OIG Wait Time Report 2016

8/16/2019 OIG Wait Time Report 2016

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VA OIG Wait Time

ReportsAs of 19 May 2016

The Department of Veterans Affairs, Office of Inspector General (OIG), conducted extensive

work related to alleations of wait time manipulation after the alleations at the !hoenix VA"ealth #are $%stem in April &'* $ince that event and throuh fiscal %ear &'+, the% received

numerous alleations related to wait time manipulation at VA facilities nationwide from veterans,VA emplo%ees, and em-ers of #onress that were investiated -% OIG criminal investiators*

As the VA OIG stated at #onressional hearins, at this time the% have completed .. criminal

investiations related to wait times and provided information to VA/s Office of Accounta-ilit%0eview for appropriate action* It has alwa%s -een their intention to release information

reardin the findins of these investiations at a time when doin so would not impede an%

planned prosecutive or administrative action* OIG -ean a rollin pu-lication of these

administrative summaries of investiation -% state so that veterans and #onress have a

complete picture of the work completed in their state* Their we-sitewww*va*ov1oi1pu-lications1administrative2summaries2of2investiation*asp lists all reports in

state se3uence* As additional reviews are completed1reported this attachment will -e updatedaccordinl%* 4ollowin is a summar% of the investiations in state order as reported to date5

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Alabama

VAMC Tuscaloosa A ! OIG Wait Time Report

This investiation was initiated -ased on alleations received throuh the Department of Veterans Affairs (VA)

Office of Inspector General (OIG) "otline from an anon%mous source claimin that clerks in the !rimar% #are

#linics at the VA edical #enter (VA#) in Tuscaloosa, A6, were -ein instructed to contact veterans to cancel

and reschedule appointments in order to improve the appearance of access to care*

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http://www.va.gov/oig/publications/administrative-summaries-of-investigation.asphttp://www.va.gov/oig/publications/administrative-summaries-of-investigation.asp


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The report/s conclusion noted that their investiation found that several individuals claimed the $A wrote the

names of esta-lished veterans who were -ein transferred from one ental "ealth #linic to another, on a separate

paper list, and then scheduled an appointment for a later date7even thouh the $A denied maintainin a paper list

when interviewed* !rior to VA OIG/s involvement, the VA# Tuscaloosa senior leadership initiated a fact2findin

in3uir% that confirmed that this had occurred* The interviews revealed there did not appear to -e an% kind of

uidance from immediate supervisors and service line chiefs1manaers to VA# Tuscaloosa emplo%ees reardin

VA policies for schedulin* The supervisors could not clearl% articulate the schedulin directives outlined in V"ADirective &''2'&., dated 8une 9, &''* The investiation did not find an% evidence that senior leadership was

aware of the inappropriate schedulin practices* The OIG referred the 0eport of Investiation to VA/s Office of

Accounta-ilit% 0eview on $eptem-er &:, &'+* The entire report is availa-le at

http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'29;*pdf * uentin G* Aucoin

= arch ?, &'? @@

Ari"o#a

VA C$OC a%e &a'asu City( A) ! OIG Wait Time Report

This investiation was initiated in response to a letter sent to $enator 8ohn c#ain -% a Department of Veterans

Affairs (VA) emplo%ee allein medical, administrative, and clerical violations, includin Bpaper scheduled

appointments,C at the VA #ommunit% ased Outpatient #linic (#O#) in 6ake "avasu #it%, AE* The report

conclusion revealed that the Bpaper schedulinC alleed -% the complainant was actuall% an encounter form iven to

patients to provide to an $A for current appointment and next appointment information* The investiation did not

reveal that an% #O# 6ake "avasu #it% personnel were keepin separate schedulin lists and also determined that

the alleed Bclerical violationsC were in fact a misunderstandin -etween the complainant and other emplo%ees* The

OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 4e-ruar% &?, &'+* The entire

report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'29*pdf * uentin G* Aucoin = arch 9, &'? @@

Ar%a#sas

VAMC ittle Roc% AR ! OIG Wait Time Report

This investiation was initiated pursuant to information received from a whistle-lower complaint to the Office of

$pecial #ounsel, allein inappropriate schedulin practices at the Department of Veterans Affairs edical #enter

(VA#), 6ittle 0ock, A0*

The report/s conclusion noted that the investiation su-stantiated that -oth non2supervisor% and supervisor%

VA# emplo%ees were improperl% schedulin patient appointments -% manipulatin the appointment dates in the

VA computer s%stem, resultin in the appearance of sinificantl% lower wait times for veterans/ clinical

appointments*

Two VA# supervisor% emplo%ees displa%ed a lack of candor while makin statements to special aents of VA

Office of Inspector General reardin their knowlede and1or participation in the manipulation of patient waitin

times* This was -ased on testimonial evidence and a review of email* The OIG referred the 0eport of Investiation

to VA/s Office of Accounta-ilit% 0eview on 4e-ruar% &, &'+* The entire report is availa-le at

2

http://www.va.gov/oig/pubs/ims/wait-times-14-02890-193.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-02890-193.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-02890-191.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-02890-193.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-02890-191.pdf


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http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'29.*pdf * uentin G* Aucoin

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Califor#ia

VAMC os A#*eles CA ! OIG Wait Time Report

An investiation was initiated -ecause a "ouse #ommittee on Veterans/ Affairs staffer referred a complaint from an

emplo%ee at the 6os Aneles Am-ulator% #are #enter (6AA##) who reported that a medical support assistant

($A) supervisor was involved in inappropriate schedulin practices* The emplo%ee alleed that the supervisor

printed out a list of patient appointments and was in the ha-it of reschedulin an% appointment with a wait time

exceedin da%s, in a s%stemic effort to misrepresent wait times -% makin them appear lower*

The report/s conclusion noted that the alleation that $!$ was accessin the VistA schedulin s%stem andreschedulin patients in violation of VA polic% was su-stantiated* Althouh this was an intentional deviation from

VA polic%, the investiation did not su-stantiate that this was -ein done specificall% to manipulate data in order to

artificiall% lower wait times* VI$F && investiated the alleations -efore the VA OIG investiation and took

corrective action* VA OIG Administrative $ummar% 2'&:9'2&;? :* The OIG referred the 0eport of Investiation

to VA/s Office of Accounta-ilit% 0eview on Auust 9, &'+* The entire report can -e accessed for review at

http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&;?*pdf *


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&&*pdf the entire report can -e accessed for review* uentin G* Aucoin = arch

;', &'? @@

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VAMC -a# .ie*o CA ! OIG Wait Time Report

This investiation was -ased on two complaints filed with the Department of Veterans Affairs (VA) Office of

Inspector General (OIG) "otline in a% &' allein misconduct and manipulation of the Bdesired datesC -%

medical support assistants ($As) at the VA edical #enter (VA#) in $an Dieo and its #ommunit% ased

Outpatient #linics (#O#s)* OIG investiated -oth alleations simultaneousl% as the% related to the same issues*

The report/s conclusion noted that interviews, alon with the anal%sis of schedulin data pulled from VistA,

revealed man% $As were initiall% alterin the desired dates of patients or schedulin veteran appointments with

ero2da% wait times* Testimonial evidence from multiple $As reardin the AO/s involvement in directin

manipulation of wait times and anal%sis results from schedulin reports contrasted sharpl% with the AO/s denials

of responsi-ilit%* In addition, emails from a "ealth !roram anal%st sent to $As included specific instructions to

ero out wait times if patients did not wish to chane to an earlier appointment* These instructions explicitl% violated

V"A $chedulin Directive &''2'&.* The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit%0eview on arch :, &'+* At http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&.*pdf the entire report can

-e accessed for review*


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VAMC .e#'er CO /pate 03 ! OIG Wait Time Report

OIG has released another Jait time 0eport on VA# Denver #olorado* A summar% of the report is included -elow

and in the updated BVA OIG Wait Time ReportsC attachment to this newsletter*

This investiation was initiated followin media outlets reportin that a former Department of Veterans Affairs (VA)

emplo%ee alleed that the VA edical #enter (VA#) Denver, #O, had kept, or was keepin, a Bsecret wait listC of

patients who were waitin to -e seen and treated at the VA# Denver $leep edicine #linic* Durin the news

-roadcasts, it was alleed that in &'&, the VA emplo%ee was iven a cop% of a manual list of names and told to

transfer the names to the VA/s Klectronic Jait 6ist (KJ6)* As a result of the alleation, the director of VA/s 0ock%

ountain Fetwork asked that an Administrative oard of Investiation (AI) -e convened to look into the matter*

In addition to the $leep edicine #linic alleation, AI was also chared with lookin into a complaint related to

alleed inappropriate schedulin lists in the ental "ealth and Audiolo% #linics and !rosthetics $ervice* In

addition to past practices, AI was also tasked to investiate an% evidence of inappropriate current practices*

