V.A. Report Confirms Improper Waiting Lists at Phoenix Center

V.A. Report Confirms Improper Waiting Lists at Phoenix Center

By RICHARD A. OPPEL Jr. and MICHAEL D. SHEAR

2:31 PM

The inspector general for the Department of Veterans Affairs reported on Wednesday that at least 1,700 veterans at the agency’s medical center in Phoenix were not registered on the proper waiting list to see doctors, creating a serious condition that means veterans “continue to be at risk of being forgotten or lost” in the convoluted scheduling process. 

All the while, the hospital falsely reported waiting times that suggested delays were minimal, the report said. 

The report prompted several leading Republicans, including Senator John McCain of Arizona, to call for the secretary of veterans affairs, Eric Shinseki, to step down. 

“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 acting inspector general for the department, said in an interim report on his investigation into the Phoenix medical center. 

Irregularities in how the 1,700 veterans were handled, the report said, mean that “these veterans may never obtain a requested or required clinical appointment.” Mr. Shinseki, who earlier this month put top administrators in Phoenix on leave, called the findings of the interim report “reprehensible” and promised to take immediate action. 

Mr. Griffin, whose office is now investigating dozens of Veterans Affairs medical facilities across the country, said he believed that “inappropriate scheduling practices are systemic throughout” the veterans health care system. 

At the same time, the most explosive allegations that have been made about the Phoenix facility — that the deaths of as many as 40 veterans were linked to manipulated waiting lists — were not addressed in the report on Wednesday. 

The report validates allegations raised by whistle-blowers and others that employees in Phoenix kept an off-the-books waiting list or used other artifices to cloak long waiting times that many veterans faced for medical care. 

For example, the investigators from the inspector general’s office reviewed a sample of 226 patients and found that they waited an average of 115 days for their first primary care appointment at the medical center, but that their average waiting time was reported to the V.A.'s national office as being only 24 days. 

The interim report did not dwell on the motivations for falsely reporting waiting times, nor did it single out any employees or hospital administrators by name. 

But it stated that a “direct consequence” of the inappropriate waiting lists was that the medical center’s leadership “significantly understated the time new patients waited for their primary care appointment” in its performance appraisal accomplishments for the 2013 fiscal year, which was a factor considered for bonuses and salary increases. 

Mr. Griffin said in the report that investigators were examining “whether any delay in scheduling a primary care appointment resulted in a delay in diagnosis or treatment, particularly for those veterans who died while on a waiting list.” He said determinations could be made only after examining autopsy reports, death certificates and nonagency documents that are still being obtained and reviewed. 

In Senate testimony this month, Mr. Griffin said investigators had examined the deaths of 17 veterans in Phoenix, but so far had found no link between their deaths and the waiting lists. 

In the report on Wednesday, Mr. Griffin added that “when sufficient credible evidence is identified supporting a potential violation of criminal and/or civil law, we have contacted and are coordinating our efforts with the Department of Justice.” 

The release of the inspector general’s report is certain to increase the pressure on Mr. Shinseki to step down. 

Representative Jeff Miller, the Florida Republican who is the chairman of the House Veterans Affairs Committee, said the report “confirmed beyond a shadow of a doubt what was becoming more obvious by the day: Wait time schemes and data manipulation are systemic throughout V.A. and are putting veterans at risk in Phoenix and across the country.” 

Mr. Miller also called on Mr. Shinseki to resign immediately, saying he “appears completely oblivious to the severity of the health care challenges facing the department.” And Mr. Miller called on the attorney general, Eric H. Holder Jr., to start a criminal investigation into what he called “V.A.'s widespread scheduling corruption.” 

Mr. McCain, who until Wednesday had declined to call for Mr. Shinseki’s resignation, finally added his voice to those demanding new leadership at the embattled agency. 

“I haven’t said this before,” Mr. McCain said Wednesday on CNN moments after the investigative report was released. “I think it’s time for General Shinseki to move on.” 

Mr. McCain’s position is likely to carry a lot of weight in Washington, where he is viewed as a respected leader on veterans issues. Mr. McCain, a former naval aviator, was captured and tortured for five years by the Vietnamese during the Vietnam War. 

Mr. McCain said on CNN that he had intended to wait to comment on Mr. Shinseki’s future until further hearings were held on the V.A. issue. But after hearing about the report on Wednesday, he decided to speak out. 

