Delaying medical care to veterans and manipulating records to hide those delays is "systemic throughout" the Department of Veterans Affairs health system, the VA's Office of Inspector General said in a preliminary report Wednesday.
"Our reviews at a growing number of VA medical facilities have thus far provided insight into the current extent of these inappropriate scheduling issues throughout the VA health care system and have confirmed that inappropriate scheduling practices are systemic throughout VHA," the report says.
Investigators with the Inspector General's Office said their probe into charges of delays in health care at a hospital in Phoenix shows that the care of patients was compromised.
In response to the interim report, the chairman of the House Veterans' Affairs Committee, Rep. Jeff Miller, R-Fla., called on VA Secretary Eric Shinseki to immediately resign and asked Attorney General Eric Holder to investigate "widespread corruption" at the VA.
"It's time for him (Shinseki) to go," Miller said.
Some 1,138 veterans had been waiting longer than six months just to get a appointment to see their primary doctors, investigators found.
The office was called in to investigate following allegations by a retired VA doctor in Phoenix who said medical personnel kept secret lists of veterans whose appointments had been delayed. The physician alleged that up to 40 veterans had died awaiting care.
"Our reviews have identified multiple types of scheduling practices that are not in compliance with policy," the interim report said.
The medical care of some 1,700 veterans may have been affected by the way waiting times were manipulated, the report said. The Inspector General's Office urged Shinseki to "take immediate action" to provide these veterans with timely health care.
Evidence is mounting that the problems of delays in patient care are more systematic than Shinseki has indicated.
Investigators said they are now looking into 42 medical facilities in connection with health care delays, the number rising sharply from 26 last week and 10 the week before that.
The Inspector General's Office said it is working with the Justice Department to determine if crimes occurred in how patients were handled.
Investigators found "multiple lists" that may be the basis for so-called "secret" waiting lists that the doctor, Sam Foote, alleged had been created.
The investigators said that while health care quality was affected, they are not reporting findings on whether patients were harmed by the delays.
"We are not reporting the results of our clinical reviews in this interim report on whether any delay in scheduling a primary care appointment resulted in a delay in diagnosis or treatment, particularly for those veterans who died while on a waiting list," the report says.
Investigators said that since launching the probe, they have received "receive numerous allegations daily of mismanagement, inappropriate hiring decisions, sexual harassment and bullying behavior by mid- and senior-level managers at this (Phoenix) facility. "These claims were reported either to investigators arriving at the hospital or on the inspector general's hotline.
At the time Shinseki asked the office to investigate the Phoenix facility, he placed the hospital administrator and two top officials there on administrative leave. Shinseki said he did so at the request of the inspector general.
The Inspector General's Office said the problems it is finding are not new, that the office has issued 18 reports dating to 2005 documenting delays in treating veterans at some of the agency's 150 hospitals and 820 clinics, and detrimental health impact these delays have had on these patients.
"It appears that a significant number of schedulers are manipulating the waiting times of established patients," the report says.
The report outlines problems found at other hospitals, evidence that supported the Inspector General Office's conclusion that the manipulation of records and delay of patients is a systemic problem for the department, the nation's largest healthcare system serving nearly 9 million veterans.
One of the schemes to hide wait times involved scheduling supervisors who would review reports concerning cases where patients were waiting longer than 14 days. In those instances, supervisors instructed schedulers "to review these reports and 'fix' any appointments greater than 14 days." This meant changed dates on files, the investigators said.
In other cases, where doctors had sent veterans to a specialist to look into an area of treatment concern, schedulers merely deleted these appointments if they were pending for too long without checking with the veteran or a doctor.