The conclusions reached -% the -oard appeared to -e Hustified and appropriate* The -oard/s composition,

includin a mem-er from the V#, also appeared to -e a ood faith effort to examine the issue fairl%* Once VA OIG

determined that the AI review results provided reasona-le assurance that schedulin issues were -ein manaed

effectivel%, we did not duplicate the review performed -% the AI* The OIG referred the 0eport of Investiation to

VA/s Office of Accounta-ilit% 0eview on 4e-ruar% &., &'?* uentin G* Aucoin =

arch 9, &'? @@

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VAMC Gra# 4u#ctio# CO /pate 01 ! OIG Wait Time Report 5#oscopy Cli#ic

An investiation was initiated -ased upon information o-tained from the Department of Veterans Affairs (VA)

Access Audit2$%stem2Jide 0eview of Access* Jhile conductin this audit, VA staff interviewed emplo%ees at theGrand 8unction, #O, VA edical #enter (G8VA#)* The emplo%ees who were interviewed -% VA staff were not

identified* One interviewee told the VA audit team that a spreadsheet was -ein used -% the G8VA# Kndoscop%

#linic to track appointments* This statement led to concerns that the spreadsheet miht -e an inappropriate

schedulin tool, thus trierin an Office of Inspector General (OIG) investiation*

The report/s conclusion noted that their investiation su-stantiated that a spreadsheet was -ein maintained in the

G8VA# Kndoscop% #linic -ut was not used for schedulin appointments* 0ather, the spreadsheet was used to

capture data for trackin purposes onl%* The spreadsheet captured patient information from various consults from the

time patients were referred -% a !rimar% #are provider to the time of the actual endoscop% procedure* The

spreadsheet was featured as part of a V"A national colla-orative and was considered a trackin measure worth% of

consideration -% V"A for use as the national -enchmark* The OIG referred the 0eport of Investiation to VA/s

Office of Accounta-ilit% 0eview on $eptem-er &, &'* At http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2

&+*pdf he entire report is availa-le* uentin G* Aucoin = arch ., &'? @@

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VA M-OC ort Colli#s CO ! OIG Wait Time Report

0efer to VA# #he%enne JL

5

http://www.va.gov/oig/pubs/ims/wait-times-14-02890-215.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-02890-215.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-02890-215.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-02890-215.pdf


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Co##ecticut

VAMC West &a'e# CT /pate 07 ! OIG Wait Time Report

This investiation was initiated -% a news report, which ran in #onnecticut on television station JTF", allein

that a veteran was denied certain VA care followin a -reast cancer dianosis and ultimatel% resultin in the

veteran/s developin ovarian cancer* The veteran claimed her appointments were scheduled and then canceled for

unknown reasons and, conse3uentl%, she ended up with a cancer that could have -een prevented* Another sement of

the same news report featured an interview with a former Department of Veterans Affairs edical #enter (VA#)

emplo%ee whose identit% was kept anon%mous and who descri-ed the VA schedulin process as d%sfunctional* 4or

example, a scheduler would -e handed a stack of patient files and told to cancel more than a third of their associated

appointments without knowin the details of each case*

The report/s conclusion noted that their investiation did not su-stantiate the claims made in the JTF" news stor%*

The anon%mous former VA# emplo%ee interviewed in the news stor% was determined to have -een an emplo%ee

at a different facilit% from 99& to &''' and had no information concernin current VA schedulin practices* A

review of the veteran/s records failed to show a connection -etween an% cancellations of appointments and thespread of her cancer* The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on

Octo-er ?, &'* The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&+:*pdf *


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• A separate list of ehavioral "ealth patients at #O# Dover, a folder of return2to2clinic routin slips

reardin the recall list at #O# Dover, and a list of Orthopedic patients re3uestin Hoint replacement

surer%, which oriinated from VA# Jilminton*

Fone of the aforementioned lists were identified as havin -een maintained as a result of wait time manipulation

or other malevolent purposes* In addition, all identified lists have -een addressed -% VA# Jilminton and no

specific patient harm was identified as a result of keepin the aforementioned* The entire report is availa-le athttp511www*va*ov1oi1pu-s1ims1wait2times22';&:2+:*pdf * uentin G* Aucoin

= arch ;, &'? @@

loria

VA O,C Tallaassee /pate 07 ! OIG Wait Time Report

This investiation was initiated pursuant to information received from a former Tallahassee emplo%ee who

previousl% worked as a edical Administration $ervices (A$) clerk at the VA Outpatient #linic (O!#) inTallahassee, 46* The complainant stated that he had information that edical Administration $ervices (A$) clerks

at the O!# in Tallahassee were purposel% manipulatin the patient Bdesired dateC for an appointment in Veterans

"ealth Information $%stems and Technolo% Architecture (VistA) to reflect the actual date of the appointment,

versus the desired date, when the two dates were reater than da%s apart* In addition, information was provided

-% another VA emplo%ee that a paper waitin list was self2reported on a% &;, &', -% a dietician, O!#

Tallahassee, for a proram called Be Active and ove*C

The report/s conclusion noted that the investiation confirmed that several emplo%ees at O!# Tallahassee were

improperl% enterin scheduled appointments and improperl% inputtin the desired dates* It was further determined

that the emplo%ees had all received the proper trainin as to the correct method, -ut were makin unintentional

errors* Once the in3uir% took place and their supervisors -ean implementin the proper procedures, these

emplo%ees felt that the supervisors were possi-l% coverin up these schedulin actions that were previousl% doneimproperl%* "owever, there was no evidence to support this -elief* The emplo%ees who reported inconsistencies in

schedulin practices represent less than &+ percent of the emplo%ees responsi-le for schedulin* The trainin records

and Ho-

descriptions documented that these emplo%ees had -een instructed on the proper procedures* All of the other

emplo%ees and supervisors interviewed were schedulin and enterin the desired dates in accordance with V"A

polic%*

The dietician who was maintainin the paper wait list, for the e Active and ove proram, was corrected -% a

supervisor, and all of the participants were scheduled into VistA immediatel%* The paper waitin list for the e

Active and ove proram was determined to -e a list maintained -% a dietician who dela%ed schedulin the

participants properl% until the class was ; weeks awa% from occurrin* This was done so that the dietician could call

and make sure the participants still wanted to attend the class -efore the% were entered into the s%stem* The entirereport is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2;?*pdf * uentin G* Aucoin = 4e-ruar% &?, &'? @@

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VA C$OC -t: Au*usti#e ! OIG Wait Time Report

A senior manaer, Forth 4lorida1$outh Georia Veterans "ealth $%stem (F41$G V"$), notified the Department of

Veterans Affairs (VA) Office of Inspector General (OIG) that a paper waitin list was -ein used at the #ommunit%

7



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ased Outpatient #linic $t* Auustine, 46* The senior manaer o-tained the list from an emplo%ee at this location

who self2reported that she was maintainin it* The OIG referred the 0eport of Investiation to VA/s Office of

Accounta-ilit% 0eview on $eptem-er :, &'* The report/s conclusion noted that the investiation determined that

the emplo%ee did not violate an% Veterans "ealth Administration directives* The entire report is availa-le for review

at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&*pdf uentin G*

Aucoin = 4e-ruar% &?, &'? @@

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VA O,C .ayto#a $eac ! OIG Wait Time Report

This investiation was initiated after the Department of Veterans Affairs (VA) Office of Inspector General (OIG)

received alleations that clerks at the Outpatient #linic (O!#) Da%tona each were deletin consults without

checkin with the ph%sicians, resultin in patients not -ein seen* In addition, the VA OIG "otline received an

anon%mous complaint allein excessive wait times for new patients and that performance o-Hectives were linked to

leaders/ compensation which could lead to potential misconduct at the VA edical #enter (VA#) in Orlando, 46*

The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on $eptem-er :, &'*

Interviews from -oth the VA# Orlando and the O!# Da%tona each disclosed that althouh the emplo%ees

were not deletin consults without first discussin the situation with a ph%sician, emplo%ees were manipulatin the

KJ6 to show a reduced wait time for veterans consults* Our investiation did not show an% evidence that this was

done at the direction of VA# manaement* The alleation of excessive wait times was not su-stantiated at the

VA# OrlandoM however, there were access to care issues identified at the O!# Da%tona each that fall under the

administrative control of the VA#* The director of the Orlando VA# was aware of the memo, Inappropriate

$chedulin !ractices* The OIG/s review of patient records did not su-stantiate the alleation of harm to patients*

The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2;*pdf * uentin G* Aucoin = 4e-ruar% &?, &'? @@

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VA+O,C 4ac%so#'ille ! OIG Wait Time Report

This investiation was initiated pursuant to information received throuh the Department of Veterans Affairs (VA)

