A scathing report finding a systemic problem at Veterans Affairs medical facilities nationwide, including manipulation of records to mask long waits for appointments, fueled new calls Wednesday for VA chief Eric K. Shinseki's resignation.
As the number of sites under investigation grew to 42, up from the 26 previously reported, the allegations over VA medical care have mushroomed into an election-year issue and become a major political headache for the Obama administration.
FOR THE RECORD:
VA investigation: An article in the May 29 Section A about an interim investigation of the Veterans Affairs healthcare system said that Randy Thompson was sitting with his father at the Phoenix VA medical center and listening to the radio. In fact, he was listening to television, and his father was already with the doctor. In addition, Earl Cattes was at the Phoenix center to pick up his medical records, not for treatment.
"We are finding that inappropriate scheduling practices are a systemic problem nationwide," said the interim report, which identified 1,700 veterans at the Phoenix VA Health Care System waiting for an appointment but not on a waiting list and therefore "at risk of being forgotten or lost" in the scheduling process.
"We have substantiated that significant delays in access to care negatively impacted the quality of care at this medical facility," Richard J. Griffin, acting inspector general for the Department of Veterans Affairs, said in the report.
Shinseki called the findings "reprehensible to me, to this department and to veterans," and said he was acting to ensure veterans received timely care.
White House Press Secretary Jay Carney said President Obama found the findings "extremely troubling" and repeated the president's belief that the VA "should take immediate steps to reach out to veterans who are currently waiting to schedule appointments and make sure that they are getting better access to care now."
Shinseki "has said that VA will fully and aggressively implement the recommendations" of the inspector general, Carney said. "The president agrees with that action and reaffirms that the VA needs to do more to improve veterans' access to care. Our nation's veterans have served our country with honor and courage, and they deserve to know they will have the care and support they deserve."
But with the report drawing immediate bipartisan outrage from Capitol Hill, support was rapidly eroding for the retired four-star Army general.
Three Democratic senators in competitive races — John Walsh of Montana, the Senate's only Iraq war veteran; Mark Udall of Colorado; and Kay Hagan of North Carolina — joined Florida Rep. Jeff Miller, the Republican chairman of the House Veterans Affairs Committee, and Sen. John McCain (R-Ariz.) on Wednesday in calling for Shinseki to step down.
At the Phoenix VA, the main subject of the interim report, investigators found that the leadership, whose bonuses were based on performance, understated the time patients waited for appointments. The medical center had said a sample of 226 veterans waited on average 24 days and only 43% waited more than 14 days.
In reality, according to the report, the 226 veterans waited on average 115 days and an estimated 84% waited more than 14 days.
The inspector general cited a number of "scheduling schemes" in use, many of them previously reported in a 2010 VA memo on "gaming strategies" that has drawn widespread attention.
Miller, who until Wednesday had resisted fellow Republicans' calls for Shinseki to resign, said the report confirmed "beyond a shadow of a doubt what was becoming more obvious by the day: Wait time schemes and data manipulation are systemic throughout VA and are putting veterans at risk in Phoenix and across the country."
Congress has moved to step up its oversight of the department, and the reports of coverups of long waits at VA facilities have already moved veterans' healthcare center stage on Capitol Hill. The report is expected to give new urgency to legislation, such as offering more veterans the option of seeking private care at no cost and expanding the VA secretary's authority to fire or demote senior employees for poor performance.
The report came as Defense Secretary Chuck Hagel ordered a sweeping 90-day review of all military healthcare facilities to ensure that military patients are not facing the same problems afflicting veterans seeking care at VA facilities. Hagel acted as the Army removed the commander of the main military hospital at Ft. Bragg, N.C., and suspended three top hospital officials after two patients died in the last week and a half.
The inspector general's report comes as Shinseki is scheduled to present to Obama the preliminary findings of a nationwide audit of VA facilities, which could seal his fate. But Wednesday's report indicated the numbers could get worse.
"We are continuing to analyze interviews of over 65 schedulers at the Phoenix HCS," Griffin said in the report. "However, at this time, it appears that a significant number of schedulers are manipulating the waiting times of established patients by using the wrong desired date of care."
Shinseki, who took over the VA in 2009, has asked for patience while the inspector general's office completes its review, expected to be ready in August. The inspector general has identified VA facilities in Phoenix, San Antonio and Fort Collins, Colo., as the subject of the review, but his office on Wednesday declined to identify any others.
Sen. Joe Manchin III (D-W.Va.) said Wednesday that Congress' patience with "what we perceive as inaction on the part of the VA to immediately and fully address these issues is vanishingly thin." Added Sen. Patty Murray (D-Wash.): "We are at the point where good intentions are no longer good enough. We need to see real actions to make sure our veterans are getting the support and care they expect and deserve, and we need to see that right away."
Dan Dellinger, national commander of the 2.4-million-member American Legion, who has called for Shinseki's resignation, said the report "reaffirmed our original position of poor oversight and failed leadership" by senior leadership.
Phil Carter, who studies veterans' issues for the Center for a New American Security, said the report showed the VA problems were "bigger than Shinseki," with a number of the problems predating his appointment. On the other hand, Carter said, the report "raises the question why the VA hasn't fixed this problem by now." He said it would be "very tough" for Shinseki to survive the report.
The inspector general's report identified "multiple types of scheduling practices that are not in compliance" with Veterans Health Administration policy, including lists that "may be the basis for allegations of creating 'secret' wait lists." Griffin has said he is working with the Justice Department to determine whether criminal charges are warranted.
Sally Barnes-Breen, whose father-in-law waited two months last fall for a follow-up at the Phoenix VA, said Wednesday that the inspector general's confirmation of a "ridiculous" wait time showed exactly why Thomas Breen, a 71-year-old Navy veteran, died of terminal bladder cancer in November.
"They just blew themselves up," she said. "Now, what do they want to do about it? They are criminals."
At the Phoenix VA medical center, patients said they had long fought service problems at the facility, which serves more than 80,000 veterans.
"If you're going to send these guys to war for 11 straight years, you need to ramp up the system," said Randy Thompson, who was listening to a TV report on the inspector general's findings while his father, 83-year-old Marine veteran David Thompson, was being treated for shortness of breath.
"They just have so much overcrowding here," said Earl Cattes, 61, sitting on the other side of the waiting room thumbing through his medical records.
In 2011, Cattes said, he waited five hours to be seen for a neck injury he suffered at work. "They need another VA hospital," the Vietnam War veteran said. "It's been horrible."
During his investigation of the Phoenix VA, the inspector general said, his office also has received "numerous allegations daily of mismanagement, inappropriate hiring decisions, sexual harassment and bullying behavior by mid- and senior-level managers at this facility." The inspector general said it was still assessing the validity of the complaints.