20 patients put at risk by Wichita VA secret waiting list
07/24/2014 12:50 PM
08/06/2014 12:20 PM
Twenty patients were put at risk by a secret waiting list at the Wichita Veterans Affairs hospital, the facility’s director confirmed to a Kansas congressman Thursday.
However, no patients were directly harmed, according to hospital director Francisco Vazquez.
While the report demanded by Rep. Tim Huelskamp, R-Fowler, contained some new numbers and assurance that no one was hurt, Huelskamp said Vazquez did not address key questions about the unauthorized waiting list of 385 patients who were seeking service from the Robert J. Dole VA Medical Center.
The story “keeps changing all the time,” Huelskamp said, criticizing the hospital for its slow – and in some cases inaccurate – release of information.
Also on Thursday, Rep. Mike Pompeo, R-Wichita, questioned whether the hospital had followed the proper procedures for reporting its errors and policy violations.
The existence of the secret waiting list was confirmed Friday in a fax sent to members of Congress. But detailed information has trickled out since through various congressional inquires.
The hospital’s public affairs staff is operating under a management-imposed news blackout and has declined to answer verbal or written questions from The Eagle.
Thursday’s report came a day after Huelskamp made an unannounced visit to the hospital, showing up at the door and demanding a meeting with administrators. Huelskamp said he took that action after being stonewalled on information requests for five days.
According to Vazquez’s response to Huelskamp, 126 patients on the secret waiting list were part of the Home Based Primary Care program.
“This program is for veterans already receiving primary care from VA who might benefit from primary care delivered in the home,” Vazquez’s letter said. “HBPC is a multi-disciplinary team approach which includes nurses, dieticians, social worker, physical therapist and providers. While many organizations provide just visiting nurse services, a program such as HBPC is not typical in the community.”
The biggest group of patients on the secret waiting list, 245, received some primary care at the hospital. The remaining 14 patients on the list apparently didn’t receive any care at all, according to Vazquez’s letter to Huelskamp.
“During the review conducted by the Quality Management department, 20 patients were identified as being at risk of potential adverse impact as a result of delays in entry into the Home Based Primary Care program,” the letter said. “These patients were referred to a panel convened by the Interim Chief of Staff, composed of physicians and the Interim Chief of Staff. It was determined by this review that no patients experienced adverse impact as a result of the delays.
“The fact that no patients were harmed as a result of use of this unauthorized list is the best possible outcome,” the letter concluded.
Huelskamp, however, said Vazquez did not answer most of his questions about how and why it happened.
“Who put it together?” he said. “Why didn’t you tell us it was 385 (veterans) on Friday? Show me your process. Tell me how you found it.”
The secret waiting list in Wichita marked an expansion of the burgeoning national scandal over veteran health care. The problem surfaced first at the VA hospital in Phoenix, where slightly more than 3,000 veterans were either on secret waiting lists or had waited more than 90 days for medical appointments.
Pompeo on Thursday pressed the Wichita hospital over whether management there had properly reported the existence of the secret waiting list to the VA’s investigative arm.
In a letter to the hospital management, he said his staff has contacted the VA Office of Inspector General and that officials there were unable to confirm that the problem was reported the way Vazquez said it was in the Friday fax.
Sens. Pat Roberts and Jerry Moran also are pressing the hospital for information on how the secret list came into being and what effect it may have had on the care of sick veterans.
So far, the Wichita hospital has disclosed that at least nine patients waited 90 days or longer to get medical appointments. That’s in addition to an undisclosed number of veterans who were on the unauthorized waiting list and faced equally excessive wait times.
Vazquez’s Friday fax said “the practice was immediately discontinued and a report made to our VISN 15 (VA Heartland Network) leadership who referred it to the VA OIG (Office of Inspector General) via the Hotline process.”
Pompeo is questioning that chain of events.
He said in his letter that the Inspector General’s Office “could not verify your claim that you ‘used the Hotline process’ to report this error.”
And if true, the hotline process was the wrong way to report the problem, Pompeo said.
“As medical center leadership, you are expected to call the Inspector General directly to ensure a fast response,” Pompeo wrote. “Why did you not contact the OIG directly when you learned of this?”
Pompeo also is pressing the hospital management to identify the person or persons who approved the use of the secret list and whether any of them received performance bonuses based on misleading information provided to VA management.