotten.” The Inspector General’s Office is conducting an independent review of the VA health care system.

Last week, acting VA Secretary Sloan Gibson said that 18 veterans in the Phoenix area whose names were kept off an official electronic appointment list have died. That’s in addition to 17 deaths reported last month by the VA’s inspector general. None of the deaths have been determined to have been caused by delays in care, but investigations are ongoing.

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