The Dayton VA Medical Center fared better than the national average in scheduling patient appointments, but neither it nor other Ohio VA facilities met the federal health agency’s goal of scheduling new patients for first-time appointments within two weeks, according to a nationwide audit released Monday.
What’s more, the audit found the need for further investigation of the Richmond, Ind., outpatient clinic, which falls within the Dayton VA outpatient clinic network. The VA also said it would investigate the Cincinnati and Cleveland VA medical centers, among others across the nation after an initial look at scheduling practices.
Kimberly Frisco, a Dayton VA spokeswoman, said Monday the medical center did not know why the Richmond clinic was targeted for additional review. “We are going to take a look at our scheduling practices (at the clinic) that may have prompted this concern,” she said.
A Cincinnati VA spokesperson was not available for comment Monday.
The audit reported 98 percent of patient appointments at VA facilities in Ohio, including Dayton and Cincinnati, were scheduled within 30 days with one exception. The Columbus VA set up 94 percent of appointments within the same time, the audit said. The national average was 96 percent of patients scheduled for appointments within 30 days.
Wait time: 42 days
At the Dayton VA, a new patient had to wait an average of 42.1 days for a primary care appointment, the audit found. That’s three times the goal the VA had set of seeing a patient within 14 days, according to the audit findings. Now, the VA says it will drop the 14-day goal, among a series of changes its planning while bipartisan legislation in Congress seeks to reform the agency.
The VA initiated the audit of scheduling practices at 731 facilities after reports an unofficial wait list at the Phoenix VA Medical Center kept as many as 1,700 veterans off an appointment list and some reportedly died waiting for care.
The audit found more than 57,000 patients have waited more than three months for an appointment at VA centers across the country. Of those, 45 patients were on a waiting list at the Dayton VA’s clinic in Lima because of a recent staffing change, Frisco said. The clinic will add a primary care physician.
No patients were on an extended wait list for primary care at the Dayton VA or at its outpatient clinics in Middletown, Springfield, or Richmond, Ind., Frisco said.
In the midst of a congressional uproar and moves to legislate reform at the veterans agency, the VA pledged accountability and transparency. VA Secretary Eric Shinseki resigned in the midst of the scandal May 30.
The audit found 13 percent of VA schedulers interviewed across the country told investigators they had received instruction from supervisors or others to enter a date different than what a veteran had requested.
Some 8 percent of staff indicated they used alternatives to an electronic wait list, the audit said. “In some cases, pressures were placed on schedulers to utilize unofficial lists or engage in inappropriate practices in order to make waiting times appear more favorable,” the VA said. At least one such instance of the practice was found in 76 percent of VA facilities, the audit said.
“I’m deeply troubled to learn that in over three-quarters of VA facilities nationwide, supervisors have directed scheduling staff to manipulate data in the system regarding when a veteran wants to be seen in order to meet performance measures coming out of Washington,” U.S. Sen. Rob Portman, R-Ohio, said in a statement.
“The audit’s findings underscore the need for immediate action to address discrepancies between VA health facilities,” U.S. Sen. Sherrod Brown, D-Ohio, said.
Among other measures, the VA said it would hire more clinical and patient support staff, send out mobile medical units to facilities in need of extra help, remove senior leaders “where appropriate,” suspend performance awards of senior executives and eliminate the 14-day wait time from employee performance reviews.
Wait times varied
The Cincinnati VA had the longest wait time in Ohio for a new patient at a VA facility. That person typically waited 52.2 days to see a primary care physician, compared to 35.7 days at the Columbus VA, the report found.
One local Hamilton veteran, who regularly uses the VA to attend a weekly appointment for his post-traumatic stress disorder, said he has no issues scheduling those appointments. That wasn’t the case when Darrel Jameson, a 58-year-old Vietnam veteran, signed up for his first appointment more than 20 years ago.
“There was an uncanny waiting period to get to any of the services,” Jameson said. “But once I was able to access the services, I have no problem getting the appointments I need to make.”
For specialty care, the VA found an average wait time of 34.1 days for a new patient in Dayton versus 43.7 days in Cincinnati and 43.2 days in Columbus.
For mental health care, new patients waited 21.3 days for a first appointment in Dayton. In Cincinnati, the figure was nearly 20 days and in Columbus the wait was 47.5 days, the audit found.
The VA said it has contacted more than 50,000 veterans nationwide to get them off wait lists and into clinics.
Established patients had much shorter wait times at an Ohio VA facility.
The wait for a primary care physician was 1.4 days in Dayton, 1.3 days in Cincinnati, and 5.2 days in Columbus. For a specialist, the wait was 3.4 days in Dayton, 3.6 days in Cincinnati, and 5.4 days in Columbus, the audit reported. And for an appointment with a mental health care specialist, the wait time was 1.6 days in Dayton, less than a day in Cincinnati and 1.4 days in Columbus.
Staff writer Amanda Seitz contributed to this story.
With thousands of local veterans and families using VA facilities, our reporters in the Dayton-area and in Washington, D.C. will continue to cover this story.