WASHINGTON - Investigators identified 1,700 veterans awaiting medical care at the Phoenix VA hospital but not on an official waiting list and an average wait of 115 days for a first appointment for those who were listed, the Veterans Affairs Department's inspector general said Wednesday. The IG concluded that "inappropriate scheduling practices are systemic throughout" the nationwide VA health care system.
Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, and Sen. John McCain, R-Ariz., immediately called for VA Secretary Eric Shinseki to resign. Miller also said Attorney General Eric Holder should launch a criminal investigation into the VA.
Richard J. Griffin, the department's acting inspector general, said in an interim report that investigators had "substantiated serious conditions" at the Phoenix VA hospital. "While our work is not complete, we have substantiated that significant delays in access to care negatively impacted the quality of care at this medical facility," he wrote in the 35-page report.
Miller said the report confirmed that "wait time schemes and data manipulation are systemic throughout VA and are putting veterans at risk in Phoenix and across the country."
Shinseki called the IG's findings "reprehensible to me, to this department and to veterans." He said he was directing the Phoenix VA to immediately address each of the 1,700 veterans waiting for appointments.
Griffin said his office has increased the number of VA health care facilities it is investigating to 42 nationwide, up from 26 known to be under investigation as of last week. He said investigators' next steps include determining whether names of veterans awaiting care were purposely omitted from electronic waiting lists and at whose direction and whether any deaths were related to delays in care.
He said investigators at some of the other 42 facilities "have identified instances of manipulation of VA data that distort the legitimacy of reported waiting times."
Justice Department officials have already been brought into cases where there is evidence of a criminal or civil violation, Griffin said.
Dr. Samuel Foote, a former clinic director for the VA in Phoenix who was the first to bring the allegations to light, said the findings were no surprise.
"I knew about all of this all along," Foote told The Associated Press in an interview. "The only thing I can say is you can't celebrate the fact that vets were being denied care."
Foote took issue with the finding by the inspector general that patients had, on average, waited 115 days for their first medical appointment.
"I don't think that number is correct. It was much longer," he said. "It seemed to us to be about six months."
Still, Foote said it is good that the VA finally appears to be addressing some long-standing problems.
"Everybody has been gaming the system for a long time," he said. "Phoenix just took it to another level. ... The magnitude of the problem nationwide is just so huge, so it's hard for most people to get a grasp on it."
The report Wednesday said 84 percent of a statistical sample of 226 veterans at the Phoenix hospital waited more than 14 days to get a primary care appointment. VA guidelines say veterans should be seen within 14 days of their desired date for a primary care appointment. A fourth of the 226 received some level of care during the interim, such as in the emergency room or at a walk-in clinic, the report said.
The report said investigators would not be able make any determination about whether long appointment waits resulted in patient deaths until after they analyze medical records, death certificates and autopsy results.
In a related matter, Griffin said investigators have received numerous allegations of mismanagement, inappropriate hiring decisions, sexual harassment and bullying behavior by mid- and senior-level managers at the Phoenix hospital. Investigators were assessing the validity of the complaints and their effect, if any, on patients' access to care, he said.