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Veteran Probe in Houston: Appointment Data Disguised

HOUSTON, Texas — A federal investigation has found that two supervisors and a director at the Michael E. DeBakey VA Medical Center and its associated clinics, were manipulating patient appointment statistics by recording clinic cancellations as patient cancellations. The report of the VA Office of Inspector General claims that the problems at the VA persist “because of a lack of effective training and oversight.”

The Office of Inspector General (OIG) received an anonymous complaint, investigated, and found that the allegations were substantiated. The Department of Veterans Affair (VA) OIG has identified 223 appointments that were incorrectly recorded as appointments cancelled by the patient. The time frame investigated was July 2014 to June of 2015. The report came out the end of June.

The OIG also found that forty-two percent of the rescheduled appointments, or 94 appointments, were rescheduled by staff.  As a result, veterans had to wait an average of 81 days in order to be seen. The 81-day wait was 78 days longer than what appeared in the VA’s electronic scheduling system. Wait times were under-reported by about 66 days for 50 appointments (22 percent) for when they were originally scheduled.

Similar problems were identified after a review of the entire Veterans Health Administration system in May and June of 2014. The report of the VA OIG stated that “These conditions persisted because of a lack of effective training and oversight.” They say, “As a result, VHA’s (Veteran Health Administration) recorded wait times did not reflect the actual wait experienced by the veterans that the wait time remained unreliable and understated.”

The VA OIG stated in its report that after it made these discoveries, it made the following recommendation:

We recommend the Veterans Integrated Service Network 16 Director confers with VA’s Office of Accountability Review; provides scheduling staff training; improves scheduling audit procedures; and takes actions when the audits identify deficiencies.

The Office of Inspector General for the VA said it found no evidence that the VAMC (Veterans Affairs Medical Center) director instructed supervisors or staff to enter appointment cancellations incorrectly. However, the VA OIG did find that two previous scheduling supervisors and a current director of two “CBOCs” (Community Based Outpatient Clinics) instructed staff to input clinic cancellations incorrectly as canceled by patient. This occurred as recently as February 2016. The OIG for the VA also found that staff did not consistently use the correct clinically indicated or preferred appointment date when scheduling appointments.

The response from the management appears below:

The VISN Director concurred with all six recommendations. They conferred with and determined the Office of Accountability Review is responsible for advising on administrative actions toward Senior Executive Service employees and members of a hospital’s leadership quadrad. Neither of the prior supervisors cited in this report was in a senior leadership position, and thus consideration of administrative actions does not fall within their purview. The VISN Director provided acceptable planned actions for Recommendations 3 through 6. Based on the actions taken, Recommendations 1 and 2 are closed and we will monitor the implementation of the remaining recommendations until completed.

These errors occurred despite the scandal in 2014 involving modification of scheduling dates. The VHA conducted a system-wide review of access in May and June 2014 and identified inappropriate scheduling practices or supervisors instructing schedulers to modify scheduling dates.

As reported by Breitbart News in December of 2014, a report by the Veteran Administration’s Office of Inspector General found that the VA misled both Congress and Americans about the scandal that resulted in veterans dying after being put on waiting lists. In June 2014, the FBI opened an investigation into allegations that records were being falsified and scheduling practices were inappropriate.

Breitbart Texas reported in March that one year ago in March 2015, President Barack Obama said, “It’s important that veterans know that somebody’s got their backs, and that, if there are problems, that we’re not being defensive about it, not hiding it.” In March 2016, veterans are still having to wait for medical care, and some are dying in the process.

It has been over a year since President Obama attended a veterans roundtable at a Phoenix VA medical facility where he said he had veterans’ “backs.” His visit came after scandalous reports were made public about VA wait times and scheduling report manipulations. His promises made to veterans can be found at this link to a March 13, 2015 White House press release.

In June 2014, President Obama accepted the resignation of VA Secretary Eric Shinseki and named Deputy Secretary Sloan D. Gibson as acting Secretary. As reported by Breitbart Texas’ Bob Price, “The rare display of accountability le[ft] veterans and citizens across America wondering what is next for our wounded and otherwise injured veterans who are caught up in the bureaucratic delays and possible criminal behavior of some VA administrators.”

On June 24, 2014, Breitbart News reported that CNN’s Drew Griffin, the reporter who uncovered the VA scandal, interviewed another whistleblower. The scheduling clerk at the Veterans Administration office in Phoenix said the deaths of veterans were still being covered up by changing lists of veterans who have died to make it appear that they were still alive. CNN had reported that more than 1,000 veterans may have died in the last decade because of malpractice or lack of care.

In September 2015, Breitbart News reported that the Department of Veterans Affairs Office of Inspector General (OIG) released a report revealing that about 307,000 sick veterans died while waiting for care. The report actually found that many of the veterans on the waiting list had been dead for over four years. “The report confirms the worst-case scenarios about the long VA wait times that have made news reports and sparked questions in Congress since last year,” the Breitbart article noted. Reports also revealed that “the [VA] enrollment program did not effectively define, collect, and manage enrollment data.”

On March 8, 2016, the Veterans Affairs Office of Inspector General released twelve reports on VA Health Care Systems in Texas. Seven of these revealed scheduling mismanagement that led to extended veteran wait times. Overall, they show that improper scheduling and scheduling data manipulation is ingrained throughout the VA Texas Health Care System. The reports also concluded that lack of supervision, poor training of employees, and non-centralized scheduling, are primary causes of data manipulation.

Most recently, Veterans Affairs Secretary Bob McDonald caused a scandal when he compared the wait for appointments for veterans, to long lines at Disney parks. He said, “When you go to Disney, do they measure the number of hours you wait in line or what’s important?” He added, “What’s important is: What’s your satisfaction with the experience.”

Lana Shadwick is a writer and legal analyst for Breitbart Texas. She has served as a prosecutor and associate judge in Texas. Follow her on Twitter @LanaShadwick2.

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