Office of Inspector General (OIG) "otline* A complainant alleed that emplo%ees at the Outpatient #linic (O!#)

8acksonville !rosthetics Department had -een instructed to create a new consult for prescription e%elasses in the

Veterans "ealth Information $%stems and Technolo% Architecture (VistA), the VA/s schedulin s%stem, if more

than ;' da%s had elapsed from the time the patient received a prescription for e%elasses to the time the veteran

acted on the prescription* The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on

$eptem-er :, &'*

The report/s conclusion noted that the investiation confirmed that !rosthetic emplo%ees at VA# Gainesville

and its affiliated institutions had -een instructed -% his manaers to recreate consults in lieu of clonin them per the

-usiness practice uidelines* Durin interviews, -oth !rosthetics manaers stated that the% made a decision at their

level to have emplo%ees create new consults in lieu of clonin them* The entire report is availa-le athttp511www*va*ov1oi1pu-s1ims1wait2times22';';2&:*pdf * uentin G*

Aucoin = 4e-ruar% &?, &'? @@

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VA C$OC Maria##a ! OIG Wait Time Report

8

http://www.va.gov/oig/pubs/ims/wait-times-14-02890-124.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-02890-124.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-02890-134.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-03403-128.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-03403-128.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-02890-124.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-02890-134.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-03403-128.pdf


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The investiation was conducted in response to three separate complaints5

• A confidential complainant informed a Department of Veterans Affairs (VA) Office of Inspector General

(OIG) emplo%ee that the VA edical #enter (VA#) Jest !alm each enaed in BaminC veterans/

desired dates for appointments*

• Another confidential complainant, who is a veteran and an emplo%ee, confirmed that schedulers use the

Bnext availa-le dateC as a veteran/s Bdesired dateC for an appointment*• A third anon%mous complainant contacted the VA OIG "otline in 8une &' and alleed that the chief of

staff and the director at the VA# Jest !alm each pressured edical Administration $ervice (A$)

staff and the chief of A$ to adHust the patients/ desired appointments for astrointestinal (GI) test consults

-ecause these patients were waitin for appointments -e%ond the ;'2da% measure and this would cause a

decrease in manaement/s -onuses*

The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on $eptem-er &9, &'*

The report/s conclusion noted that the investiation su-stantiated that A$ schedulers were usin the clinic/s next

availa-le date as a veteran/s desired date and chaned appointments that fell outside of the 2da% desired date

polic% outlined in V"A Directive &''2'&.* $chedulers did not understand the overall effect of amin access on

department resource allocations* A review of #AA0s corro-orated the use of the next availa-le date as a patient/s

desired date* VA# Jest !alm each schedulers violated V"A Directive &''2'&. when the% used the clinic/snext availa-le date, instead of a veteran/s desired date, to meet the 2da% oal, resultin in inaccurate veteran

access assessments for VA# Jest !alm each*

The investiation did not su-stantiate that VA# Jest !alm each manaement directed schedulers to ame

appointment times or that the A$ #hief was pressured -% VA# Jest !alm each manaement to chane GI

appointments* A review of the director/s personnel file provided no indication that an% -onuses or appraisal ratins

were tied solel% to facilit% access levels* The investiation also found no indication that VA# Jest !alm each

staff inappropriatel% destro%ed an% records* The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2

times22'&:9'2&.*pdf * uentin G* Aucoin = 4e-ruar% &?, &'? @@

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VAMC Gai#es'ille /pate 02 ! OIG Wait Time Report 1

A former Department of Veterans Affairs (VA) emplo%ee alleed that edical Administration $ervices (A$) clerks

at the VA outpatient clinic (O!#) in Tallahassee, 46, were purposel% manipulatin schedulin data in the VA

schedulin s%stem, known as the Veterans "ealth Information $%stems and Technolo% Architecture (VistA)* Due to

Tallahassee VA O!# fallin administrativel% under the alcolm 0andall VA edical #enter (VA#), VA Office of

Inspector General (OIG) aents decided to interview A$ clerks at the alcolm 0andall VA# Gainesville to

determine if similar issues alleedl% occurrin in Tallahassee were present there* Durin the course of the

investiation, a current VA# emplo%ee reported that a paper wait list file existed in the alcolm 0andall VA#

pharmac% in Gainesville, 46* The OIG referred their 0eport of Investiation to VA/s Office of Accounta-ilit%

0eview on $eptem-er :, &'*

The report/s conclusion noted that their Investiation into the schedulin practices of A$ clerks identified twoemplo%ees who were not determinin the patient/s desired date correctl% under V"A directives or policies,

specificall% V"A Directive &''2'&.* In addition, a pharmac% emplo%ee was maintainin a paper file s%stem for &;

patients waitin to -e scheduled for treatment instead of enterin the patients into the VistA s%stem recall list, as

re3uired* This issue was addressed -% VA# staff* The entire report is availa-le at

http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2;+*pdf * uentin G*

Aucoin = 4e-ruar% &?, &'? @@

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VAMC Gai#es'ille /pate 0 ! OIG Wait Time Report 2

This investiation was instiated pursuant to information received from a reporter* The reporter in3uired a-out a

Bsecret waitin listC found at the alcolm 0andall Veterans Affairs edical #enter (VA#) Gainesville, 46, -% an

inspection team7later determined to -e the VA Access Audit Team* The OIG referred the 0eport of Investiation to

VA/s Office of Accounta-ilit% 0eview on $eptem-er :, &'*

The report/s conclusion noted that their investiation revealed that on a% ;, &', durin the VA Access Audit

conducted at the alcolm 0andall VA#, a paper wait list of &9 patients awaitin recall for future appointments

was found at the VA# "#* 4urther investiation showed that $upervisor ; failed to ensure that the "# clerks

under her supervision had the correct trainin on, and access to, the VA/s schedulin s%stem module for recallin

patients who need future appointments* A review of appointment histories for the &9 patients showed that no

patients were denied treatment -ecause of the paper wait list* All clerks now have trainin and access to the 0ecall

module in VistA and all patient appointments have -een entered* The entire report is availa-le for review at

http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2;*pdf * uentin G* Aucoin

= 4e-ruar% &?, &'? @@

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VAMC $ay ,i#es ! OIG Wait Time Report

This investiation was initiated pursuant to information received -% the Department of Veterans Affairs (VA) Office

of Inspector General (OIG) "otline* The anon%mous complainant alleed that the former VA edical #enter

(VA#) a% !ines (now #* J* ill Loun


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$ay ,i#es &C- C:W: $ill ;ou#* VA Meical Ce#ter


13/39

the onset of this investiation, an OIG special aent -riefed the director and his assem-led team, and advised them

that the investiation would focus on an alleation of improper cancellation of consults* The director and his

assem-led team did not disclose pro-lems with -atch closures that had -een improperl% completed the previous

month* Jhen the director was asked in a follow2up interview to explain wh% the improper -atch cancellation of

FV## consults was not mentioned durin the initial -riefin hosted -% the director7iven the ver% specific

alleations that would -e investiated -% OIG7the director responded, BI think the% were Hust answerin %our

3uestions,C and added, BI don/t know wh% the% did not mention it*C Jithholdin this information durin the initialmeetin hosted -% the director could have dela%ed the OIG investiation on improper FV## consult closures* The

director/s omission of ke% information he possessed reardin improper closures he directed demonstrated a lack of

candor* The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on $eptem-er :,

&'* The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22';':2&&?*pdf * uentin G* Aucoin = arch ;, &'? @@

&a8aii

VAMC &o#olulu &I ! OIG Wait Time Report

On $eptem-er &9, &', an anon%mous complainant contacted the Department of Veterans Affairs (VA) Office of

Inspector General (OIG) "otline reardin various violations at VA edical #enter (VA#) "onolulu, "I* The

complainant alleed that a "ealth Administration $ervice ("A$) specialist for the !acific Islands "ealthcare $%stem

(!I"#$) provided !I"#$ schedulers with the followin instructions5

• Fot to schedule veteran appointments more than ;' da%s in advanceM and

• Fot to input the veteran/s Bdesired dateC into the s%stem when offerin appointments due to critical short

staffin* $chedulers instead offered availa-le appointments to veterans, which was contrar% to VA polic% at

the time*

The report/s conclusion noted that Data anal%sis reardin schedulin practices at !I"#$ determined that

patients were scheduled further than ;' da%s in advance, contrar% to the alleations of the anon%mous complaint*

Interviews of VA !I"#$ $As and supervisors at "A$ did not develop an% information that manaement

instructed staff to disreard patient desired dates when inputtin appointmentsM however, one $A identified

situations in which veterans would accept the next availa-le appointment dates, which would -e listed as the

patients/ desired dates in order to move patients from the KJ6* The OIG referred the 0eport of Investiation to VA/s

Office of Accounta-ilit% 0eview on $eptem-er &, &'+* The entire report is availa-le at

http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2+.*pdf * uentin G* Aucoin

