The director of the veterans hospital in Wichita has informed two U.S. senators that the hospital kept a secret waiting list of patients that was found to have endangered veterans and that nine veterans waited more than 90 days for an appointment with a primary-care doctor.
Those revelations came by fax late Friday, about five hours after Sen. Pat Roberts had met with officials of the Robert J. Dole Veterans Affairs Medical Center in Wichita – and three hours after the senator told the Republican Pachyderm Club that he’d received assurances the hospital was “doing just fine.”
“I’m not very happy to see a fax when I’m leaving to find out that’s not the case,” Roberts said Monday.
The fax, also sent to Roberts’ Senate colleague Jerry Moran, contained few details and referred the senators to a Wichita-based public affairs spokesman if they had further questions. The spokesman is on vacation and his replacement – who was on vacation last week – said she was not immediately prepared to field questions about the hospital’s dealings with Roberts or the fax sent to the senators.
Roberts said his No. 1 priority is to find out how many veterans were endangered and exactly what has been done to correct the problem. He said he has learned that the list that placed veterans at risk involved patients who had been discharged from the hospital and were supposed to receive ongoing primary care while recovering at home.
Roberts also said he wants to find out why he wasn’t told about the waiting list problem in his Friday morning meeting with hospital officials.
He said he’s also sending a synopsis of his meeting to the VA Office of Inspector General “so they know what’s going on.”
The fax, sent on behalf of Dole Medical Center Director Francisco Vazquez, said that the Office of Inspector General had found nine veterans in Wichita who had waited more than 90 days for treatment.
But the larger issue was that the inspector general found an unauthorized secret waiting list for treatment that “placed veterans at risk.”
Overall, the inspector general’s office found 10 secret lists in the VA’s Heartland Network, which includes Kansas, Missouri and parts of Illinois, Indiana, Kentucky and Arkansas.
Of those 10 lists, two were found to have actually placed veterans at risk, including the one in Wichita, Vazquez’s fax said.
In the cases where the secret lists didn’t put patients at risk, staffers were educated about “more appropriate techniques.” Wichita “terminated” the list and corrected gaps in patient access, the fax said.
“Investigations for accountability are ongoing” and “veterans on the list are being contacted to ensure they are receiving the correct level of care,” the fax said.
An earlier letter from the VA to Roberts stated that 21 patients had waited more than 90 days for service in Wichita. Roberts said Friday during his speech that he found out from the hospital that the number was much less.
“There may be some reports that there are 21 people missing,” Roberts said in his Friday speech. “That’s not correct, that’s an error.
“And by missing I’m talking about the situation in Arizona where there have been 1,700, with the Office of Inspector General pointing out that people have applied and their names just end up in a drawer somewhere or someplace worse. That’s not happening in Wichita, it’s not happening in Topeka, and I have every confidence it will not be happening in Kansas City.”
However, the fax from the Dole hospital indicated that 96 veterans in the Heartland Network area had faced waits of 90 days plus, including: Kansas City, 12 veterans; Eastern Kansas (Topeka and Leavenworth), eight; St. Louis, 26; Columbia, Mo., 19; Poplar Bluff, Mo., 14; and Marion, Ill./Evansville, Ind., eight.
The national scandal over VA scheduling began at the Phoenix veterans hospital and has spread to other facilities across the country.
On Monday, Roberts said on a system-wide basis there are apparently two key causes why secret waiting lists were compiled – an obsolete computer system for scheduling appointments and, in some cases, performance bonuses tied to scheduling goals that couldn’t be met.
“There’s a real disincentive to report it accurately,” Roberts said. “That’s what happened in Arizona.”
Roberts said he thinks the Wichita situation was caused by the staff’s attempt to work around the outdated computerized scheduling system.
He said the hospital officials he met with complained about having to use a computer system based on long-outdated DOS – Disk Operating System software. DOS was the forerunner of Microsoft Windows.
Another major factor in care delay is the difficulty VA administrators face in hiring and firing employees, Roberts said.
He said he’s learned it can take six to nine months to hire doctors, which is longer than most medical-school graduates can afford to wait before beginning their careers.
In addition, Roberts said the system for dismissing unproductive employees is a Byzantine maze of verbal and written warnings, suspensions and appeals, which also takes too long for efficient operation.