Managers at more than a dozen Veterans Affairs medical facilities lied to investigators about scheduling practices and other issues, the department's inspector general said Tuesday.
Richard Griffin, the VA's acting inspector general, said his office is investigating allegations of wrongdoing at 93 VA sites across the country, including 12 reports that have been completed and submitted to the VA for review.
"The rest are very much active," Griffin told the Senate Veterans Affairs Committee on Tuesday.
Griffin's office has been investigating VA hospitals and clinics across the country following reports of widespread delays that forced veterans in need of medical care to wait months for appointments. Investigators have said efforts to cover up or hide the delays were systemic throughout the agency's network of nearly 1,000 hospitals and clinics.
While incomplete, Griffin provided the panel with a snapshot of the results so far.
Managers at 13 facilities lied to investigators about scheduling problems and other issues, he said, and officials at 42 of the 93 sites engaged in manipulation of scheduling, including 19 sites where appointments were cancelled and then rescheduled for the same day to meet on-time performance goals.
Sixteen facilities used paper waiting lists for patients instead of an electronic waiting list as required, Griffin said.
Griffin was testifying on an investigative report by his office on delays in patient care at the troubled Phoenix veterans' hospital, where a whistleblower first exposed long delays and falsified waiting lists. A resulting scandal led to the ouster of former VA Secretary Eric Shinseki last spring.
The Aug. 26 report said workers at a Phoenix VA hospital falsified waiting lists while their supervisors looked the other way or even directed it, resulting in chronic delays for veterans seeking care. The inspector general's office identified 40 patients who died while awaiting appointments in Phoenix, but the report said officials could not "conclusively assert that the absence of timely quality care caused the deaths of these veterans."
Investigators identified 28 patients who experienced "clinically significant delays in care" that negatively affected the patients, Griffin said. Of those patients, six died, he said. In addition, the report identified 17 patients who received poor care that was not related to delays or scheduling problems, Griffin said. Of those patients, 14 died.
Three high-ranking officials at the Phoenix facility have been placed on leave while they appeal a department decision to fire them.
Griffin said the report by his office provides the VA with "a major impetus to re-examine the entire process of setting performance expectations for its leaders and managers" throughout the system.
Veterans Affairs Secretary Robert McDonald called the report troubling and said the agency has begun working on remedies recommended by the report.
"I sincerely apologize to all veterans who experienced unacceptable delays in receiving care at the Phoenix facility, and across the country," McDonald said Tuesday. "We at VA are committed to fixing the problems and consistently providing the high quality care our veterans have earned and deserve in order to improve their health and well-being."
The VA has reached out to all veterans on official and unofficial waiting lists at the Phoenix hospital, McDonald said.
The Phoenix hospital has hired 53 additional full-time employees in recent months as officials move to address a patient backlog that resulted in chronic delays for veterans seeking care, McDonald said. Officials completed nearly 150,000 appointments at the hospital in May, June and July, McDonald said, a significant increase over previous years.
In all, the VA has reached out to more than 266,000 veterans nationwide to get them off waiting lists and into clinics, McDonald said.
McDonald on Monday unveiled what he called a three-point plan to rebuild trust among veterans, improve service delivery and set a course for the agency's long-term future. The plan should be implemented by Veterans Day, Nov. 11, he said.
The former Procter & Gamble CEO also said he wants to make the VA less formal, starting with his own title. "Call me Bob," not Mr. Secretary, he said.
He gave his cellphone number to a roomful of reporters as a sign of his intent to open up what he called the VA's closed culture, which he said has made it difficult to root out problems at the agency's far-flung local and regional offices.