= arch ;, &'? @@

Iao

VAMC $oise I. ! OIG Wait Time Report

This investiation was initiated -ased on information received throuh the Department of Veterans Affairs (VA)

Office of Inspector General (OIG) "otline from an anon%mous source allein that non2VA medical consultations

that had not -een scheduled from to 9' da%s were -ein canceled -% staff per the direction of a manaer in

"ealth Administration $ervices ("A$) at VA edical #enter (VA#) oise*

13

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14/39

The report/s conclusion noted that VA# oise did sustain dela%s in providin ophthalmolo% and orthopedic

care to patients primaril% due to lack of VA providers in these clinics* !atients were appropriatel% placed on the

KJ6 when consults could not -e scheduled* VA OIG review of records indicated VA# oise closed consults per

VA polic%* The recent VA A#I has sinificantl% decreased the num-er of outstandin consults in the s%stem* The

OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 4e-ruar% ;, &'+* The entire

report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&;;*pdf * uentin G* Aucoin = arch &&, &'? @@

Illi#ois

VAMC -re'eport I /pate 01 ! OIG Wait Time Report

This investiation was initiated -ased upon information reported to the Department of Veterans Affairs (VA) Office

of Inspector General (OIG) "otline -% an emplo%ee at the VA edical #enter (VA#) in $hreveport, 6ouisiana,

that a manaer in ental "ealth $ervices instructed emplo%ees in the ental "ealth #are 6ine not to use theVeterans "ealth Information $%stems and Technolo% Architecture (VistA) Klectronic Jaitin 6ist (KJ6), and to

keep a BsecretC list instead* The complainant also referred to a secret wait list kept on the ental "ealth #linic/s

shared network drive*

The investiation was expanded proactivel% to include whether schedulers outside the ental "ealth #linic were

manipulatin wait times in VistA* The proactive review did not include ental "ealth -ecause the OIG Office of

"ealthcare Inspections (O"I) was conductin an inspection of ental "ealth in response to alleations from

$enator 0ichard urr, who at the time was the 0ankin em-er of the $enate #ommittee on Veterans/ Affairs* The

inspection results were pu-lished on 8anuar% ., &'?, "ealthcare Inspection5 !atient #are Deficiencies and ental

"ealth Therap% Availa-ilit% Overton rooks VA edical #enter $hreveport, 6ouisiana, 0eport Fo* 2'+'.+2.*

The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 8une, &'+*

The report/s conclusion noted that their investiation did not corro-orate complainant/s alleation that

emplo%ees in the ental "ealth #are 6ine were instructed not to use the VistA* The evidence revealed that there

was a spreadsheet used in the ental "ealth #linic, VA# $hreveport, identif%in approximatel% &,.'' veterans

who needed to -e assined to a ental "ealth provider* "owever, it was not a list used in place of schedulin

patients who wanted to -e seen, nor was it used as a su-stitute for the KJ6* There was no evidence that the manaer

instructed emplo%ees in the ental "ealth #linic to avoid usin the KJ6 or to keep a secret list* Fone of the

witnesses interviewed, who had knowlede of the su-Hect matters in the complaint, corro-orated the complainant/s

alleations that the emplo%ees in the ental "ealth #are 6ine were instructed not to use VistA, KJ6, and to keep a

secret list instead* Jith reard to the spreadsheet, no one denied the existence of the spreadsheet -ut did den%

alleations reardin the purpose of the list and that it was a secret list*

0eardin the proactive review of non2ental "ealth evidence was found that some schedulers outside the

ental "ealth #linic at VA# $hreveport were inputtin patients/ appointments into VistA in a wa% that

manipulated the actual wait time -etween the desired date and the actual date of the appointment* "owever, there

was no evidence that schedulers were intentionall% manipulatin wait times* Kvidence indicated that there had -een

inappropriate trainin %ears ao that carried throuh into present da% work activities* There was also some evidence

of a culture existin in the past, more than & %ears ao, which ma% have promoted manipulation of wait times* ut

that culture was not apparent at the time of this investiation or in the recent past* There was no evidence of specific

patient harm* The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2.;*pdf *

uentin G* Aucoin = arch ;, &'? @@

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15/39

+o+o+O+o+o+

VAMC .a#'ille I ! OIG Wait Time Report

This investiation was initiated -ased upon a report from the Department of Veterans Affairs (VA) Veterans

Interated $ervice Fetwork (VI$F) Fational $tand Down Team B"eads pC memo reardin a visit to the VA

edical #enter (VA#) Danville on a% +, &'* The OIG referred their 0eport of Investiation to VA/s Officeof Accounta-ilit% 0eview on 8anuar% 9, &'+* The report/s conclusion noted that their investiation revealed that a

list was emailed weekl% -% the former !rimar% #are coordinator to $As containin patients with wait times

reater than or ;' da%s -etween the desired dates and the actual appointment dates* pon receivin such lists,

one $A chaned dates within VistA to reduce wait times to ero* Fo-od% told her to do thisM she Hust assumed that

it should -e done* That $A felt if such chanes were not made, there would -e repercussions -% manaement

aainst those which she deemed to -e on a -lack list* Another $A said she was instructed to chane dates within

the s%stem to ero out wait times reater than da%s, -ut she could not remem-er who told her to do so* Let

another $A said a supervisor told her that desired dates should alwa%s match appointment dates* This supervisor

denied ever ivin such instructions* The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22

'&:9'2.*pdf * uentin G* Aucoin = arch ;, &'? @@

+o+o+O+o+o+

VAMC &i#es I /pate 07 ! OIG Wait Time Report

Alleations made pu-licl% -% the complainant were the focus of the investiation at the "ines, I6, Veterans Affairs

"ospital (VA") conducted -% the Department of Veterans Affairs (VA) Office of Inspector General (OIG)* The

complainant primaril% alleed that the VA" "ines ental "ealth Division maintained Bsecret -acklo lists*C The

complainant also alleed that she had -een told that wait times were manipulated to ensure that the staff received

lare -onuses and that, -ecause of this, patients were harmed* The complainant was interviewed -% the VA OIG

prior to the referral dated 8une +, &', that the Office of $pecial #ounsel sent to the VA $ecretar% pursuant to Title

+, nited $tates #ode, $ection &;, with alleations from the same complainant* Therefore, the investiation

focused on the complaints she raised durin her interview with the VA OIG* The OIG referred their 0eport of

Investiation to VA/s Office of Accounta-ilit% 0eview on 8anuar% &?, &'+*

The report/s conclusion noted that althouh dela%s in access to care remain an onoin issue at VA" "ines, this

investiation uncovered no evidence to su-stantiate the existence of secret wait lists at VA" "ines* Jith respect to

the !riscilla 0eport mentioned -% witnesses, we found that the report, which was enerated at the VA", identified

scheduled appointments that fell outside the esta-lished accepta-le 2da% wait time* It was not a secret report* In

reards to the complainant/s primar% alleations of ental "ealth treatment dela%s and usae of an% secret lists

associated with ental "ealth prorams, there is no evidence to suest the trackin tools or roup introductor%

sessions used -% that department were in conflict with the aforementioned schedulin directives or used with intent

to hide dela%s in treatment*

It appears the Trauma $ervices data-ase was used to assist in the trackin of modern mental health treatment in a

wa% that worked around deficiencies in anti3uated VA schedulin software* On a% :, &', the VA" director

issued a memo to all emplo%ees VA OIG Administrative $ummar% 2'&:9'2:' ' Administrative $ummar% of

Investiation -% VA OIG in 0esponse to Alleations* 0eardin !atient Jait Times at the VA# in "ines, I6

notif%in them that takin steps to make wait times look ood without actuall% improvin the timeliness of

appointments was inappropriate* VA OIG determined that there was a violation of Veterans "ealth Administration

(V"A) Directive &''2'&., V"A Outpatient $chedulin !rocess and !rocedures* The investiation showed that

$As throuhout "ines were chanin data within the VistA s%stem under the direction of $A supervisors, who

asserted these orders oriinated from the service chief*

15



16/39

Althouh the existence of $A clerical errors due to anti3uated confusin schedulin software appears valid, the

service chief denied ivin orders for $As to o -ack into VistA and chane data su-se3uent to wait time I0

Data 0eports -ein issued (!riscilla 0eport)* The results of these chanes, whether -% desin or -% unintentional and

indirect effect, resulted in decreased wait time datasets* The interpretation of schedulin processes, in specific reard

to desired date interpretation and neotiation of desired date with veterans, appears to var% amon the $As

interviewed* The service chief admitted to implementin schedulin methods in which the $As could encourae

areement from veterans for alternate desired dates closer to the scheduled appointment dates* Jhile arua-l%

practical, this violates V"A $chedulin Directive &''2'&.* There is no evidence to suest manaement a-ove the

service chief had knowlede of these practices* The entire report is availa-le at

http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2:'*pdf * uentin G* Aucoin

