Audit: VA Left 100K Veterans Waiting for Care

The Department of Veterans Affairs on Monday said it has reached out to 50,000 veterans across the country to get them out of a waiting line for health care and into a VA facility or private care.

The action follows the release of a VA audit that found about 57,000 veterans have been waiting 90 days or more for their first VA medical appointments. An additional 63,000 veterans have never received appointments over the past 10 years after enrolling and requesting them, the Veterans Affairs Department said Monday.

The VA's audit released Monday issued more alarming statistics to go with last week's confirmation by VA officials that executives throughout the system had manipulated wait times for veterans seeking care. About 13 percent of schedulers in the VA's 73 hospitals and outpatient clinics reported being told by supervisors to falsify appointment schedules to make patient wait times appear shorter, according to the audit.

"We need to be able to have higher integrity in our performance measures reporting for access," a senior VA health care official told reporters during a background briefing Monday after the department announced the results of the audit.

VA officials said the agency will be working out a process for handling cases where facility executives, managers and staff manipulated appointment wait times to conceal the fact they were not able to meet patient needs.

Last week, VA officials said VA inspectors and auditors found systemic manipulation of the appointment scheduling system by VA staff and officials at numerous facilities, including the VA Medical Center in Phoenix, where some patients on a hidden wait list died before seeing a doctor.

The release of the audit's interim report resulted in the resignation of former VA Secretary Eric Shinseki. The management of the Phoenix hospital is already in the process of being fired, and more are expected at other facilities as a result of audit findings.

To get the overflow of veterans quickly into care, the VA will be hiring additional clinical and patient support staff where needed, both permanent and temporary, deploying mobile medical units to select locations and utilize more community and private health care practices.

In addition to clinical personnel, the new hires will be in the administrative and engineering areas. The VA expects to fund the changes by reallocating money it already has and adjusting internal resources.

The official estimated it will cost about $300 million to meet the appointment demands, which includes utilizing community and private health care resources.

While the VA effects these changes it has put a hold on new hires at VA headquarters in Washington and at the regional Veterans Integrated Service Networks, the 23 regional headquarters that oversee VA hospitals and clinics across the country.

The VA also announced on Monday that it would be developing a new process for measuring patient satisfaction, and will make its access to care more transparent by posting data twice a month.

The manipulation of the schedules has been linked to hospital and clinic officials' determination to make it appear they were making the VA's goal of getting vets in for an appointment within 14 days of asking for one. Hitting these marks were important because they were factors in whether senior hospital officials' earned bonuses.

For that reason the VA announced it is also eliminating the 14-day goal as a performance measure, thereby removing a financial incentive to game the appointment schedules. Additionally, the 14-day goal will itself be given a fresh look even as the VA moves to speed up the process for getting veterans care, the VA official said.

"The setting of a performance standard of 14 days was not realistic for our system at the time, and I think we have to reassess what is the right standard," he said. "Removing it from individual performance plans removes the incentive to report other than what the true wait experience is, and we need to know that in order to accelerate care for veterans."

The official said VA has to find a way to continue operating more quickly.

"I believe we have to," he said. "We have to make timely access to car part of our operating rhythm ... We're going to do it through the rest of the fiscal year and 2015 and beyond. It has to be our focus."

In announcing the audit findings and VA actions on Monday, Acting VA Secretary Sloan Gibson reiterated that no senior executives in the Veterans Health Administration will receive a performance bonus for 2014. That decision was made just over a week ago by VA Secretary Eric Shinseki just hours before he resigned from the VA's top post.

-- Bryant Jordan can be reached at bryant.jordan@monster.com