Staff at the Phoenix VA hospital doctored their records, keeping hundreds of veterans off the official waiting lists and ensuring some would never get to see a doctor for treatment, according to a preliminary audit released Wednesday that confirms some of the worst accusations in the burgeoning scandal.
The report from the Department of Veterans Affairs inspector general was even worse than many lawmakers expected, and it spurred another round of calls for VA Secretary Eric K. Shinseki to resign.
Joining those calls were three Senate Democrats, who became the first to break with President Obama, who has steadfastly defended his VA chief.
The inspector general’s report said Phoenix VA officials kept 1,700 veterans off the official books, allowing the officials to lie about waiting times and making themselves eligible for bonuses. The scathing report also suggests that VA headquarters in Washington was aware as far back as 2010 of many of the schemes VA offices were using to doctor the books.
Top VA officials told Congress on Wednesday that they first thought the secret lists were part of an initiative to reschedule canceled appointments, and that they were destroyed because they contained sensitive information about patients.
“I did not think they were secret lists,” Dr. Thomas Lynch, assistant deputy undersecretary for health for clinical operations, said after his initial trip to the Phoenix facility.
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None of the three witnesses was allowed to offer an opening statement at the evening hearing of the House Veterans’ Affairs Committee.
Rep. Jeff Miller, Florida Republican and committee chairman, frequently cut off long-winded answers and asked Joan Mooney, assistant secretary for congressional and legislative affairs, whether she could give the committee an answer without looking at her notes.
He promised to prod the VA until the committee receives the documents requested as part of a subpoena issued this month.
“Until the VA understands that we are deadly serious, you can expect us to be over your shoulder every single day,” he said.
Inspector general investigators said the wait list problems aren’t new. They have released 18 reports since 2005 examining the damage of lengthy wait times on patient care, the report said.
In the case of the Phoenix facility, investigators found at least 1,700 veterans who were not on the electronic waiting lists, meaning there was no accurate way to measure their wait times.
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“These veterans were and continue to be at risk of being forgotten or lost in Phoenix [health care system’s] convoluted scheduling process,” the investigators said in their report. “As a result, these veterans may never obtain a requested or required clinical appointment.”
Lawmakers on Capitol Hill said they were stunned by the revelations, and a number of politically vulnerable Democrats said Wednesday they had concluded it was time for Mr. Shinseki to be ousted.
Rep. Ron Barber and Rep. Kyrsten Sinema, both Arizona Democrats, said they were stunned to learn that VA headquarters knew as far back as 2010 that some officers were cooking their books with scheduling techniques.
Meanwhile, four Democrats in the Senate who are facing tough election prospects this year demanded Mr. Shinseki’s resignation: Mark Udall of Colorado, Kay R. Hagan of North Carolina, Al Franken of Minnesota, and John E. Walsh of Montana. Mr. Walsh is a combat veteran of the Iraq War.
Mr. Shinseki said he has placed the leaders of the Phoenix facility on administrative leave and that he will try to get the veterans to see doctors as quickly as possible.
“I have reviewed the interim report, and the findings are reprehensible to me, to this department, and to veterans,” he said. “I am directing that the Phoenix VA Health Care System immediately triage each of the 1,700 veterans identified by the [inspector general’s office] to bring them timely care.”
At Wednesday evening’s House panel hearing, Dr. Lynch promised that each of the 1,700 veterans would be contacted by the close of business Friday to see what care they still needed and to determine how to provide that care as soon as possible. The department will first try to contact veterans by telephone; if they can’t be reached, the VA will send a certified letter, Dr. Lynch said.
That wasn’t enough to mollify committee members.
Rep. David “Phil” Roe, Tennessee Republican, said he doesn’t understand how VA officials live with themselves as they receive huge paychecks but aren’t able to provide adequate care to poorer veterans who have no options for health care other than the VA.
“I don’t understand how you can look in the mirror in the morning and shave, and not throw up,” said the veteran of the Army Medical Corps.
Rep. Mike Coffman, Colorado Republican, called for the three witnesses at the hearing to lose their jobs, saying that they were failing to provide accurate information to the committee.
“You are not being forthright in your testimony,” he said. “You are here to serve yourselves, and not the men and women who have made extraordinary sacrifices to serve this country.”
The scandal began last month when reports surfaced that at least 40 veterans died while awaiting care on a secret wait list at the Phoenix facility.
The interim report that the inspector general released Wednesday did not determine whether delays in scheduling appointments led to deaths.
A final inspector general report is expected at the end of the summer. Mr. Shinseki has asked for an internal VA audit to be completed early next month.
Since the Phoenix accusations surfaced, staff members at other facilities across the country have raised similar concerns, and the inspector general said it is investigating 42 VA facilities. Wednesday’s interim report found that faulty scheduling practices are a “systemic problem nationwide.”
In Phoenix, investigators said real wait times were drastically different from what officials were reporting back to Washington. Of 226 veterans, the data from Phoenix showed the average wait time to be 24 days for an initial primary care appointment. The inspector general found that the average wait time was 115 days.
A “significant number” of schedulers were manipulating data to make wait times appear shorter, the report found. The report details a number of schemes, including listing the next available appointment as the patient’s desired date of care and overwriting existing appointments.
In addition to lapses in patient care and deliberate manipulation of data, the report also found a poor work environment at the Phoenix facility with evidence of improper hiring practice, sexual harassment and bullying by managers.
Sen. Bernard Sanders, Vermont independent and chairman of the Senate Veterans’ Affairs Committee, said many veterans still receive high-quality care at VA hospitals despite the report’s findings. He said he planned to introduce legislation next week to make sure veterans across the country can access that care in a timely manner.
“I urge the secretary to review whether the department’s goal for seeing patients within 14 days is realistic under its current budget,” Mr. Sanders said. “The VA must determine what new staffing may be needed at VA hospitals in parts of the country where there have been significant increases in patient loads.”