= 4e-ruar% &?, &'? @@

Io8a

VAMC .es Moi#es IA /pate 02 ! OIG Wait Time Report

This investiation was initiated -ased on an anon%mous complaint to the Office of Inspector General (OIG) "otline

advisin of a Bsecret waitin listC at the VA edical #enter (VA#) for !s%chotherap% $ervice in Des oines, IA*

The caller advised that a spreadsheet was kept on the shared drive for !s%chotherap% $ervice and was destro%ed -% a

VA# Des oines clinical ps%choloist, the keeper of the list, prior to Veterans of "ealth Administration/s (V"A)

a% &' audit* The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 8anuar%

;', &'+* The report/s conclusion noted that their investiation did not su-stantiate the existence of a BsecretC wait

list* Jhat was alleed to -e a Bsecret waitin listC was in fact two spreadsheets created -% the !s%chotherap%

$ervice 6ine to track wait times for initial consults and later for the more specific treatment of ps%chotherap%*

VA# manaement was aware of the spreadsheets* The entire report is availa-le at

http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&&*pdf * uentin G*

Aucoin = arch ;, &'? @@

>a#sas

VAMC Tope%a >- /pate 01 ! OIG Wait Time Report

The investiation was initiated -ased on information provided -% an anon%mous complainant via the Department of

Veterans Affairs (VA) Office of Inspector General (OIG) "otline reardin the improper cancelin of appointments

-% clinics within VA edical #enter (VA#) 6eavenworth and VA# Topeka* The complainant asserted that the

clinics1facilities have a lon2standin unofficial polic% to report clinic appointments that are canceled -% doctors or

other staff mem-ers as Bcancelled -% patient,C instead of correctl% listin those appointments as Bcancelled -%

clinic*C The clinic1facilit% is alleedl% paid for the provider/s time if the appointment is canceled -% patient, instead

of not ettin paid if the clinic was canceled -% the provider*

The report/s conclusion noted that their investiation revealed no evidence to support the anon%mous alleations*

VA clinics do not receive fundin -ased on appointments -ein canceled -% patient and not -% clinic* The VA

fundin and reim-ursement process was not -ased on the classification of canceled appointments, -ut rather on the

16



17/39

completion of appointments, which would increase the amount of dollars to the VI$F and not to the specific facilit%

under the VK0A s%stem* The VI$F then decided how to distri-ute the funds to the VA#s within its area of

responsi-ilit%* #ancellation of appointments, whether -% the patient or the clinic, had no -earin on fundin at the

facilit% -ecause the work was not completed* 4urthermore, there was no indication that appointments canceled -%

clinics had increased over the past %ear* The OIG referred the 0eport of Investiation to VA/s Office of

Accounta-ilit% 0eview on 8anuar% ;', &'+* * The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2

times22'&:9'2&&+*pdf * uentin G* Aucoin = arch &&, &'? @@

+o+o+O+o+o+

VAMC Wicita >- ! OIG Wait Time Report

This investiation was initiated -ased upon information provided -% a senior official at the Department of Veterans

Affairs edical #enter (VA#) Jichita reardin the alleed deletion of a Bnon2sanctionedC or unauthoried

"ome ased !rimar% #are ("!#) patient consult list -% two VA# "!# emplo%ees ("!# and "!#&)*

"!# and "!#& alleedl% deleted a patient consult list after a litiation hold memo was sent out -% VA #entral

Office (VA#O) to all VA emplo%ees on or a-out a% , &'* Durin the course of this investiation, the senior

official referred to the VA Office of Inspector General (OIG) additional alleations he received reardin incorrectschedulin trainin provided -% a !rimar% #are 6ead medical support assistant ($A) to #ommunit% ased

Outpatient #linic (#O#) $alina staff*

The report/s conclusion noted that their investiation confirmed the existence of two "!# patient lists, which

were located on the VA#/s $hare!oint drive* "owever, all "!# patients were entered into VistA and nothin

indicative of intentional and1or malicious falsification of wait time data was discovered* One list was deleted at the

direction of "!#, who said she was not aware of the litiation hold memo at the time* An internal review

conducted -% VA# personnel concluded that no veterans experienced an adverse effect as a result of -ein placed

on the "!# lists* The investiation did not su-stantiate that the !rimar% #are 6ead $A was fraudulentl%

providin incorrect schedulin instructions to #O# $alina staff* The OIG referred the 0eport of Investiation to

VA/s Office of Accounta-ilit% 0eview on 8anuar% ;', &'+* The entire report is availa-le at

http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2.*pdf . uentin G* Aucoin= arch &&, &'? @@

>e#tuc%y

VAMC ouis'ille >; /pate 02 ! OIG Wait Time Report

This investiation was initiated -% alleations sent to the Department of Veterans Affairs (VA) Office of Inspector

General (OIG) Office of Investiations reardin manipulation of wait times and schedulin data at the VA edical

#enter (VA#), 6ouisville, NL* $pecificall%, a supervisor% medical support assistant ($A $upervisor) alleedl%

instructed other $As in the Outpatient $urer% #linic to use a different Bdesired dateC in order to show a reduction

in wait times and avoid scrutin% on the facilit%/s AKG

The report/s conclusion noted that their investiation found that with reard to the desired date determination,

$As in the clinic were schedulin patient appointments correctl%, in accordance with VA directives or policies,

specificall% Veterans "ealth Administration Directive &''2'&.* 4urthermore, all $A emplo%ees reported that the

$A $upervisor never instructed them to use a date other than the correct desired date when schedulin

17

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18/39

appointments* The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 8une &;,

&'+* The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'29&*pdf * ; ! OIG Wait Time Report

An investiation was initiated pursuant to information received -% the Department of Veterans Affairs (VA) Office

of Inspector General (OIG) from a senior leader ($enior 6eader ), reardin potential improper appointment

schedulin and falsification of audit data at the #ommunit% ased Outpatient #linic (#O#) Dupont, VA edical

#enter (VA#), in 6ouisville, NL* The alleation specificall% stated that a supervisor% medical support assistant

($upervisor% $A) for the #O#, altered a -usiness office audit to chane her clinic/s monthl% schedulin

accurac%*

The report/s conclusion noted that their investiation found that $As at #O# Dupont were schedulin patient

appointments correctl% with respect to the desired date determination, in accordance with V"A Directive &''2'&.*

Althouh $upervisor% $A did chane column & in the audit from a BFoC to a BLes,C the information in this

column was more su-Hective or interpretive* The chane was the result of a difference of interpretation -etween two

supervisors and was found to have no effect on the scheduled appointment/s desired date or appointment wait times*

The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 8une &:, &'+* The entire

report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&.*pdf * uentin G* Aucoin = arch &+, &'? @@

ouisia#a

VA &C- ?e8 Orlea#s@$ato# Rou*e ! OIG Wait Time Report

This case was initiated in a% &' -ased on information provided -% an anon%mous source to the Department of

Veterans Affairs (VA) Office of Inspector General (OIG) "otline allein that the schedulin staff mem-ers at the

VA Outpatient #linic (O!#) Few Orleans and the #ommunit% ased Outpatient #linic (#O#) aton 0oue were

manipulatin patient appointment information* The alleed manipulation was intended to make patient access to

care appear to -e more timel% than the actual wait time experienced -% patients* The OIG referred the 0eport of

Investiation to VA/s Office of Accounta-ilit% 0eview on April ., &'+*

The report/s conclusion noted that their investiation revealed that O!# Few Orleans VA and #O# aton

0oue schedulin staff did not properl% use patients/ desired dates when schedulin appointments for patients* The

areed2upon dates, or next availa-le dates, were used as patients/ desired dates* As a result, the true wait times were

not recorded* This was caused -% incorrect trainin and a lack of understandin of the s%stem* The schedulin staff was not pressured or instructed -% manaement to misuse the desired date* The investiation did not identif% an%

schemes or BaminC of the s%stem that appeared to -e intended to improve VA emplo%ee performance measures*

Fo specific patient harm was identified as a result of the a-ove alleations* The entire report is availa-le at

http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2?:*pdf * uentin G* Aucoin

= arch ;, &'? @@

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19/39

Massacusetts

VAMC ?ortampto# MA /pate 01 P OIG Wait Time Report

This case was initiated -ased on information provided -% a Department of Veterans Affairs (VA) Fational $tand

Down Team, which was assem-led -% the Veterans "ealth Administration (V"A) to evaluate schedulin practices at

