42 VA Health Facilities Manipulated Scheduling Data, VA OIG Says

September 10, 2014 in News

Administrators at 13 Department of Veterans Affairs health facilities have lied to federal investigators who are looking into allegations of manipulated waiting lists and other issues, VA’s acting inspector general told the Senate Veterans’ Affairs Committee on Tuesday, the New York Times reports (Oppel, New York Times, 9/10).

Background

Richard Griffin — VA’s acting inspector general — said that 93 VA facilities are being investigated for potential wrongdoing (Klimas, Washington Times, 9/9). The investigation comes after an initial audit found that staff at more than 100 VA health clinics across the U.S. used methods other than the department’s official electronic appointment tracking system to make it appear that veterans had shorter wait times for care (iHealthBeat, 7/30).

Details of VA OIG’s Initial Findings

Griffin told the committee that a majority of facilities under investigation manipulated scheduling time data. Specifically, officials at 42 of the 93 VA health facilities under investigation by VA OIG had manipulated scheduling data, including:

  • 19 facilities where staff canceled appointments before rescheduling them for the same day in an attempt to meet performance goals (Washington Times, 9/9);
  • 16 facilities where staff used paper waiting lists instead of the required electronic waiting lists (AP/San Francisco Chronicle, 9/9); and
  • Some facilities where staff wrongfully reported the next appointment date available to patients as the date patients asked for the appointment (New York Times, 9/10).

In total, Griffin said his staff estimates that about one-fourth of the VA facilities under investigation did not manipulate scheduling data, but they are “pretty confident that it was knowingly and willingly happening” at the other three-fourths of facilities under investigation.

Responding to a question from the committee as to why there had been such widespread manipulation of scheduling data, Griffin said, “Frankly, when something is going on for as many years — not everywhere — but at a number of the facilities, it almost becomes the accepted way of doing scheduling” (Carney, National Journal, 9/9). He added, “I think you have a culture where it’s okay to disregard directives from the most senior people in the administration. You need to come to understand that is not acceptable behavior” (Washington Times, 9/9).

Next Steps

Griffin said he hopes that VA OIG’s investigation will be completed by the end of the year and that his office would release findings on specific facilities as they are completed (Kesling, Wall Street Journal, 9/9). He said that reports on 12 of the facilities had been completed but that the “rest are very much active” (AP/San Francisco Chronicle, 9/9).

According to National Journal, investigators would need to report any evidence of criminal wrongdoing to the U.S. Attorney’s Office, which would make a determination about whether to move forward with prosecutions of VA staffers (National Journal, 9/9).

Testimony on Phoenix VA Facility

Meanwhile, Griffin offered additional details of a VA OIG report on a VA health center in Phoenix, Ariz. (New York Times, 9/9).

In May, VA’s OIG released an interim report that found preliminary evidence that the Phoenix VA Health Care System inappropriately used electronic health record systems to facilitate improper scheduling practices, affecting as many as 1,700 patients (iHealthBeat, 5/30).

The latest report found:

  • 28 instances at the facility of “clinically significant delays of care”; and
  • 17 examples of poor medical care that was not related to manipulations of waiting lists, 14 of which involved patients who are now deceased.

Griffin said such findings “reflect unacceptable and troubling lapses in follow-up, coordination, quality and continuity of care.”

Griffin also defended the report’s finding that claims that 40 veterans might have died because of delayed care at the Phoenix facility are unsubstantiated (New York Times, 9/9).

Sen. Dean Heller (R-Nev.) questioned Griffin as to whether VA OIG had allowed VA to insert language not included in its initial report saying that its investigators could not “conclusively assert” that the delays in care caused the veterans’ deaths.

Griffin responded, “No one in VA dictated that sentence go into that report, period” (Wall Street Journal, 9/9).

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