VA scandal: Houston system also manipulated wait times

More than two years after a scandal involving manipulated wait times at the Phoenix Veterans Affairs system led to the resignation of then-VA Secretary Eric Shinseki, a report from the VA’s Office of Inspector General uncovered similar malfeasance within the Houston system.

At Houston facilities, staff obscured long wait times by improperly canceling more than 200 appointments and rescheduling them. On average, the actual appointment took place three months later than the documentation shows, even as official VA records showed wait times of zero days in many cases. Of nearly 400 appointments the OIG investigated, 223 were mishandled, with staff frequently rescheduling based on lack of clinic or hospital availability, but marking the cancellation or rescheduling as the result of a patient request. Four appointments cancelled by the VA were never rescheduled.

The order to rig the data came from three midlevel managers and continued as recently as February of this year, according to the OIG. The investigation found no evidence of misconduct by top-level managers. While the department recommended disciplinary action against the three managers, those managers’ superiors declined to do so in April, blaming outdated software. The software is both difficult to navigate and largely obsolete, they told OIG inspectors.

"The complex, antiquated  nature of the scheduling software makes it exceedingly  difficult for any employee to navigate proficiently 100 percent of the time," they said, according to the report. "This problem is further magnified because the Medical Support Assistants who are required to use this system to schedule, reschedule and cancel appointments comprise a large population of often inexperienced, entry-level employees." 

“These conditions persisted because of a lack of effective training and oversight. As a result, [the VA’s] recorded wait times didn’t reflect the actual wait experienced by the veterans and the wait time remained unreliable and understated,” the report states. Indeed, many employees the OIG interviewed didn’t seem to understand their error, according to the article, and employee training and auditing procedures didn’t account for many of the issues.

- read the report (.pdf)