Almost five months after a federal report substantiated a whistleblower’s allegations about wait-time fraud at the Tucson veterans hospital, local VA officials won’t say if any hospital employees have been disciplined or fired related to the misconduct.
An internal investigative board is still looking into the allegations of wait-time manipulation, said Tom Antonaccio, spokesman for the Southern Arizona VA Health Care System on South Sixth Avenue.
“Once the investigation is concluded, we can certainly discuss the appropriate release of information related to this investigation,” he said in an email.
For the Tucson whistleblower who brought the allegations to light, that’s unacceptable.
“The internal board at the VA should have been able to take care of this in this amount of time,” said Diane Suter, 62, who worked in the Tucson VA’s Ocotillo Primary Care Clinic until August 2014. “It’s ridiculous. They’re not going to do anything.”
The Nov. 9 Office of Inspector General report validated Suter’s claims about falsified wait times in the Tucson VA’s electronic scheduling system to make waits appear shorter. Wait times under 14 days were tied to doctors’ bonuses at the time.
The report recommended disciplinary action for workers who encouraged wait-time manipulation.
Suter said her nurse manager told her to falsely input a patient’s desired appointment date as the same day that the appointment was ultimately scheduled, making it appear that there was no wait time.
Suter, who worked for 17 years as a registered nurse in the VA system, said she suffered retaliation after pushing back against the dishonest scheduling practices. The nurse manager who ordered Suter to falsify wait times still works at the Tucson VA, she said.
Antonaccio said he could not share any details about the administrative investigative board, including how many members it has and who they are, nor could he estimate when the board is expected to finish its inquiry.
“We have to respect that process until it’s complete,” he said.
Firing VA employees for misconduct is an uphill battle, said Matt Dobson, Arizona state director for Concerned Veterans for America. The group supports the VA Accountability First Act, which Dobson said would protect whistleblowers as well as reduce lengthy appeals that can keep bad employees on staff for years.
“There’s tons of people that are great that work at the VA, and they get surrounded by these people that don’t care and they can’t be touched,” he said.
The legislation is opposed by the American Federation of Government Employees, a union that represents 230,000 VA employees. The union argues the bill weakens protections for VA workers, including 120,000 who are veterans themselves, and could undermine recruitment efforts to address staffing shortages.
“Instead of hiring the more than 45,000 frontline caregivers our veterans desperately need, they’d rather spend their time sticking it to the people who serve veterans every day,” the union’s national president, J. David Cox Sr., said in a March news release.
WAIT TIMES IMPROVED
Local VA officials have touted improvements in wait times for patients over the past couple of years.
In February, wait times for primary-care appointments averaged just over four days; specialty care wait times averaged just over seven days; and mental health appointment wait times averaged under three days, Antonaccio said.
That month, the VA completed almost 96 percent of 36,000 appointments in under 30 days, but the remainder do need improvement, he said.
“We remain focused on improving access with a goal of seeing all our veterans within 30 days of the preferred or clinically-indicated date,” he said in an email.
The hospital has hired 100 new staff members over the past couple of years and recently increased compensation for primary-care providers, psychiatrists, hospitalists, emergency-room doctors and surgeons, he said.
Three years after a wait-time scandal broke out at the Phoenix VA, veterans across the country too often still face delays in care, and VA executives have not been held accountable, Dobson said.
Earlier this month, Phoenix military veteran Steve Cooper, 46, was awarded $2.5 million in a lawsuit against the Phoenix VA for its failure to diagnose his prostate cancer before it became terminal, the Arizona Republic reported.
The judge ruled a nurse practitioner breached the standard of care by failing to order follow-up testing after finding abnormalities in Cooper’s prostate in 2011. When he was finally diagnosed 11 months later, his cancer was Stage 4.
On March 13, the Office of Inspector General issued a separate report highlighting areas needing improvement at the Tucson VA. The routine quality-of-care evaluation, based on an October 2016 review, found weaknesses in areas including general safety, community nursing home program oversight and training related to management of violent behavior. Identified weaknesses include:
- In some patient care areas, biohazardous waste was not stored in a secure location.
- In a review of random patients’ electronic health records, three of 17 patients did not undergo required lab tests before receiving blood-thinning medication.
- When patients were transferred to another VA or non-VA facility, providers did not consistently document that they forwarded medical history, preliminary diagnoses and results of diagnostic tests to the receiving facility.
U.S. Rep. Raúl Grijalva, D-Tucson, said the report reflects the consequences of a “chronically underfunded” Veterans Affairs Department. “Until the VA receives the support it urgently needs, more instances of unacceptable care are sure to arise around the country,” he said in a written statement.
Antonaccio emphasized the routine report is unrelated to the issue of wait times at the VA, and it mentions some accomplishments at the VA. That includes the 2015 creation of a “clinical surveillance team” devoted to expediting follow-up with patients whose radiological results contain unexpected findings.
“As an organization we appreciate having an independent body take a look and offer recommendations to us so we can improve our practices,” he said.
Contact reporter Emily Bregel at email@example.com or 573-4233. On Twitter: @EmilyBregel