Inspector General: VA Schedulers ‘Zeroed Out’ Wait Times for Texas Veterans Seeking Health Care

Barbara Hollingsworth | March 23, 2016 | 12:18pm EDT
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The Michael E. DeBakey VA Medical Center in Houston, Texas. (US Dept. of Veterans Affairs)

(  -- An investigation by the inspector general of the U.S. Department of Veterans Affairs (VA) “substantiated” reports that schedulers at the VA Medical Center (VAMC) in Houston, Texas “zeroed out” patient wait times between 2010 and 2014 in order to make it appear that veterans were being seen by healthcare professionals during the standard 14-day time period.

“Interviews of [25 current and former] schedulers in all three services disclosed that clerks had been trained to schedule by using the patients’ actual appointment date as their desired date,” a March 8 report by Quentin Aucoin, assistant inspector general (IG) for investigations at the VA, revealed.

“If an appointment was not available on the patient’s desired date, then the clerks were instructed to use the actual appointment date as the desired date. The clerks did this by ‘going out of the system and going back in’, so as to reflect that the desired date and the appointment date was the same, thereby zeroing out the wait time,” the report stated.

A former Primary Care supervisor told inspectors that “if clerks were scheduling patients outside of the 14-day time frame, they could be ‘written up’, which he later defined as written counseling,” the IG report stated.

Another VA employee said that “the desired date and the actual appointment day always had to be zero, and that if they failed to do this, their name would appear on ‘a list’.”

One supervisor “denied that she ever instructed anyone to do this,” the IG reported. “She agreed that the guidance may have been misinterpreted by some clerks, but emphasized it was never her intention or direction that wait times should be zeroed out.”

Other VA officials also denied telling staff to “zero out” wait times.

VA Secretary Robert McDonald. (US Dept. of Veterans Affairs)

“The senior manager in Primary Care stated that…wait time measures were seen as goals, not as mandates…

"He agreed that manipulating data in order to meet a performance measure is unacceptable, and he stated that had this practice come to his attention, he would have corrected his staff.”

A Mental Health Care manager admitted “in retrospect, the statistics did not seem realistic to her and the statistics were not representative of what was actually happening at the time with regard to the challenges they were facing in terms of access and patient wait times," according to the report.

"However, she pointed out that the statistics were not generated by her, but were instead provided to her by her administrative staff.”

After acknowledging that “she was ultimately responsible for ensuring that her staff are scheduling properly,” the manager “denied instructing anyone on her staff to zero out wait times,” the IG noted.

The facility’s director also denied instructing clerks to “zero out” wait times. “He stated that he never reviewed any data, which would have led him to believe that wait times were being manipulated in any way”.

However, “a review of scheduling data obtained by the VA OIG Investigative Data Systems and Analysis Division revealed that during the years 2010 through 2014, nearly all Houston VMAC Primary Care, Mental Health, and Dental Service appointments were scheduled to show zero-wait time by making the desired date match the appointment date. This was done pervasively in almost all cases and by all schedulers,” the IG report stated.

“We remain troubled that the VA continues to fail to provide timely health care to our nation’s veterans, despite receiving enhanced authorities and funding from Congress to hire new employees and address additional problems facing the VA,” Texas Gov. Greg Abbott and U.S. Senators John Cornyn and Ted Cruz said in a March 17 letter to VA Secretary Robert McDonald.  

 “These ongoing scheduling problems clearly evidence failures of leadership at senior levels of these Health Care Systems in Texas and, more broadly, within the Veterans Health Administration,” the letter continued.

“Our veterans have fulfilled their solemn duty to the nation, and the VA has an obligation to provide them with timely, high-quality health care.”

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