VA medical facilities* The V"A Fational $tand Down Team informed the VA Office of Inspector General (OIG) that

an emplo%ee alleed that manaement at the VA edical #enter (VA#) in Forthampton, A, was BaminC

access num-ers in ental "ealth -% () encourain the entr% of inaccurate desired dates, and (&) repetitivel%

creatin and cancelin clinic appointments to ultimatel% achieve a Bdesired dateC closer to the actual appointment

date* The VA OIG investiation initiall% focused on ental "ealth -ut expanded to !rimar% #are, -ased on new

alleations received from confidential sources reardin concerns a-out the lack of responsiveness to consults and

the failure to use the Klectronic Jait 6ist (KJ6)*

The report/s conclusion noted that their investiation revealed that ental "ealth schedulin staff misused the

desired date when schedulin in response to consults* Kvidence indicates that the misuse was primaril% caused -% a

lack of understandin of the s%stem and not pressure from manaement to meet performance measures* The

investiation also revealed that the KJ6 was enerall% not used throuhout $ervice 6ines althouh there were

opportunities when it could have -een applied* The investiation did not identif% an% schemes or amin of the

s%stem that was intended to improve performance measures* Fo specific patient harm was identified as a result of

the a-ove alleations* The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&?*pdf

* The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on Octo-er ;, &'*

uentin G* Aucoin = arch &&, &'? @@

Mici*a#

VAMC $attle Cree% MI /pate 01 P OIG Wait Time Report

An anon%mous Department of Veterans Affairs (VA) Office of Inspector General (OIG) "otline complainant alleed

that "ealthcare for "omeless Veterans ("#"V) !roram supervisors at the VA edical #enter (VA#) attle

#reek asked "#"V emplo%ees to retroactivel% schedule appointments for veterans who had -een seen as part of

outreach work* This schedulin method ave the appearance that veterans were seen more 3uickl%* The complainant

asserted that this practice was unethical in that the veterans did not have scheduled appointments*

The report/s conclusion noted that their investiation found no irreularities with the schedulin practices used in

the "#"V !roram* oth proram social workers and supervisors clearl% descri-ed wh% their schedulin and

documentation methods were consistent with -est practices* The% emphasied that there were no veterans waitin

for services in their proram, and that services were provided when veterans presented at the office for the walk2in

proram* The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 8une &:, &'+*

The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&&:*pdf * uentin G* Aucoin = arch &&, &'? @@

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20/39

Mi##esota

VAMC Mi##eapolis /pate 0 P OIG Wait Time Report .e#tal Cli#ic

This investiation was initiated -ased on information reported to the Office of Inspector General (OIG) "otline

allein that the Dental $ervice in VA edical #enter (VA#) inneapolis was manipulatin data associated with

patient wait times* In particular, the complainant alleed that the chief of Dental $ervices (#D$) Bstronl% advisedC

emplo%ees to hide patient records and to falsel% report waitin times*

The report/s conclusion was that their interviews failed to su-stantiate the alleation that the #D$ instructed staff

to manipulate patient waitin list data to hide the fact that patient wait times exceeded the 2da% o-Hective

enumerated in VA polic%* Thouh there was communication a-out compl%in with the 2da% o-Hective, there is no

indication the data were manipulated to hide an% wait times* The OIG referred the emorandum for 0ecord to VA/s

Office of Accounta-ilit% 0eview on 4e-ruar% &;, &'+* At http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2

&+*pdf the entire report is availa-le for review * uentin G* Aucoin = 4e-ruar% &9,

&'? @@+o+o+O+o+o+

VAMC Mi##eapolis /pate 0B P OIG Wait Time Report GI Cli#ic

This investiation was initiated -ased on information provided -% two former emplo%ees of the *$* Department of

Veterans Affairs edical #enter (VA#) in inneapolis, F* The emplo%ees alleed that while the% worked as

medical support assistants ($As) in the VA# inneapolis Gastroenterolo% (GI) #linic, the% were instructed to

alter appointment and schedulin records* The% also alleed that the% were instructed -% manaement to cancel

veterans/ appointments without the veterans/ knowlede, -ut made entries in the computeried schedulin s%stem

indicatin that the veterans were contacted* oth emplo%ees had previousl% -een removed from 4ederal service and

claimed that the% -rouht these concerns up to manaement prior to their removal

The report/s conclusion was the investiation did not su-stantiate that a spreadsheet was used for schedulin

purposes* Accordin to the clinic director, as well as others, the GI #linic uses a icrosoft Access data-ase for the

sole purpose of trackin its patients* This data-ase is used for those patients who need to -e seen for follow2up care

in the future, such as ;2%ear, +2%ear, or '2%ear follow2up appointments* The VA/s schedulin s%stem does not allow

for schedulin appointments that far into the future, so this data-ase is used to ensure no veterans are forotten or

lost* It is a well2known proram, is not a secret to an%one, and is accessi-le -% all GI #linic staff* It is maintained -%

the clinic director* The alleations made -% the complainants were not su-stantiated* 4or example, statements -%

-oth complainants that $As sent out the results letters contradicted all other information reardin the results

letters* The OIG aents were consistentl% told that results letters were onl% sent out -% the medical providers,

throuh edical edia*

At no time did an $A have an%thin to do with results letters* Throuh other interviews, it was discovered that

prior to April1a% &', GI #linic patients were onl% -ein sent letters askin them to schedule appointments and

the onl% telephone calls were to the patients whose medical issue was deemed urent* As another example, when

asked what happens to a consult when it is canceled, complainant & stated it is Hust simpl% closed out* Other

interviews disputed this* If a consult is discontinued or canceled, the referrin ph%sician is notified via s%stem2

enerated email* The ph%sician then re2schedules the patient -% creatin another consult* The OIG referred the

0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 8une &?, &'+* At

http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2+*pdf the entire report is availa-le for review* uentin G* Aucoin = 4e-ruar% &9, &'? @@

20



21/39

+o+o+O+o+o+

VAMC Mi##eapolis /pate 09 P OIG Wait Time Report .ecease Vet

This investiation was conducted -ased on information reported in the news media insinuatin that the VA edical

#enter (VA#) inneapolis had manipulated the date in which an appointment was canceled* The media reported

that the VA computer s%stem showed that the veteran called to cancel his appointment on the date in 3uestion, -ut in

fact, the veteran had died prior to the date indicated in the VA s%stem*

The report/s conclusion was that the alleations were not su-stantiated* The OIG sent the emorandum for

0ecord to VA/s Office of Accounta-ilit% 0eview on 8une , &'+* At http511www*va*ov1oi1pu-s1ims1wait2times2

2'&:9'2&?*pdf the entire report is availa-le for review* uentin G* Aucoin =

4e-ruar% &9, &'? @@

Missouri

VAMC >a#sas City MO ! OIG Wait Time Report Cariolo*y Cli#ic

This investiation was initiated -ased upon information provided -% Veterans Interated $ervice Fetwork (VI$F)

+ manaement reardin schedulin practices in the #ardiolo% #linic of the Veterans Affairs edical #enter

(VA#) in Nansas #it%, O* A VA# Nansas #it% internal review of the schedulin practices in the #ardiolo%

#linic revealed that a #ardiolo% schedulin clerk/s practices were erratic and potentiall% unrelia-le* $ome

#ardiolo% providers used a B%ellow sheetC to indicate dates for return appointments for their patients* In a% &',

approximatel% ,';& of these %ellow sheets were found in a drawer and file ca-inet that had apparentl% not -een

processed -% the clerk*

The report/s conclusion was that the investiation su-stantiated that the clerk maintained paper records relatin

to the schedulin of patients in the #ardiolo% #linic that she did not process* An immediate review of the paper

records -% VA# Nansas #it% schedulin supervisors and clinical staff was completed over the course of & da%s in

a% &' and identified that ;. of the ,';& sheets represented dela%ed appointments, and all ;. were immediatel%

scheduled* A clinical review -% VA# Nansas #it% officials found no specific harm to patients as a result of the

schedulin dela%s* The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on

$eptem-er &, &'* At http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&'&*pdf the entire report is availa-le

for review*


22/39

per week* The investiation disclosed that the complainant had first2hand knowlede of the excessive wait time

alleation onl%M he received information concernin the other alleations from another source* This source also

expressed a concern that the !ain #linic miht have manipulated wait time data that resulted in -onuses -ein paid

to VA# administrators*

The report/s conclusion was that the investiation revealed

• The alleation that the !ain #linic had secret wait lists was unsu-stantiated*• The alleation of excessive wait times at the !ain #linic was su-stantiated, -ut positive chanes had -een

implemented prior to the investiation to alleviate the pro-lem*

• The alleation reardin cameras -ein secretl% installed in the !ain #linic was unsu-stantiated*

• The alleation that manaement worked onl% 2da% weeks was unsu-stantiated*

• The alleation that the !ain #linic miht have manipulated wait time data that resulted in -onuses -ein

paid to VA# administrators was unsu-stantiated*

The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 4e-ruar% &, &'+*

The entire report can -e reviewed at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&;&*pdf *


