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VOL. 129 | NO. 113 | Wednesday, June 11, 2014

Memphis Veterans Affairs Medical Center Flagged in Audit

By Bill Dries

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The Memphis Veterans Affairs Medical Center is one of four federal VA hospitals in Tennessee that the Veterans Health Administration – in a national audit announced Monday, June 9 – flagged for further review and investigation.

The audit, which began in mid-April, is a reaction to allegations that excessive wait times were endangering the health of veterans across the country and that some administrators were posting false wait times in records.

Veterans Affairs Secretary Eric Shinseki, who resigned in May, ordered the audit.

The goal was to schedule an appointment within 14 days of a request. But the report concludes that “was simply not attainable given the ongoing challenge of finding sufficient provider slots to accommodate a growing demand for services.”

The Memphis Veterans Affairs Medical Center was flagged for further review after a national audit examining wait times at VA facilities. 

(Daily News File/Lance Murphey)

“Imposing this expectation in the field before ascertaining the resources required and its ensuing broad promulgation represent an organizational leadership failure,” the report read.

The figures for Memphis in the audit show 97 percent of the 48,998 appointments that the auditors followed were scheduled within 30 days.

However, the audit also shows 272 newly enrolled veterans over the past decade requested an appointment as they enrolled and an appointment had not yet been scheduled.

The average wait time for new primary care patients not seen at the Memphis facility in the previous two years was 50 days. The average wait time was 48 days for new specialty care patients and 31 days for new mental health patients.

For established patients in all three categories, the average wait time at Memphis was 1.93 days to 2.68 days.

The difference is critical with the Memphis center and other Veterans Affairs facilities seeing more troops returning from Iraq and Afghanistan.

Last year, the Memphis facility opened a new wing specifically for Iraq and Afghanistan veterans.

U.S. Rep. Steve Cohen of Memphis said Monday in a written statement from Washington that any delay in care is “unacceptable.”

Cohen termed the report “disappointing,” saying it “underscores that more still needs to be done – not only in Memphis but around the nation – to fulfill our commitment to our veterans.”

U.S. Sen. Lamar Alexander of Tennessee has said the problems point to the need for veterans to be able to seek medical care at any facility they choose instead of being limited to Veterans Affairs hospitals and medical centers.

The Memphis VA Medical Center is part of the Department of Veterans Affairs’ Veterans Integrated Service Network 9, which includes facilities in Tennessee, Kentucky and West Virginia. Of those, the audit called for further review of facilities in Nashville, Memphis, Chattanooga and McMinnville, Tenn.; and Dupont and Ft. Knox, Ky.

The audit released Monday concluded that across the country, 13 percent of the Veterans Affairs staffers involved in scheduling patients said in interviews “they received instruction (from supervisors or others) to enter a date different than what the Veteran had requested in the appointment scheduling system.”

The electronic wait list was used to calculate the average wait time for veterans to monitor how rapidly veterans were being seen by doctors and other hospital staff.

The audit included interviews with more than 3,700 staff involved in scheduling patients at VA facilities across the country, including in Memphis.

The report also concludes that 8 percent of those doing the scheduling who were interviewed used something other than the electronic wait list.

“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 report reads.

Memphis was one of 216 sites that were “phase one” sites – meaning they are medical centers serving at least 10,000 veterans. Of the 216 hospitals and medical facilities in that category, 81 or 37 percent, were found to require further review. The report says that review is “a preliminary step and further actions will be taken after the determination of the extent of issues.”

Nationally, the audit survey showed that 96 percent of the frontline staff at the facilities responding to a question about whether they were trained on the scheduling policy said they had been trained. But half could not recall when their last training was. And 14 percent of the schedulers appeared to have been trained “in anticipation of the audit.” That is the percentage who said they had been trained within the week before they were surveyed.

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