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Fraud may mask true wait times for vets seeking care

Jun. 2, 2014 - 06:00AM   |  
Chicago Area Hines Veterans Hospital Sited In Mass
A sign marks the entrance to the Edward Hines Jr. VA Hospital on in Hines, Illinois. (Scott Olson / Getty Images)
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The Department of Veterans Affairs official internal data show it failed to treat three out of five veterans within its 14-day target period for care, VA statistics obtained by USA Today show.

But as bad as those numbers are, greater numbers of patients may have been kept waiting, according to an audit released last week that shows rampant fraud in keeping official appointment records. Some 13 percent of schedulers at 216 VA health facilities said they were instructed in how to falsify the wait times they reported to VA headquarters. At least one instance of false scheduling occurred at 64 percent of the facilities, the audit showed.

Those reported numbers, made available through a Freedom of Information Act request, showed that even without the fraud, patients were kept waiting. In the six-month period ending March 31, the VA’s 150 hospitals and 820 outpatient clinics failed to treat more than 200,000 veterans who came in for first-time primary care appointments in 14 days.

On Friday, VA Secretary Eric Shinseki resigned after turning over to President Obama results from the audit that showed widespread falsification of appointment records. Shinseki acknowledged that the tough, 14-day wait time standard may have led scores of schedulers to manipulate records. He ordered that the 14-day standard no longer be linked with performance bonuses and salary increases.

According to an interim Inspector General report issued last week, veterans at a Phoenix VA hospital were waiting months even before being tracked in this official record — their names kept on separate, secret lists. Internal VA audit results released Friday show that 13 percent of staff at 216 VA health facility sites were instructed in how to manipulate wait-time data to hide delays in medical treatment of veterans. At least one instance of this type of instruction was found at 62 percent of the facilities, the audit says.

“This behavior runs counter to our core values,” says the audit.

The department may have lost its focus by concentrating so heavily on measuring wait times, said Thomas Lynch, an assistant deputy undersecretary who is investigating the scandal of VA leadership, in Congress this week.

Once a patient is entered in that official database, the waiting isn’t over. The average wait time was not even getting close to the VA’s aspiration of a 14-day wait period for new appointments, according to the data. Nationwide, the average wait was nearly double that — 27 days.

The official numbers also reveal veterans waiting months for care at some hospitals and clinics.

In Nashville, it takes more than two months for the average new patient to see a doctor. In Atlanta, Gainesville, Fla., and Portland, Ore., veterans are put on hold for more than 50 days.

Only 19 of the VA’s 140 health care facilities reported average wait times within the administration’s target range. Some — in Richmond, Va., Columbia, S.C., and Hampton, Va. — said fewer than 20 percent of new patients got in to see a doctor within that 14-day time frame.

The VA has confirmed that 42 facilities are under investigation for having falsified their wait records.

Numbers from other hospitals reveal a two-tiered system of care. Hawaii’s VA Pacific Islands Health Care System reported that 42 percent of its patients saw doctors within 14 days. But those who didn’t get seen quickly were left to linger: the average wait time for the rest was 2˝ months.

Shortly before resigning Friday, Shinseki directed that wait times no longer be a part of hospital directors’ performance review. And he also canceled any bonuses for this year.

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