23/39

?e8 ;or%

VAMC $roo%ly# ?; ! OIG Wait Time Report

This investiation was initiated -ased upon information provided -% an emplo%ee at the Department of Veterans

Affairs (VA) edical #enter (VA#) in rookl%n, FL, who contacted VA Office of Inspector General (OIG) on

8une &, &'* The complainant alleed that the 0adiolo% Department at VA# rookl%n was manipulatin

patient schedulin and misrepresentin wait times for medical scans

The report/s conclusion was that the investiation did not su-stantiate the alleation* The 0adiolo% Department

at VA# rookl%n currentl% follows the &'': polic% recommended -% the former VA Fational 0adiolo% director

reardin Bno2showC appointments* The polic% directs that a supervisor, or his1her representative, check the

appointment list at the end of each da% to identif% an% no2shows* !rovided there is no inclement weather, and

excludin Department of Defense patients, $As were directed to cancel the order for testin of an% no2show andnotif% the ph%sician/s office that the order was canceledM the ph%sician must then re2order the test* The OIG referred

the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on Auust &&, &'* The entire report is

availa-le for review at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'29'*pdf * uentin G* Aucoin = arch + &'? @@

+o+o+O+o+o+

VA C$OC Rocester ?; ! OIG Wait Time Report

The investiation was initiated -ased on information received from a complainant who stated that a medical support

assistant ($A) supervisor at the Veterans Affairs (VA) #ommunit% ased Outpatient #linic (#O#) in 0ochester,

FL, asked a su-ordinate $A to contact veterans and verif% that the% still wanted to keep their current appointment

date* The $A alleedl% was told that if the veterans wanted to keep their current appointments, the $A shouldalter the veterans/ Bdesired dateC to reflect the date of appointment, thus creatin the illusion that #O# 0ochester

was providin medical appointments on the exact date desired

-% patients*

The report/s conclusion was the investiation revealed that an $A was ordered -% an $A supervisor to contact

nine veterans via telephone, -ut he1she failed to do so* It was determined that the $A never called or contacted the

veterans and lied a-out it to manaement and to OIG special aents* The manaer suspected that the $A did not

call the veterans and had another emplo%ee do so* Jhen the veterans were contacted, the% were all satisfied with

their oriinal appointment dates and confirmed the% had not -een contacted -% the $A* Durin a second interview,

the $A admitted that he1she provided false information to manaement and VA OIG special aents* #hanes to the

desired dates made -% the $A were attri-uted to his misunderstandin of supervisor% instructions* The OIG

referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 8une ;, &'+* The entire report is

availa-le for review at http511www*va*ov1oi1pu-s1ims1wait2times22';+&2.:*pdf * uentin G* Aucoin = arch + &'? @@

+o+o+O+o+o+

VA C$OC Rocester ?; ! OIG Wait Time Report

The investiation was initiated -ased on information provided -% a confidential complainant (##)* The ## alleed

that a former medical support assistant ($A) supervisor ($A $upervisor ) at the Department of Veterans Affairs

(VA) #ommunit% ased Outpatient #linic (#O#), in 0ochester, FL, instructed #O# 0ochester !rimar% #are

23

http://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTYwMzE2LjU2NjE0NzMxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE2MDMxNi41NjYxNDczMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3Mjg0MzAxJmVtYWlsaWQ9cmFvZW1vQHNiY2dsb2JhbC5uZXQmdXNlcmlkPXJhb2Vtb0BzYmNnbG9iYWwubmV0JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&103&&&http://www.va.gov/oig/pubs/ims/wait-times-14-02890-190.pdfhttp://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTYwMzE2LjU2NjE0NzMxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE2MDMxNi41NjYxNDczMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3Mjg0MzAxJmVtYWlsaWQ9cmFvZW1vQHNiY2dsb2JhbC5uZXQmdXNlcmlkPXJhb2Vtb0BzYmNnbG9iYWwubmV0JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&103&&&http://www.va.gov/oig/pubs/ims/wait-times-14-02890-190.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-03542-178.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-03542-178.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-03542-178.pdfhttp://links.govdelivery.com/track?type=click&enid=ZWFzPTEmbWFpbGluZ2lkPTIwMTYwMzE2LjU2NjE0NzMxJm1lc3NhZ2VpZD1NREItUFJELUJVTC0yMDE2MDMxNi41NjYxNDczMSZkYXRhYmFzZWlkPTEwMDEmc2VyaWFsPTE3Mjg0MzAxJmVtYWlsaWQ9cmFvZW1vQHNiY2dsb2JhbC5uZXQmdXNlcmlkPXJhb2Vtb0BzYmNnbG9iYWwubmV0JmZsPSZleHRyYT1NdWx0aXZhcmlhdGVJZD0mJiY=&&&103&&&http://www.va.gov/oig/pubs/ims/wait-times-14-02890-190.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-03542-178.pdf


24/39

#linic $As to make veterans/ desired dates for appointments at the #O# to -e the same date as the scheduled

appointment date or first availa-le date* The ## stated this has resulted in the appearance of a ero2da% wait time for

veterans seekin !rimar% #are appointments at the #O# and created the perception that there was ade3uate

staffin at the #O# when that was not the case*

The report/s conclusion was the investiation revealed that several schedulers at the #O# were routinel% usin the

first availa-le appointment date as the desired date* This was likel% due to erroneous information provided -% $A

supervisors who stated that the% trained staff to use the first availa-le date as the desired date -ecause the%

misunderstood the correct procedure* This issue was -ein corrected -% manaement throuh the issuance of

additional uidance and oversiht and other corrective actions*

The VA emplo%ees interviewed advised that manaement never provided instruction intended to limit

cooperation with OIG auditors or investiators for an% in3uir% into the #O# patient wait time issue* The% were

advised Hust to -e honest if the% had to answer an% 3uestions* Fo one was aware of an% computeried, hard cop%, or

separate patient waitin lists* In addition, the emplo%ees interviewed were never directed to destro% or shred an%

documents pertainin to patient waitin lists or wait times other than what was destro%ed durin the normal course

of -usiness* The% were never informed that there was an% monetar% ain for an%one relatin specificall% to patient

wait times* In addition, the% were not aware of an% manaerial chanes that occurred recentl% -ecause of

disciplinar% actions relative to the wait times* an% of the emplo%ees voiced their opinion that there was no

malicious intent -% an% emplo%ee to defraud or mislead an%one reardin wait times*The% commented that the ero2da% wait time created a misconception that the schedulers were handlin their

workload in an appropriate manner* The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit%

0eview on

Auust &&, &'* The entire report is availa-le for review at http511www*va*ov1oi1pu-s1ims1wait2times22';+&2

:;*pdf * uentin G* Aucoin = arch + &'? @@

?ort Caroli#a

VAMC .uram ?C ! OIG Wait Time Report

This investiation was initiated -ased on information received from a Department of Veterans Affairs (VA) edical

#enter (VA#), Durham, F#, emplo%ee, who alleed some emplo%ees enaed in inappropriate schedulin

practices -etween &''9 and &'&* The emplo%ee had provided documentation to the VA# Durham Director* As a

result of the alleations, Veterans "ealth Administration (V"A) placed two VA# Durham emplo%ees on

administrative leave pendin a V"A review of the alleations* These are the issues addressed durin the

investiation5

• Jhether schedulers were usin the next availa-le appointment date as the veterans/ desired dates*C

• Jhether schedulers were instructed to chane appointment information*

• Jhether an instructor, durin a schedulin trainin class, instructed schedulers to use the Bnext availa-le

dateC as the veteran/s desired date* As part of the same alleation, an emplo%ee attempted to correct the

instructor -ut was stifled -% another staff mem-er*

• Jhether schedulers in the !rimar% #are #linic of VA# Durham and the 0aleih #ommunit% ased

Outpatient #linic (#O#) were schedulin inappropriatel%*

• Jhether a doctor acknowleded that reports contained Bdoctored num-ers*C

• Jhether a doctor suested usin a method, referred to as the Bspecial method,C to add time to veteran

patients/ follow2up examinations*

The report/s conclusion was the investiation did not su-stantiate all of the alleations as presented -% the

complainant* Investiation determined that the first availa-le date was used as the veteran/s desired date prior to the

24

http://www.va.gov/oig/pubs/ims/wait-times-14-03542-183.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-03542-183.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-03542-183.pdfhttp://www.va.gov/oig/pubs/ims/wait-times-14-03542-183.pdf


25/39

issuance of the $choenhard memo* $u-se3uent to the memo, this practice was reatl% diminished and a trainin

proram was developed and used to ensure schedulin was completed appropriatel%* The OIG referred the 0eport of

