The Department of Veterans Affairs overstates how quickly it cares for veterans, understates how many are waiting for care and may be "gaming" its own system to show better results, according to an internal investigation.
Three-fourths of veterans were seen within the required 30 days, far fewer than the 95 percent claimed by the VA. The VA hospital in Columbia was one of 10 hospitals reviewed and had the poorest record of seeing patients within 30 days, according to the report released late Monday by the VA's watchdog arm.
The hospitals also included only a fraction of patients who needed care on the required waiting lists.
The report is similar to a draft version the Observer obtained and wrote about in June.
"America's veterans deserve the best," said Kevin Bishop, spokesman for U.S. Sen. Lindsey Graham, an S.C. Republican and member of the Senate Veterans' Affairs Committee. "Any time that standard is not being met is cause for concern. Senator Graham is reviewing the report and will work to ensure our veterans get the care they deserve."
Patients not put on list
Waiting times for veterans to see doctors are closely watched by Congress and veterans' advocates. The measure is an indicator of how well the hospitals meet patient demand. But long wait times can reflect poorly on hospital directors, creating pressure to show speedier care and fewer people waiting.
VA investigators said appointment schedulers interpreted managers' instructions to reduce waiting times "as instruction to never put patients on the electronic waiting list," the report stated. "This seems to have resulted in some 'gaming' of the scheduling process."
U.S. Sen. Daniel Akaka, a Hawaii Democrat and chairman of the Senate VA committee, called the results "simply not acceptable." The committee requested the audit as a follow-up to a 2005 investigation that found similar problems.
Monday's report said the agency had not completed five of eight recommendations investigators made two years ago. Akaka said it was "disturbing news that VA continues to skew" waiting time reports.
Investigators analyzed 700 medical appointments scheduled for last October at 10 VA medical centers and interviewed 113 VA schedulers. The Salisbury and Asheville, N.C., VA hospitals -- those most likely to serve Charlotte-area veterans -- were not part of the audit.
The Columbia hospital saw 64 percent of patients, less than two-thirds, within 30 days, investigators found. That tied with an Ohio medical center for the poorest showing. At 84 percent, Detroit was the best, but still below VA claims of 95 percent.
Patients saw primary care doctors more quickly than they received specialty care, such as treatment for heart disease and mental health disorders.
"The accuracy of VHA's reported waiting times could not be relied on and the electronic waiting lists were not complete," the report stated.