Department of Veterans Affairs inspectors say they found an unofficial list of some 1,700 veterans who were waiting to get appointments with doctors at the VA Medical Center in Phoenix, Arizona, where whistleblowers allege up to 40 vets died awaiting treatment.
VA Acting Inspector General Richard Griffin, in a preliminary report released on Wednesday, offered no indication that any deaths are linked to the secret wait list and said the investigation is continuing at the Phoenix hospital along with 41 other facilities where complaints have been made.
"We identified an additional 1,700 veterans who were waiting for a primary care appointment but were not on the [electronic waiting list]. Until that happens, the reported wait time for these veterans has not started. Most importantly, these veterans were and continue to be at risk of being forgotten or lost in Phoenix HCS's convoluted scheduling process," the VA IG wrote in its report.
VA Secretary Eric Shinseki said Griffin's findings are "reprehensible to me, to this Department, and to veterans."
Shinseki, acting on Griffin's top recommendation, said he is ordering the Phoenix VA hospital to "immediately triage each of the 1,700 veterans identified by the OIG to bring them timely care."
Shinseki has already put three Phoenix officials on administrative leave over the allegations, but said Griffin has requested he take no additional personnel actions there until the review is complete.
"We are not providing [these] VA medical facilities advance notice of our visits to reduce the risk of destruction of evidence, manipulation of data and coaching staff on how to respond to our interview questions," he says in the report.
Rep. Jeff Miller, R-Fla., who chairs the House Veterans Affairs Committee, said Griffin's interim findings are enough to warrant a criminal investigation by the Justice Department and for VA Secretary Eric Shinseki to step down.
"Shinseki is a good man who has served his country honorably, but he has failed to get VA's health care system in order despite repeated and frequent warnings from Congress, the Government Accountability Office and the IG," Miller said.
Griffin, in his report, recommended that Shinseki act immediately to get care for the 1,700 veterans whose appointment requests were kept separate from both the hospital's active appointment list and an authorized electronic waiting list intended to track unmet demand.
"Our reviews have identified multiple types of scheduling practices that are not in compliance with [VA] policy," Griffin wrote. "Since the multiple lists we found were something other than the official EWL, these additional lists may be the basis for allegations of creating 'secret' wait lists."
The secret waiting list was first reported in April by CNN. Since then whistleblowers from other facilities have made similar allegations about secret wait lists, manipulated appointment schedules and more.
Griffin says in his report that IG staff on the ground in Phoenix and others working the national Hot Line have "received numerous allegations daily of mismanagement, inappropriate hiring decisions, sexual harassment, and bullying behavior by mid- and senior-level managers at the Arizona hospital.
What Griffin and his team have substantiated so far is that "serious conditions" at the Phoenix facility delayed 1,700 veterans from access to health care services.
The official electronic waiting list had 1,400 names on it. The 1,700 veterans not on that list were found through several sources including a New Enrollee Appointment Request tracking report. It had 1,100 names of vets indicating they wanted a primary care appointment as of April 28, but had not received one.
Another 400 names were gleaned from screenshot paper printouts. These were newly enrolled veterans who had called the Phoenix facility helpline and requested a primary care appointment but had not been scheduled for one.
Another 200 names were veterans referred for primary care but the consultation date was still pending. These 200 were seen in a non-primary care clinic, such as mental health or the emergency department, but were then referred to primary care.
In none of the cases above were the veterans entered into the electronic waiting list, which is supposed to be used so the VA can properly track how well, or poorly, it is meeting demand.
Griffin wrote that all the complaints are being investigated. If they turn out to be true, the IG will also look into how they affect facility management's ability to improve the situation.
Complete recommendations on how to handle the situation in Phoenix will be included in a final report, he said.
In addition to getting the 1,700 veterans on the secret list into care, Griffin also recommends that VA headquarters review all waiting lists at the Phoenix hospital to find those veterans who may be at greatest risk because of any delay to care and ensure they are taken care of quickly.
These would include veterans who would be new patients to a specialty clinic, he said.
Griffin also recommended that Shinseki order a nationwide review of patient waiting lists at VA facilities to make sure veterans are being seen in an appropriate time given their medical condition.
Finally, he said, Shinseki should order a New Enrollee Appointment Request report from every facility that would identify all newly enrolled vets and direct hospital and clinic managers to show that patients have received appropriate care on the facility's electronic waiting list.
Congress has received testimony on long appointment wait times and the unreliability of the data VA reports for decades.
Two years ago the Senate Veterans Affairs Committee heard from a former mental health administrator with the VA Medical Center in Manchester, New Hampshire, that hospital officials across the country routinely shared best practices for getting around VA policy on appointments.
Nicholas Tolentino told the senators the executives had a financial interest in making sure the numbers looked good because they were tied to annual bonuses.
Most of the heat put on the VA, however, has come from the House side of Congress. Until Wednesday, however, Miller has not called for Shinseki to resign.
"VA needs a leader who will take swift and decisive action to discipline employees responsible for mismanagement, negligence and corruption that harms veterans while taking bold steps to replace the department's culture of complacency with a climate of accountability," Miller said in his statement. "Sec. Shinseki has proven time and again he is not that leader. That's why it's time for him to go."
-- Bryant Jordan can be reached at firstname.lastname@example.org.