Investiation to VA/s Office of Accounta-ilit% 0eview on Auust 9, &'+* The entire report is availa-le for review

at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&+'*pdf *


26/39

corrections made were properl% done* Fo one could produce the letter re3uestin that $As certif% the% did not

chane or manipulate desired dates* The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit%

0eview on Octo-er ;, &'* The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2

??*pdf * uentin G* Aucoin = arch :, &'? @@

+o+o+O+o+o+

VAMC ,ilaelpia ,A /pate 01 ! OIG Wait Time Report

This investiation was initiated pursuant to information provided on a% ;', &', -% an emplo%ee (complainant) at

the Veterans Affairs edical #enter (VA#) in !hiladelphia, !A, who had information relative to alleations of

wrondoin in the Audiolo% and Vascular Departments and the K%e #linic of the VA#* The complainant claimed

that a former manaer in Audiolo% was alleedl% keepin a password2protected icrosoft Kxcel spreadsheet on his

Department of Veterans Affairs (VA) computer that identified and was used to track patients who re3uired consults

for non2VA care at the !enns%lvania Kar Institute (!KI), Klkins !ark, !A* The complainant also alleed appointments

were not appropriatel% -ein made for veterans in the Vascular Department, and possi-l% other departments, durin

a period a "ealth Administration $ervices ("A$) clerk went on leave and was out for an extended period* 6astl%, a

manaer in the K%e #linic was alleedl% Bcookin the -ooksC in that clinic -% manipulatin consults* Durin the

investiation, another issue surfaced that consults in !h%sical edicine and 0eha-ilitation (!0) were -eincanceled and re-ooked within Veterans Information $%stems and Technolo% Architecture (VistA) for unknown

reasons*

The report/s conclusion was the investiation revealed that a spreadsheet was used -% the former manaer in

Audiolo% approximatel% to + %ears ao, when such use was permitted* "e said he used the spreadsheet to track

patients referred to !KI for hearin aid evaluations* $uch patients would not have appeared on an% wait list after

-ein referred* Accordin to the complainant, VA# manaement took appropriate corrective actions reardin this

issue followin discover% and contacted all of the veterans (approximatel% 9'') on the spreadsheet* The

investiation also failed to show wrondoin relatin to the schedulin responsi-ilities of the clerk who went out on

leave -ecause coverae was provided durin her a-sence*

Jith respect to alleations relatin to the K%e #linic, the alleed manipulation had to do with the ina-ilit% of

VistA to properl% interface with a particular piece of dianostic e3uipment* An% BmanipulationC was claimed to have

-een done so the vascular ultrasound machine could interface with VistA and enerate a patient list for the work to

-e done on a particular date* The investiation revealed that the vascular ultrasound machine does not interface with

all parts of VistA and reads onl% consults* Appointments scheduled for veterans in VistA were not affected in an%

wa% -% the manner in which consults were handled*

Durin the investiation, an issue surfaced that consults were -ein canceled and re-ooked within VistA for !0

with the complainant providin no explanation as to wh% this was -ein done* The investiation revealed no

wrondoin in !0 and that the complainant, who is not involved in schedulin, was unfamiliar with the process

for deletin old consults that were left open in VistA after a patient had -een seen*

The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 8anuar% &:, &'+* The

entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2.9*pdf * uentin G* Aucoin = arch :, &'? @@

,uerto Rica

26



27/39

VAMC -a# 4ua# ,R ! OIG Wait Time Report

The investiation was initiated -ased upon a Department of Veterans Affairs (VA) Office of Inspector General (OIG)

"otline complaint allein multiple issues that involved mismanaement -% the director, VA edical #enter

(VA#) in $an 8uan, !0* These issues included BaminC wait lists in !rimar% #are and specialt% clinics -% "ealth

Administration $ervice ("A$) staff under the direction of the chief of staff (#O$), and the associate director (AD)*

The report/s conclusion was the investiation found that VA# $an 8uan "A$ schedulers in !rimar% #are and a

specialt% clinic used the clinics/ next availa-le date as the veterans/ desired date and chaned appointments that fell

outside of the 2da% desired date polic% to -e within da%s* $chedulers stated that there was no senior

manaement direction to manipulate wait timesM however, pressure from first2level supervisors to meet the 2da%

oal was clearl% evident* The manipulation of wait times appeared to -e an unintended conse3uence of this pressure

com-ined with limited availa-ilit% of appointments within da%s of the desired dates* The investiation did not

identif% an% inappropriate destruction of records -% VA# $an 8uan staff related to schedulin outpatient

appointments* A review of the director/s and the AD/s personnel files did not identif% an% -onuses or appraisal

ratins solel% tied to patient access levels at the facilit%* The emplo%ee who tauht the staff in &''9 was retired at the

time of the investiation and the current manaer confirmed that "A$ staff were -ein trained the proper wa% to

schedule appointments* As for the statement made -% "A$ #lerk & a-out the list provided to a supervisor of

veterans he1she could not schedule, the investiation was una-le to corro-orate this claim*

The OIG referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on $eptem-er &9, &'*

The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'2&9*pdf * uentin G* Aucoin = arch &, &'? @@

Te##essee

VA C$OC Catta#oo*a T? ! OIG Wait Time Report

An anon%mous source alleed that two Department of Veterans Affairs (VA) emplo%ees at the #ommunit% ased

Outpatient #linic (#O#), #hattanooa, TF, which is part of the Tennessee Valle% "ealthcare $%stem (TV"$),

took home personnel records on veterans1emplo%ees in order to conceal the records from a Veterans "ealth

Administration

(V"A) inspection team arrivin at the facilit% in a% &'* The report/s conclusion was that the VA Office of

Inspector General (OIG) investiative efforts did not su-stantiate the alleations that the identified VA emplo%ees

took home an% personnel or other VA records* The OIG referred the 0eport of Investiation to VA/s Office of

Accounta-ilit% 0eview on 8une , &'+* The entire report is availa-le at http511www*va*ov1oi1pu-s1ims1wait2times2

2'&:9'29*pdf * uentin G* Aucoin = arch :, &'? @@

+o+o+O+o+o+

VA C$OC Catta#oo*a T? /pate 01 ! OIG Wait Time Report

This investiation was initiated followin receipt of a report from the Veterans "ealth Administration (V"A)

Fational $tand Down Team (F$DT) and containin alleations from three medical support assistants ($As)* The

$As alleed that #hattanooa, TF, #ommunit% ased Outpatient #linic (#O#) emplo%ees were -ein directed

-% the usiness Office to chane patient Bdesired datesC to the actual appointment dates patients were seen, even

27



28/39

when the providers clearl% wanted the patients to -e seen sooner* The F$DT report also rela%s the $As alleation

that emplo%ees were -ein placed on a B-ad -o%C list if the% did not compl% with this direction*

The report/s conclusion was the investiation did not su-stantiate that a -ad -o% list existed or that $As were

written up for enterin the correct desired date* Fo evidence of an% effects on patient care was identified durin this

investiation, and no wait time manipulation intended to Bame the s%stemC was discovered* A need for standardied

scheduler trainin was identified* This need was also independentl% identified -% the director of TV"#$, whoinitiated a standardied trainin proram for all of TV"#$* As of Auust &., &', all #O# #hattanooa

schedulers had attended this trainin* Althouh the investiation could not rule out the possi-ilit% that schedule

manipulation occurred in the past, the evidence showed that once formalied scheduler trainin -ean at the #O#

in 8une &', an% indications that schedule manipulation ma% have -een takin place no loner existed* The OIG

referred the 0eport of Investiation to VA/s Office of Accounta-ilit% 0eview on 8une , &'+* The entire report is

availa-le at http511www*va*ov1oi1pu-s1ims1wait2times22'&:9'29+*pdf * uentin G* Aucoin = arch :, &'? @@

+o+o+O+o+o+

VAMC Mempis T? ! OIG Wait Time Report

An anon%mous complainant contacted the Department of Veterans Affairs (VA) Office of Inspector General (OIG)

"otline allein that two senior manaement emplo%ees at the VA edical #enter (VA#) in emphis, TF, were

chanin consultation times to hide the fact that patients were receivin dela%ed treatment for pulmonar% function

exams* The complainant also alleed that VA# emphis used B-ous schedulinC and Bsecret listsC to cover the

fact that the% missed re3uired deadlines*

The report/s conclusion was the investiation did not su-stantiate the alleations that VA# emphis chaned

consultation times to hide dela%s in treatment for pulmonar% function exams and that the facilit% used -ous

schedulin or had a secret list* The investiation found that the first availa-le date was used as the desired date in

&' and &'&, -ut the practice had stopped* In addition, approximatel% : months prior to the investiation, there

was list of patients needin mammorams that was used outside the appropriate process -% the usiness Office* The

inappropriate schedulin practices for mammorams were resolved -efore this investiation was initiated* The OIG

referred the 0eport of Investiation

Documents

OIG Wait Time Report 2016