Managers at more than a dozen Veterans Affairs medical facilities lied to federal investigators about scheduling practices and other issues, the department's inspector general said Tuesday.
Richard Griffin, the VA's acting inspector general, said his office is investigating allegations of wrongdoing at 93 VA sites across the country, including 12 reports that have been completed and submitted to the VA for review.
"The rest are very much active," Griffin told the Senate Veterans Affairs Committee on Tuesday.
Griffin's office has been investigating VA hospitals and clinics across the country following reports of widespread delays that forced veterans in need of medical care to wait months for appointments. Investigators have said efforts to cover up or hide the delays were systemic throughout the agency's network of nearly 1,000 hospitals and clinics.
While incomplete, Griffin provided the panel with a snapshot of the results so far.
Managers at 13 facilities lied to investigators about scheduling problems and other issues, he said, and officials at 42 of the 93 sites engaged in manipulation of scheduling, including 19 sites where appointments were cancelled and then rescheduled for the same day to meet on-time performance goals.
Sixteen facilities used paper waiting lists for patients instead of an electronic waiting list as required, Griffin said.
Lying to a federal investigator is a federal crime, although Griffin said no one at the VA has been charged with a crime. The FBI and Justice Department are investigating allegations of wrongdoing at the Phoenix VA and other sites.
Griffin was testifying on an investigative report by his office on delays in patient care at the troubled Phoenix veterans' hospital, where a whistleblower first exposed long delays and falsified waiting lists. A resulting scandal led to the ouster of former VA Secretary Eric Shinseki last spring.
The Aug. 26 report said workers at a Phoenix VA hospital falsified waiting lists while their supervisors looked the other way or even directed it, resulting in chronic delays for veterans seeking care. The inspector general's office identified 40 patients who died while awaiting appointments in Phoenix, but the report said officials could not "conclusively assert that the absence of timely quality care caused the deaths of these veterans."
Investigators identified 28 patients who experienced "clinically significant delays in care" that negatively affected the patients, Griffin said. Of those patients, six died, he said. In addition, the report identified 17 patients who received poor care that was not related to delays or scheduling problems, Griffin said. Of those patients, 14 died.
Three high-ranking officials at the Phoenix facility have been placed on leave while they appeal a department decision to fire them.
Griffin said the report by his office provides the VA with "a major impetus to re-examine the entire process of setting performance expectations for its leaders and managers" throughout the system.
Griffin also defended the independence of his office and the report's findings.
Sen. Dean Heller, R-Nev., asked Griffin if the VA had requested that the IG's office insert a sentence into the final report that said investigators could not "conclusively assert" that delays in care caused any patient deaths. The statement appeared to deflate an explosive allegation that helped launch the scandal in the spring — that delays may have resulted in patient deaths — and some Republican lawmakers have questioned whether the statement was intended to protect or exonerate the VA.
Griffin sharply disputed that.
"No one in VA dictated that sentence go in that report, period," he said.
It is common practice for an inspector general to send a copy of its findings to the agency in question to elicit an official response, which is then included in the final report. Griffin said his office has a policy of making no substantial changes to reports after allowing the VA to inspect and comment.
"Our job is to speak truth to power, and our record reflects that is what we have always done," he said.
Veterans Affairs Secretary Robert McDonald called the IG report troubling and said the agency has begun working on remedies recommended by the report.
"I sincerely apologize to all veterans who experienced unacceptable delays in receiving care at the Phoenix facility, and across the country," McDonald said Tuesday. "We at VA are committed to fixing the problems and consistently providing the high quality care our veterans have earned and deserve in order to improve their health and well-being."
The VA has reached out to all veterans on official and unofficial waiting lists at the Phoenix hospital, McDonald said.
The Phoenix hospital has hired 53 additional full-time employees in recent months as officials move to address a patient backlog that resulted in chronic delays for veterans seeking care, McDonald said. Officials completed nearly 150,000 appointments at the hospital in May, June and July, McDonald said, a significant increase over previous years.
In all, the VA has reached out to more than 266,000 veterans nationwide to get them off waiting lists and into clinics, McDonald said.
McDonald on Monday unveiled what he called a three-point plan to rebuild trust among veterans, improve service delivery and set a course for the agency's long-term future. The plan should be implemented by Veterans Day, Nov. 11, he said.