The first comprehensive review of the medical care system for veterans found widespread scheduling abuses, data falsification and long waiting times at dozens of hospitals and clinics across the country.
In its audit of 731 medical facilities, the Department of Veterans Affairs reported Monday that 57,436 veterans have been waiting more than 90 days for an initial medical appointment.
The VA hospital in St. Louis had one of the worst average wait times for patients seeking specialist care. The St. Louis hospital had the fifth-highest wait time in that category -- 86 days, according to the audit.
Thirteen percent of schedulers told VA auditors that supervisors or other co-workers had instructed them to enter a different date in the appointment system than the one requested by a veteran.
"This audit is absolutely infuriating and underscores the depth of the scandal," Paul Rieckhoff, founder of Iraq and Afghanistan Veterans of America, a New York-based advocacy group, said in a statement. "Our vets demand action and answers."
The medical facility with the longest average wait time for a new patient to see a primary care physician was the VA medical center in Honolulu, at 145 days, while the VA hospital in Harlingen, Texas, topped the list for waits to see specialists, also at 145 days on average.
The VA hospital in Durham, N.C., had the longest average wait for veterans seeking mental health care, at 104 days.
Among other VA hospitals with long wait times for various types of care were the William Jennings Bryan Dorn VA Medical Center in Columbia, S.C., and VA centers in Dallas and Fayetteville, N.C.
Eight percent of schedulers said pressure had been placed on them to bypass the VA's official Electronic Wait List system and maintain unofficial lists in order to make waiting times appear shorter than they actually were, according to VA interviews with 3,772 clinical and administrative staff.
Congressman John Shimkus, R-Collinsville, asked Monday that VA employees and veterans in his district contact his office at 288-7190 to report any irregularities in VA scheduling procedures they have witnessed.
"Today's release of the VA's Access Audit confirms that the problems with veterans getting timely service are even more widespread than previously revealed," Shimkus said. "My office has aided numerous veterans through the years who have experienced similar issues, and I encourage anyone currently in that situation -- as well as VA employees -- to share with me any knowledge of irregularities at the VA."
Retired Army Gen. Eric Shinseki resigned May 31 as head of the Department of Veterans Affairs after acknowledging that inordinate wait times and scheduling data falsification were more widespread than he'd believed.
Before his exit, Shinseki in mid-April directed the Veterans Health Administration to conduct the agency-wide audit.
A key finding of the audit was that the 14-day target for waiting times Shinseki established in 2011 was unrealistic and "not obtainable."
That problem was exacerbated by tying hospital managers' bonuses to meeting the 14-day target.
Setting such an unrealistic waiting-time target and linking it to performance bonuses created "an organizational leadership failure," the audit found.
Sloan Gibson, named by President Barack Obama as acting VA secretary, said Monday that the agency is eliminating the 14-day scheduling goal and suspending all performance awards for senior executives of the Veterans Health Administration.
Gibson said the VA also will deploy mobile medical units to provide care to some of the vets who've been waiting a long time for care.
Gibson ordered a hiring freeze at the Washington headquarters of the Veterans Health Administration and at 12 of its regional offices, except for critical positions to be approved by him on a case-by-case basis.
"This data shows the extent of the systemic problems we face, problems that demand immediate action," Gibson said in a statement. "Veterans deserve to have full faith in their VA, and they will keep hearing from us until all our veterans receive the care they've earned."
Gibson said the VA has contacted 50,000 vets nationwide to get them off waiting lists.
The scandal erupted at the VA hospital in Phoenix, where Gibson acknowledged during a visit last week that 18 veterans had died while waiting for medical appointments.
A probe by the agency's inspector general found that vets waited an average of 115 days for their first medical appointment at the Phoenix hospital, 91 days longer than the center reported in its logs.
The new audit flagged 112 VA medical centers and clinics for further review.
The audit shows nearly 900 veterans have requested appointments at Illinois' Veterans Administration hospitals in the past decade but not received them.
The Veterans Affairs Department released findings Monday of a national audit on quality of care and wait times. It follows allegations that 40 patients died awaiting care at a Phoenix hospital where employees kept a secret waiting list to cover up delays.
The audit shows 494 new patients requested an appointment at the VA hospital in Marion, Illinois but no appointment was scheduled.
It also shows the average wait time for a primary care appointment was 33 days for patients at Edward Hines Jr. VA Hospital outside Chicago and 54 days in Danville.
Republican U.S. Sen. Mark Kirk says the VA hasn't been forthcoming enough about problems.
The Veterans Affairs Department says nearly 1,400 patients who sought appointments through the VA medical center in St. Louis over the past decade were never seen.
The VA on Monday released details of an audit of 731 VA hospitals and outpatient clinics. Thirteen percent of schedulers reported being told by supervisors to falsify appointment schedules to make patient waits appear shorter.
The audit found that system-wide, more than 57,000 patients are still awaiting initial medical appointments 90 days or more after requesting them.
It also found that nearly 64,000 who enrolled in the VA system over the past 10 years have never had appointments, including 1,354 in St. Louis, 188 in Kansas City, 102 in Poplar Bluff and 71 in Columbia.
The VA says it is taking corrective action.
NEW PATIENT PRIMARY CARE LONGEST AVERAGE WAIT TIME:
1. Honolulu, Hawaii: 145 days
2. VA Texas Valley Coastal Bend HCS, Harlingen, Texas: 85 days
3. Fayetteville, North Carolina: 83 days
4. Baltimore HCS, Maryland: 81 days
5. Portland, Oregon: 80 days
6. Columbia, South Carolina: 77 days
7. Central Alabama Veterans HCS, Montgomery, Alabama: 75 days
8. Providence, Rhode Island: 74 days
9. Salt Lake City, Utah: 73 days
10. Richmond, Virginia: 73 days
NEW PATIENT SPECIALIST CARE AVERAGE WAIT TIME:
1. VA Texas Valley Coastal Bend HCS, Harlingen, Texas: 145 days
2. El Paso, Texas: 90 days
3. White City, Oregon: 88 days
4. Clarksburg, West Virginia: 86 days
5. St. Louis, Missouri: 86 days
6. Middle Tennessee HCS, Nashville, Tennessee: 71 days
7. Durham, North Carolina: 69 days
8. Hampton, Virginia: 68 days
9. Mountain Home, Tennessee: 67 days
10. VA Central Western Massachusetts HCS, Leeds, Massachusetts: 67 days
NEW PATIENT MENTAL HEALTH CARE AVERAGE WAIT TIME:
1. Durham, North Carolina: 104 days
2. Clarksburg, West Virginia: 96 days
3. Amarillo, Texas: 61 days
4. El Paso, Texas: 60 days
5. Erie, Pennsylvania: 57 days
6. Central Alabama Veterans HCS, Montgomery, Alabama: 57 days
7. White City, Oregon: 57 days
8. VA Texas Valley Coastal Bend HCS, Harlingen, Texas: 55 days
9. Hampton, Virginia: 54 days
10. Dallas, Texas: 50 days