The inquiry into whether a Veterans Affairs facility in Phoenix falsified government records to hide excessive wait times has broadened to include several other veterans centers nationwide, as officials said Thursday that complaints about delays in appointment-making and inadequate treatment date back almost a decade.
Federal prosecutors have joined the agency's investigation to determine whether criminal charges should be filed.
At the same time, the Department of Veterans Affairs' acting inspector general testified that a preliminary review of 17 patient deaths associated with the Arizona center had not shown they were caused by delays in receiving treatment.
"It's one thing to be on a waiting list," said Richard J. Griffin, acting inspector general for the VA. "It's another thing to conclude that as a result of being on a waiting list, that was the cause of death."
But he said his office was reviewing far more than the 40 possible deaths first widely reported as being associated with the Phoenix facility.
The latest disclosures renewed calls for embattled Veterans Affairs Secretary Eric K. Shinseki to resign. His hesitation to take decisive action until the agency's investigation is complete has infuriated senators and veterans' service organizations.
Shinseki testified Thursday before the Senate Veterans' Affairs Committee that the allegations made him "mad as hell." But he asked lawmakers for patience until the inspector general finishes the investigation, which is expected to run until August. Shinseki said he placed three officials from the Phoenix facility on administrative leave on the recommendation of the inspector general.
He signaled that he had no plans to leave office unless President Obama removed him. "Every day I start out with the intent to provide as much care and benefits to the people I went to war with," said the retired Army general and Vietnam War combat veteran. "I intend to continue this mission until I'm satisfied — either that goal or I'm told by the commander in chief that my time has been served."
Obama has stood by Shinseki, one of his longest-serving Cabinet secretaries. But the White House sent a top aide, Deputy Chief of Staff Rob Nabors, to intervene at the beleaguered veterans department.
White House spokesman Jay Carney said Thursday that the president "certainly is very concerned and angry about the allegations that we've seen regarding specifically the Phoenix office. We need to find out the truth. That's why there are investigations and reviews underway. But certainly, should it be the case that the allegations that have been made are true, that would be outrageous."
Republican leaders, including Sen. Mitch McConnell (R-Ky.) and Rep. Eric Cantor (R-Va.), have sought to pin the problems on Obama's leadership.
But a growing group of lawmakers from both sides of the political aisle is audibly dissatisfied with what it characterizes as long-running systemic problems throughout the veterans' healthcare system. One Democratic senator called for the FBI to launch a criminal investigation.
Several senators provided detailed stories from their home states about long wait times, dating back several years.
Sen. Johnny Isakson (R-Ga.) cited an eight-page memo from VA officials in August 2010 detailing the ways workers were "gaming" the books to disguise excessive wait times, including keeping a second set of logs.
The memo told center directors that such practices would not be tolerated because the "work-arounds" compromised the "honesty of our work."
"There's no gray area," Isakson said. "It's not, 'We think this is happening.' It's, 'We know this is happening.'"
"Clearly this problem has gone on far too long," said Sen. Patty Murray (D-Wash.), who has investigated VA complaints. "We need more than good intentions. What we need now is decisive action."
Shinseki testified for more than an hour as the committee chairman, Sen. Bernie Sanders (I-Vt.), warned the panel against a "rush to judgment" for a healthcare system that has faced a jump in service, in part from an aging veterans population and a flood of troops returning from the wars in Iraq and Afghanistan. The agency books 85 million appointments each year for veterans.
It was Shinseki, who previously served as the Army's chief of staff, who clashed with the George W. Bush administration when he warned that more troops would be needed in Iraq than the Pentagon had suggested at the time.
But in many cases, Shinseki appeared unaware Thursday of specific problems senators raised, and he showed little urgency in his responses to their pleas for immediate action.
When asked by Sanders whether VA officials were "cooking the books," the secretary demurred.
"I'm not aware, other than a number of isolated cases, that there is evidence of that," he said.