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VA audit: A third of Puget Sound schedulers say they’re told to manipulate patient wait-time data

One third of Lakewood and Seattle Veterans Affairs hospital schedulers surveyed in an audit say they were instructed to change how long military veterans waited forappointments, according to a nationwide VA record-keeping audit.

It is a strikingly high percentage that surprised lawmakers and appeared to contradict statements from top VA officials who said in May that Northwest hospitals did not have serious problems with wait-time data being doctored.

“These revelations are unacceptable to everyone who believes it’s our responsibility to provide quality care for those who served,” said Rep. Derek Kilmer, D-Gig Harbor.

The new data comes from an audit launched amid allegations that VA hospitals in Arizona and Colorado manipulated data on how long patients waited to see doctors by keeping “secret waiting lists” outside of normal VA record-keeping systems.

The VA in June released a preliminary report confirming that officials at the VA medical center in Phoenix misreported data on delays in care. The report indicated the practice was common across the VA, and it led to the resignation of VA Secretary Eric Shinseki. Congress has been working on a bipartisan deal to improve care and increase accountability at the VA, with a projected price tag of at least $15 billion.

The preliminary audit report indicated VA hospitals in the Puget Sound, Portland and in Spokane should receive further review from VA inspectors, but it did not cite any specific wrongdoing.

At the time, VA Northwest Director Lawrence Carroll wrote in a memo to employees that auditors “found no evidence of secret waiting lists. Rather it was confirmed, that on the whole, staff understood what they needed to do in regards to scheduling and managing wait times.”

Megan Crowley, spokeswoman for the VA’s Northwest region, said Carroll made those statements after hearing preliminary reports from auditors following their hospital visits. She had not seen the more detailed information until this week.

“There was absolutely no intent to paint a better picture or give false information,” she said. “We were responding with the information we had at the time.”

It’s not clear how many schedulers in Lakewood and Seattle were interviewed by the VA auditors. A total of about 3,700 VA staffers were interviewed nationwide.

At 33.3 percent, the percentage of VA Puget Sound staffers surveyed who reportedly were told to manipulate data is far higher than the national average of 13 percent.

It’s also the highest percentage among large hospitals in the Northwest, according to a report obtained by The News Tribune. In Portland, 2.5 percent of schedulers surveyed reported being told to manipulate data. In Anchorage, the rate was 10 percent.

Rep. Denny Heck, D-Olympia, called the new information from the audit “deeply disturbing.” He is planning to visit the VA’s American Lake hospital in Lakewood to follow up on the report.

A small portion of VA Puget Sound staffers surveyed — fewer than 5 percent — told auditors they sometimes track appointment requests outside the VA’s official scheduling system. By contrast, 31.3 percent of staffers surveyed in Spokane told auditors they track appointments outside the normal system. That kind of “off the books” record-keeping was central to the allegations of wrongdoing in Phoenix.

USA Today published a nationwide look at the findings today.

“We’re just taking every new bit of information as we get it, and we’re taking it very seriously,” Crowley said.

VA Puget Sound Director Michael Murphy has held several staff meetings on appropriate record-keeping over the past three months, VA spokeswoman Kim Wilkie said. About 300 Seattle and Lakewood schedulers attended the first meetings in May.

He told staff members they should notify senior managers “if they are ever directed to do anything they believe to be improper,” Wilkie said.

Senior officials from VA Puget Sound have reinforced the message with regular visits to scheduling sites at the two main hospitals in six community clinics, she said.

The VA is straining with rapid growth fueled by new veterans from the Iraq and Afghanistan wars, expanded benefits for Vietnam veterans and a surge of other older veterans who are turning to the VA after leaving the workforce.

The VA set a high standard for delivering care as it braced for that growth, aiming to see 99 percent of patients within two weeks of a request for an appointment.

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