Manipulation of Patient Data at Veterans’ Affairs Medical Facilities

Late last week, USA TODAY published an expose of its investigation into the manipulation of patient data at Veterans’ Affairs medical facilities around the country. Following revelations about patient scheduling manipulation at the Phoenix VA uncovered in 2014, the VA Inspector General initiated probes into hundreds of VA facilities. Despite this apparent attempt by the VA at more transparency and accountability, the Inspector General appears to have been sitting on the reports and soft-pedaling their release, issuing the reports one at a time over a period of many months. In fact, about 35 investigations had been completed for a year or more, but the Inspector General released the findings only recently. The reports themselves reveal the systematic manipulation of veterans’ appointment dates at dozens of VA facilities. At many of the facilities under investigation, the culture of falsifying veteran wait times was deep-seated and had been ongoing for years. Similar to the Phoenix VA scandal, the Inspector General’s reports demonstrate that at nearly half of the VA facilities subject to the probes, VA appointment schedulers and their supervisors were actively “zeroing out” appointment wait times to give the appearance that those facilities were meeting VA metrics designed to provide veterans with faster access to necessary medical care. In many cases, VA employees manipulated wait times by misrepresenting veterans’ actual appointment dates as their “desired” appointment dates to give the false appearance that veterans were being seen within the VA’s required wait time. In other cases, appointment schedulers simply canceled and rebooked appointments to show shorter wait times. And still in other instances, VA employees were cancelling appointments altogether and keeping paper lists of patients who would only be scheduled when appointments might become available. If you or a family member were lost to follow up in the VA appointment system, had difficulty getting timely appointments, or unexpectedly had visits canceled and rescheduled, then chances are there is a possibility that you may have been subject to the VA’s culture of scheduling manipulation. Despite the health consequences and cost to human life that this sort of misrepresentation undoubtedly has had, you probably will not be surprised that learn that virtually no one at the VA facilities under investigation lost their jobs as a result of these findings. Consistent with the typical bureaucratic response to a problem, there was a lot of “retraining” but almost no firings or employee discipline. So far, it is too early to know how many VA patients were negatively impacted by this latest scandal and it remains unclear what the fallout will be, but you will recall that at the Phoenix VA alone, there were dozens of deaths linked to the scheduling manipulation. If you are curious about whether your VA hospital was involved, you can check for yourself here to see which facilities were caught cooking their books.