WASHINGTON -- More than 57,000 veterans have been waiting 90 days or more for their first VA medical appointments, and an additional 64,000 appear to have fallen through the cracks, never getting appointments after enrolling and requesting them, the Veterans Affairs Department said Monday.
It's not just a numbers problem. Thirteen percent of schedulers in the facility-by-facility nationwide audit of 731 VA hospitals and outpatient clinics reported being told by supervisors to falsify appointment schedules to make patient waits appear shorter.
The audit is the first nationwide look at the VA network in the uproar that began with reports two months ago of patients dying while awaiting appointments and of cover-ups at the Phoenix VA center. A preliminary audit last month found that long patient waits and falsified records were "systemic" throughout the VA medical network, the nation's largest single health care provider with nearly 9 million veterans and their families as patients.
The controversy forced VA Secretary Eric Shinseki to resign May 30. Shinseki took the blame for what he decried as a "lack of integrity" through the network. Legislation is being written in both the House and Senate to allow more veterans, including those enrolled in Medicare or the military's TRICARE program, to get treatment from outside providers if they can't get timely VA appointments. The proposals also would make it easier to fire senior VA regional officials and hospital administrators.
The audit said a 14-day target for waiting times was "not attainable," given growing demand for VA services and poor planning. It called the 2011 decision by senior VA officials setting it, and then basing bonuses on meeting the target, "an organizational leadership failure."
The audit is the third in a series of reports in the past month on long wait times and falsified records at VA facilities nationwide.
Acting VA Secretary Sloan Gibson said Monday that VA officials have contacted 50,000 veterans across the country to get them off waiting lists and into clinics and are in the process of contacting 40,000 more.
A previous inspector general's investigation into the troubled Phoenix VA Health Care System found that about 1,700 veterans in need of care were "at risk of being lost or forgotten" after being kept off an electronic waiting list. While the investigation focused on Phoenix, it pointed to problems throughout the sprawling health care system.
The report issued Monday offers a broader picture of that overall system. The audit includes interviews with more than 3,772 employees nationwide between May 12 and June 3. Respondents at 14 sites reported having been sanctioned or punished over scheduling practices.
Wait times for new patients far exceeded the 14-day goal, the audit said. For example, the wait time for primary care screening appointment at Baltimore's VA health care center was almost 81 days. At Canandaigua, New York, it was 72 days. On the other hand, at Coatesville, Pennsylvania, it was only 17 days and in Bedford, Massachusetts just 12 days. The longest wait was in Honolulu -- 145 days.
But for veterans already in the system, waits were much shorter.
For example, established patients at VA facilities in New Jersey, Connecticut and Battle Creek, Michigan, waited an average of only one day to see health care providers. The longest average wait for veterans already in the system was in Fayetteville, North Carolina, a military-heavy region with Fort Bragg Army Base and Pope Air Force Base nearby.