VA: No wait-time issues at Phila., Horsham sites

A national investigation into claims that Veterans Affairs employees doctored records to hide backlogs in treatment for veterans found no such wrongdoing at its Philadelphia and Horsham facilities, VA officials said Thursday.

The agency's Office of Inspector General said it examined complaints about scheduling problems at its West Philadelphia hospital, and noted the "archaic" computer system there. But it did not find any willful manipulation of data.

In reviewing more than four years' worth of data from the Horsham clinic, inspectors found it never had more than six patients waiting for care at a time, and said "very few" had to wait more than 14 days for an appointment. The report did, however, cite employees there for sloppiness and inattention to policies regarding appointment scheduling.

The findings come amid a review of 77 VA sites nationwide after complaints that agency workers manipulated records to hide the length of time veterans had to wait for treatment.

In Philadelphia, inspectors said, an employee had told them a former manager once said his bonus was dependent upon keeping treatment wait times within the agency standards.

But the former manager, in the audiology department, disputed that, the report said.

Inspectors did find that at times, there were many veterans, "often numbering several hundreds," on the wait list for hearing-aid consultations.

The former manager - like all employees cited, he was not identified in the report - said that to remedy that, he authorized staff overtime, worked with non-VA facilities to see the veterans, pleaded for additional staff, and placed additional audiologists at the VA's clinics in Horsham and Gloucester City.

The inspectors also said they could not substantiate a complaint about a breakdown in the appointment process for some Philadelphia departments while a scheduling clerk was on leave. And it said another claim that a manager in the eye clinic was "cooking the books" was mistaken.

Investigators said that because of "the archaic nature" of a patient computer system, appointments in the eye clinic scheduled more than 90 days ahead of time had to be canceled and reentered into the computer system from one to five days before the appointment so an ultrasound machine could interact with the computer system and generate a required daily patient list.

"The clinic has no delays, and if a provider requests an ultrasound for the next or same day, it can be accommodated," the report said.

Inspectors also found that a complaint regarding appointments in the physical medicine and rehabilitation inpatient program was misinformed, and came from someone who "is not involved in scheduling" and "was unfamiliar with the process for deleting old" appointments.

The review in Horsham centered on allegations that higher-ups directed assistants to change a patient's "desired date" for an appointment to the next available date.

A nurse manager told inspectors that if a patient was "willing to negotiate on the date" of an exam, the appointment date and the desired date would be entered as the same date.

But if the patient was unwilling to negotiate, then the first date the patient wanted was entered as the desired date.

An administrative officer "stressed the overall objective was to correct errors, not to skew the data," the report says.

Still, the office found policies relating to the inputting of the "desired date" were not followed.

The office said it had provided its reports to the VA's Office of Accountability Review for appropriate action.

shawj@phillynews.com

215-854-2592

@julieshawphilly