Inspectors at the Department of Veterans Affairs caught Phoenix VA managers falsifying patient appointment records during a probe six years ago, but agency officials did not divulge those findings at the time, according to documents obtained by The Arizona Republic.
An “administrative investigation” conducted in 2008 at Phoenix VA Health Care System says the medical center had “an accepted past practice to alter appointments to avoid wait times greater than 30 days, and that some employees still continue this practice.”
“We also found that some schedulers did not understand their performance standards and that the medical center did not use the electronic wait list in accordance with policy,” a report on the investigation states.
Those conclusions are virtually identical to findings the OIG made during a similar Phoenix investigation released in August under pressure from whistle-blowers, Congress and media coverage.
Existence of the 2008 report was disclosed publicly Wednesday by the Washington Examiner in articles that suggest the OIG repeatedly has failed in its oversight duty by not publishing reports, obfuscating the level of fraud and failing to hold VA executives accountable.
Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans’ Affairs, said revelations show the inspector general “missed the forest for the trees, often labeling what we now know to be systemic and willful manipulation of medical care appointment data as basic procedural problems and breakdowns in training.
“What’s worse, the OIG actually identified many of the Phoenix VA Health Care System’s wait-time issues in a 2008 report that it refused to make public, effectively keeping the problem hidden,” Miller said.
In the OIG’s August report on VA care in Phoenix, acting Inspector General Richard Griffin listed numerous previous inquiries that had targeted patient-access issues nationwide to show that the VA’s watchdog arm fulfilled its oversight obligations in the past. The 2008 findings were vaguely referenced in one paragraph among the exhibits. However, the 2008 report was not available at the OIG website.
Moreover, the OIG, VA headquarters and Phoenix medical center officials failed to provide copies of the 2008 report in response to records requests this year from The Arizona Republic about prior investigations.
Cathy Gromek, an OIG spokeswoman, said, “The report was not a secret. … We have nothing to hide.”
In 2008, inspectors found that appointment schedulers systematically falsified the wait periods for patient care because supervisors would “ding the heck out of you” if accurate times were shown. The report says bosses instructed staffers to “keep wait times at zero” and “encouraged ‘fixing’ appointments” that showed delays exceeding 30 days. Supervisors also told investigators they suffered negative performance evaluations if wait times exceeded VA goals.
The report concluded that schedulers were confused about policies and lacked training. It said inspectors “did not substantiate allegations of mismanagement of resources, abuse of authority or improper hiring” in Phoenix, so those issues were not even addressed in the findings.
The OIG report on Phoenix VA issued in August is virtually a carbon copy of the earlier findings, except that inspectors determined that Arizona administrators knew their employees were cooking the books, and reaped bonus pay because of the false record-keeping.
Sharon Helman, the Phoenix director, was suspended pending termination amid the scandal this spring along with other administrators. They remain on paid leave, and VA officials refuse to comment on their status.
