A long-awaited internal investigation has found that Department of Veterans Affairs scheduling clerks throughout Central Texas masked the true nature of wait times at hospitals and clinics in the region by inputting false appointment data.
More than 20 VA employees, from San Antonio to Kerrville to Austin, told investigators they engaged in the practice, according to a report released this week. Several said supervisors instructed them to manipulate the data and that they feared being fired if they did not participate.
According to the investigation, one former scheduling clerk at the Austin Outpatient Clinic said she “was taught to manipulate the desired date by one of the supervisors and another employee. After moving to another facility, she was again trained to make the patient wait times equal zero.”
Another scheduler in Kerrville said “a former VA supervisor threatened to fire her if she did not make the wait times equal zero.” The practice involved logging patients’ desired appointment dates to sync with appointment openings.
Despite the findings, the VA Office of Inspector General did not find executives ordered the data manipulation. Instead, the report noted that “numerous employees opined that there was no malicious intent by any employee to defraud or mislead anyone regarding wait times. Many individuals indicated problems with scheduling ranged (sic) from improper training, lack of supervision, to non-centralized scheduling.”
In a letter sent to congressional offices and released to the media late Wednesday, local VA officials hailed the report as vindication, writing that “it is important to note that OIG has not substantiated any case in which a VA senior executive or other senior leader intentionally manipulated scheduling data.”
The investigation was sparked by allegations of data manipulation in Central and South Texas made by a San Antonio scheduling clerk in the spring of 2014, part of a wave of allegations that convulsed the VA over accusations of lack of transparency and resulted in the resignation of former VA secretary Eric Shinseki.
Earlier this month, the OIG began releasing the results of investigations into scheduling practices across the nation. The federal Office of Special Counsel has complained that at least two investigations were “incomplete” and “failed to respond” to issues raised by whistleblowers.
Local VA leaders said that despite the lack of “intentional wrongdoing,” the OIG report shows “the need for standardized training on scheduling.” All employees involved in scheduling have been retrained, they said.
Several Central Texas supervisors told investigators the data manipulation was the result of “bad habits” of schedulers. One San Antonio administrators said “the concept of scheduling errors seemed to confuse schedulers.” The administrator “stated that there was pressure to get patients seen in a timely manner but there was no pressure to manipulate the data,” the report said.
Investigators also determined that no VA employee received a bonus or award related “specifically” to wait time measures.
Yet the report found data manipulation was widespread in San Antonio, Kerrville and the Austin clinic, where “almost all schedulers and clinics had zero wait times.”
Several schedulers said they feared ending up on what one scheduler called a “hit list” if they scheduled appointments with wait times longer than 14 days.
“In order to make sure her name was not on the list, she stated she would make the wait time equal zero,” the report said of a San Antonio scheduler.
In response to the growing scandal in 2014, Congress approved $16.3 billion to pay for new staff and facilities and pay for private sector care for veterans facing long waits. In Central Texas, the money helped fund 118 new positions — a mix of medical providers and support staff.
Last year, VA numbers showed that the rate of delayed appointments was falling in Austin, but remained higher than the national average.
Corry Schiermeyer, a spokeswoman for U.S. Rep. John Carter, R-Round Rock, said the congressman “continues to pressure the VA leadership… and will continue to do so until real reform is made.” Last year, Carter called on the FBI to investigate the VA hospital in Temple over abuse and misconduct, and is seeking an update, Schiermeyer said.
The VA OIG also dismissed several other allegations in reports released Wednesday, including a claim that the chief of imaging services for the Central Texas VA manipulated appointment times for radiological studies and that a home-based primary care program in San Antonio prohibited the use of an electronic wait list, which theoretically could reveal long wait times.
WHAT WE REPORTED
In 2014, the Statesman detailed allegations from a Department of Veterans Affairs scheduling clerk, who said that VA leadership in Central Texas had directed schedulers to manipulate wait-time data at local medical facilities by inputting false appointment dates.
The story, and subsequent Statesman coverage of other VA whistleblower claims, sparked the probe by the VA’s office of inspector general into local medical centers and calls for a wider investigation of VA scheduling practices in Texas by two dozen members of the state’s congressional delegation. The coverage was part of nationwide media coverage that led to the resignation of VA Secretary Eric Shinseki.