Regional VA centers fingered in national audit

A nationwide audit of veterans' hospitals has flagged two facilities that serve patients in Cape Girardeau, according to the U.S. Department of Veterans Affairs.

Cited for further investigation are the Marion VA Medical Center in Marion, Illinois, and a community-based outreach clinic in West Plains, Missouri. Other regional facilities in Kansas -- the VA Medical Center in Leavenworth and the Robert J. Dole VA Medical Center in Wichita -- also are under scrutiny.

U.S. Sens. Roy Blunt, R-Mo., and Claire McCaskill, D-Mo., issued statements Monday afternoon. Blunt said the report was appalling, and McCaskill's spokeswoman, Sarah Feldman, said its information appears to be "frustratingly incomplete" and "continues to lack context."

More than 57,000 veterans nationwide have been waiting 90 days or more for their first VA medical appointments; an additional 64,000 appear never to have been granted appointments at all.

"Too many of our veterans in Missouri and across the nation have been denied adequate care for far too long," Blunt said. "I contacted the VA St. Louis Health Care System for an explanation a month ago, and still haven't received a response."

Feldman said McCaskill's office is examining the audit.

"What is clear is that some veterans are falling through the cracks, and when we're talking about men and women who've served our country in uniform, that is unacceptable," Feldman said in an email. "Claire is encouraged that potential wrongdoing is being referred to the independent watchdog, the Inspector General, for investigation. A self-audit is an important step for the VA, but Claire also remains focused on feedback provided directly by veterans, and on what is eventually found by the independent Inspector General, and she will continue to hold VA leaders accountable to both."

Nationwide, 13 percent of schedulers in the report on 731 hospitals and outpatient clinics said supervisors told them to falsify appointments to make wait times appear shorter.

The audit is the first nationwide look at the VA network since patients were reported to be dying while waiting for appointments and since cover-ups at the Phoenix VA center were revealed in May. A preliminary review last month found long patient waits and falsified records were "systemic" throughout the VA medical network, the nation's largest single health care provider serving nearly 9 million veterans.

The audit involved more than 3,772 interviews of clinical and administrative staff involved in scheduling at VA medical Centers, large community-based outpatient clinics serving at least 10,000 veterans and a sampling of smaller clinics.

Audit findings systemwide show:

* A complicated scheduling process resulted in confusion among scheduling clerks and front-line supervisors in a number of locations.

* A 14-day wait-time target for new appointments was not only inconsistently used throughout the health-care system, but was not attainable given growing demand for services and lack of planning for resources.

* Overall, 13 percent of scheduling staff interviewed indicated they received instruction to enter an appointment date different from what veterans had requested.

* Eight-percent of scheduling staff indicated they used alternatives to the official Electronic Wait List. In some cases, pressures were placed on schedulers to use unofficial lists or engage in inappropriate practices to make wait times appear more favorable, the report said.

The Associated Press contributed to this story.

rcampbell@semissourian.com

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