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VA inspector general points to 'inappropriate' practices

This May 19, 2014 photo shows a  a sign in front of the Veterans Affairs building in Washington, DC.
This May 19, 2014 photo shows a a sign in front of the Veterans Affairs building in Washington, DC.
When President Obama spoke from the White House last week on the controversy surrounding the Department of Veterans Affairs, he didn't propose specific solutions so much as he outlined a fact-finding process. Step One: waiting for the VA's inspector general to report on how, whether, and to what extent various facilities -- not just the Phoenix hospital -- may have cooked the books.
That report was released this afternoon.

Thousands of veterans have been negatively affected by long appointment wait times for medical care and convoluted scheduling practices at Phoenix's VA hospital, a report released Wednesday by the Department of Veteran Affairs' Office of the Inspector General found. The review "confirmed that inappropriate scheduling practices are systemic throughout VHA," according to the report. The investigation looked into how an apparent "secret" waiting list of veterans waiting for appointments was created and maintained. The retired VA doctor who reported misconduct at the Phoenix hospital alleged that some 40 veterans died while waiting for appointments.

The entirety of the 35-page report is online here (pdf).
Some of the specific numbers, all of which were striking, brought the scope of the controversy into sharper focus: "[A]t 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."
Investigators also found that out of a sample of 226 patients, veterans waited "an average of 115 days for their first primary care appointment at the medical center."
The reported number after the manipulation of the data? Only 24 days.
The revelations led a handful of members of Congress, including Sen. John McCain (R-Ariz.), to call for VA Secretary Eric Shinseki to resign, though it's not altogether clear why the inspector general's report pushed them to make this announcement. The public now has more details than it did this morning, but the basic controversy remains the same, and the challenges facing Shinseki and his team haven't changed.
As for the VA secretary himself, Shinseki issued a statement of his own this afternoon:

"I respect the independent review and recommendations of the Office of Inspector General (OIG) regarding systemic issues with patient scheduling and access. I have reviewed the interim report, and the findings are reprehensible to me, to this Department, and to Veterans.  I am directing that the Phoenix VA Health Care System (VAHCS) immediately triage each of the 1,700 Veterans identified by the OIG to bring them timely care. "I have already placed the Phoenix VAHCS leadership on administrative leave, and have directed an independent site team to assess scheduling and administrative practices at the Phoenix VAHCS. This team began their work in April, and we are already taking action on multiple recommendations from this report. "We will aggressively and fully implement the remaining OIG recommendations to ensure that we contact every single Veteran identified by the OIG. I have directed the Veterans Health Administration (VHA) to complete a nation-wide access review to ensure a full understanding of VA's policy and continued integrity in managing patient access to care.  Further, we are accelerating access to care throughout our system and in communities where Veterans reside. "It is important to allow OIG's independent and objective review to proceed until completion.  OIG has requested that VA take no additional personnel actions in Phoenix until their review is complete."

Note, the IG's findings are not the final word, and the IG's office said investigations are ongoing, including the questions surrounding the quality of the case veterans received through the facilities in question.