Average Wait For VA San Diego New Patient Care Is 44 Days

WASHINGTON — More than 57,000 veterans have been waiting 90 days or more for their first VA medical appointments, and an additional 64,000 appear to have fallen through the cracks, never getting appointments after enrolling and requesting them, the Veterans Affairs Department said Monday.

The audit showed that the wait time at VA San Diego for new patient primary care on average was 43.8 days. The average wait time for new patient mental health care was 34.5 days. The audit also reported that VA clinics in Escondido and El Centro "were flagged for further review and investigation."

In a statement, VA San Diego Healthcare System said:

The audit found that in San Diego, 94 percent of appointments were booked with a wait time of 30 days or less, but new patients had to wait an average of two weeks longer.

Established patients at the VA San Diego Healthcare System were seen within three to five days, according to the audit.

It's not just a numbers problem. Thirteen percent of schedulers in the facility-by-facility nationwide audit of 731 VA hospitals and outpatient clinics reported being told by supervisors to falsify appointment schedules to make patient waits appear shorter.

The audit is the first nationwide look at the VA network in the uproar that began with reports two months ago of patients dying while awaiting appointments and of cover-ups at the Phoenix VA center. A preliminary audit last month found that long patient waits and falsified records were "systemic" throughout the VA medical network, the nation's largest single health care provider with nearly 9 million veterans and their families as patients.

The controversy forced VA Secretary Eric Shinseki to resign May 30. Shinseki took the blame for what he decried as a "lack of integrity" through the network. Legislation is being written in both the House and Senate to allow more veterans, including those enrolled in Medicare or the military's TRICARE program, to get treatment from outside providers if they can't get timely VA appointments. The proposals also would make it easier to fire senior VA regional officials and hospital administrators.

The audit said a 14-day target for waiting times was "not attainable," given growing demand for VA services and poor planning. It called the 2011 decision by senior VA officials setting it, and then basing bonuses on meeting the target, "an organizational leadership failure."

The audit is the third in a series of reports in the past month on long wait times and falsified records at VA facilities nationwide.

Acting VA Secretary Sloan Gibson said Monday that VA officials have contacted 50,000 veterans across the country to get them off waiting lists and into clinics and are in the process of contacting 40,000 more.

A previous inspector general's investigation into the troubled Phoenix VA Health Care System found that about 1,700 veterans in need of care were "at risk of being lost or forgotten" after being kept off an electronic waiting list. While the investigation focused on Phoenix, it pointed to problems throughout the sprawling health care system. An audit of the Veterans Affairs San Diego Healthcare System found it is operating in compliance with agency standards for patient scheduling.

The report issued Monday offers a broader picture of that overall system. The audit includes interviews with more than 3,772 employees nationwide between May 12 and June 3. Respondents at 14 sites reported having been sanctioned or punished over scheduling practices.

Wait times for new patients far exceeded the 14-day goal, the audit said. For example, the wait time for primary care screening appointment at Baltimore's VA health care center was almost 81 days. At Canandaigua, New York, it was 72 days. On the other hand, at Coatesville, Pennsylvania, it was only 17 days and in Bedford, Massachusetts just 12 days. The longest wait was in Honolulu — 145 days.

But for veterans already in the system, waits were much shorter.

For example, established patients at VA facilities in New Jersey, Connecticut and Battle Creek, Michigan, waited an average of only one day to see health care providers. The longest average wait for veterans already in the system was in Fayetteville, North Carolina, a military-heavy region with Fort Bragg Army Base and Pope Air Force Base nearby.

Steps VA has taken to address patient-care scandal

Some steps the Department of Veterans Affairs has taken to address a scandal over long patient waits for care and phony records hiding delays at VA hospitals and clinics nationwide:

May 30: VA Secretary Eric Shinseki resigns, he and agency officials announce that:

— Top level agency officials will not receive performance bonuses this year;

— Employees' performance in meeting a 14-day wait-time target for patients' appointments will no longer be considered in employee job reviews. The agency found its strapped clinics were not always able to meet that goal and it was pressuring some workers to falsify wait-time information;

— Steps will be taken against officials involved in falsifying wait-time data and senior officials at facilities where audits identify problems;

— Senior officials will be removed from the VA's Phoenix facility, a focus of the department's problems.

June 4: Acting VA Secretary Sloan Gibson says agency is contacting 1,700 veterans the department's inspector general found were omitted from the Phoenix center's official waiting list and is starting to schedule appointments for them.

June 5: Gibson says retaliation won't be tolerated against agency workers who have complained about covering up of scheduling delays. Gibson makes that vow after independent federal Office of Special Counsel says it is investigating possible retribution against 37 VA employees.

June 9: The VA announces additional steps including:

— Starting to contact more than 90,000 veterans waiting for care — including 50,000 already reached — to accelerate appointments. Those without appointments or waiting more than a month are being given a choice of a VA appointment as soon as possible or seeing a local non-VA health care provider.

— Planning further investigation of 112 of the 731 VA facilities visited by agency auditors, because initial interviews with workers suggested that data on appointments may have been falsified or that employees may have been told to do so.

— Immediate hiring freeze at the VA's Veterans Health Administration office in Washington, D.C., and 21 regional Health Administration offices around the U.S.;

— Hiring extra clinical and patient-support staffers for the most overburdened VA facilities;

— Using temporary staffing measures, including mobile medical units, to accelerate care for veterans on wait lists;

— Collecting data from patients and those making initial appointments to assess their satisfaction with care;

— Starting an external audit of VA's system for scheduling appointment.

Associated Press writer Donna Cassata and City News Service contributed to this report.