“I think it’s reached that point,” he said. “This keeps piling up.” 

 Jr. and MICHAEL D. SHEAR

2:31 PM

The inspector general for the Department of Veterans Affairs reported on Wednesday that at least 1,700 veterans at the agency’s medical center in Phoenix were not registered on the proper waiting list to see doctors, creating a serious condition that means veterans “continue to be at risk of being forgotten or lost” in the convoluted scheduling process. 

All the while, the hospital falsely reported waiting times that suggested delays were minimal, the report said. 

The report prompted several leading Republicans, including Senator John McCain of Arizona, to call for the secretary of veterans affairs, Eric Shinseki, to step down. 

“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 acting inspector general for the department, said in an interim report on his investigation into the Phoenix medical center. 

Irregularities in how the 1,700 veterans were handled, the report said, mean that “these veterans may never obtain a requested or required clinical appointment.” Mr. Shinseki, who earlier this month put top administrators in Phoenix on leave, called the findings of the interim report “reprehensible” and promised to take immediate action. 

Mr. Griffin, whose office is now investigating dozens of Veterans Affairs medical facilities across the country, said he believed that “inappropriate scheduling practices are systemic throughout” the veterans health care system. 

At the same time, the most explosive allegations that have been made about the Phoenix facility — that the deaths of as many as 40 veterans were linked to manipulated waiting lists — were not addressed in the report on Wednesday. 

The report validates allegations raised by whistle-blowers and others that employees in Phoenix kept an off-the-books waiting list or used other artifices to cloak long waiting times that many veterans faced for medical care. 

For example, the investigators from the inspector general’s office reviewed a sample of 226 patients and found that they waited an average of 115 days for their first primary care appointment at the medical center, but that their average waiting time was reported to the V.A.'s national office as being only 24 days. 

The interim report did not dwell on the motivations for falsely reporting waiting times, nor did it single out any employees or hospital administrators by name. 

But it stated that a “direct consequence” of the inappropriate waiting lists was that the medical center’s leadership “significantly understated the time new patients waited for their primary care appointment” in its performance appraisal accomplishments for the 2013 fiscal year, which was a factor considered for bonuses and salary increases. 

Mr. Griffin said in the report that investigators were examining “whether any delay in scheduling a primary care appointment resulted in a delay in diagnosis or treatment, particularly for those veterans who died while on a waiting list.” He said determinations could be made only after examining autopsy reports, death certificates and nonagency documents that are still being obtained and reviewed. 

In Senate testimony this month, Mr. Griffin said investigators had examined the deaths of 17 veterans in Phoenix, but so far had found no link between their deaths and the waiting lists. 

In the report on Wednesday, Mr. Griffin added that “when sufficient credible evidence is identified supporting a potential violation of criminal and/or civil law, we have contacted and are coordinating our efforts with the Department of Justice.” 

The release of the inspector general’s report is certain to increase the pressure on Mr. Shinseki to step down. 

Representative Jeff Miller, the Florida Republican who is the chairman of the House Veterans Affairs Committee, said the report “confirmed beyond a shadow of a doubt what was becoming more obvious by the day: Wait time schemes and data manipulation are systemic throughout V.A. and are putting veterans at risk in Phoenix and across the country.” 

Mr. Miller also called on Mr. Shinseki to resign immediately, saying he “appears completely oblivious to the severity of the health care challenges facing the department.” And Mr. Miller called on the attorney general, Eric H. Holder Jr., to start a criminal investigation into what he called “V.A.'s widespread scheduling corruption.” 

Mr. McCain, who until Wednesday had declined to call for Mr. Shinseki’s resignation, finally added his voice to those demanding new leadership at the embattled agency. 

“I haven’t said this before,” Mr. McCain said Wednesday on CNN moments after the investigative report was released. “I think it’s time for General Shinseki to move on.” 

Mr. McCain’s position is likely to carry a lot of weight in Washington, where he is viewed as a respected leader on veterans issues. Mr. McCain, a former naval aviator, was captured and tortured for five years by the Vietnamese during the Vietnam War. 

Mr. McCain said on CNN that he had intended to wait to comment on Mr. Shinseki’s future until further hearings were held on the V.A. issue. But after hearing about the report on Wednesday, he decided to speak out. 

“I think it’s reached that point,” he said. “This keeps piling up.”