Audit: Wait times still a problem at NC VA hospitals

According to the VA's Office of Inspector General, schedulers were using incorrect or inaccurate dates that start the clock ticking to determine wait times, which meant that thousands of vets were ineligible to receive more timely medical care from outside providers.

"I depend on this place, and I don't trust them, not in the least bit," said Brian Ryals, a Navy veteran who gets his health care from the Durham VA Medical Center.

Ryals suffers from arthritis in his spine and joints, a shoulder injury, Crohn's disease and other ailments, and he said getting an appointment to see a doctor at the VA hospital is often a struggle.

"The colonoscopy's the big one I still haven't heard about. I think it's coming up in the next three months, but I've been waiting for over six months already," he said. "They don't have enough doctors, they don't have enough nurses, and I understand that, but a lot of people there are incompetent."

The VA has been plagued by long wait times for care for years, and a nationwide audit in 2014 that showed facilities doctoring their figures – some veterans died while waiting for care – led to the resignation of the VA secretary, federal investigations and an overhaul of the system.

The goal for VA hospitals across the country is to get every veteran the appointment he or she needs within 30 days, but the Inspector General's report shows the wait times reported by North Carolina's four VA hospitals continue to be inaccurate.

Investigators conducted the audit from April 2016 to January and found the start date used to calculate wait times was entered into the system incorrectly 69 percent of the time in Durham, 49 percent of the time in Fayetteville, 56 percent of the time in Salisbury and 75 percent of the time in Asheville.

Because of the errors, the Durham VA hospital reported a six-day average wait for care it should have been listed as 22 days, according to the audit. At the Fayetteville VA hospital, the wait time should have been listed as 30 days, not the 22 days the hospital reported, auditors said.

"The discrepancies between OIG and VHA [Veterans Health Administration] wait times are the result of OIG's use of a methodology that was inconsistent with VHA policies at the time of the audit," said Elizabeth Goolsby, director of the Fayetteville VA hospital. "All scheduling audits and follow-up training at Fayetteville VAMC were compliant with VHA requirements."

But the Inspector General responded that its figures were "based on VHA guidance in place during the scope of the audit." Even using the methodology the hospitals said should be used, investigators said they still found a 59 percent error rate in wait time data.

"We're not getting a straight answer to the real wait times," U.S. Sen. Thom Tillis said.

The North Carolina Republican put some of the blame on outdated scheduling systems in the VA, but he said the culture in the agency also is at fault.

"Some of it's just pure administrative. Some of it is the mentality of the people who are taking the call to begin with," Tillis said. "Their organization is outdated. Their technology is outdated."

Ryals said he's not surprised by the audit's finding and the response of VA administrators.

"If they are not worried about the Inspector General, then what are they worried about?" he said. "Would it take the president of the United States to come down here and say, 'This is how I want you to treat the people that served our country?'

"They're my brothers and sisters, and they deserve more," he said of all veterans. "I want some accountability."

The inaccurate wait times has led to confusion as to whether veterans were eligible for the Choice program, which allows them to use outside doctors if the VA can't see them within 30 days.

In Durham and in Fayetteville, it took an average of 14 to 16 days, respectively, to authorize Choice care. Veterans had to wait a total of 85 days in Durham and 94 days in Fayetteville to see a Choice provider, according to the audit.

"It took me months to see a rheumatologist about my back and to get an actual explanation and diagnosis," Ryals said. "If I'm going through this much pain, how much pain are they [other veterans] going through?"

Both the Fayetteville and Durham VA hospitals said they're now in compliance with scheduling rules, and wait times for pending appointments are well below the 30-day standard. The Durham hospital contacted Ryals this week to set up several appointments, including the colonoscopy he's been waiting for for months.

Still, Tillis has demanded an explanation from VA Secretary David Shulkin on the audit's findings.

"You can't explain away the wait times – maybe some, but not a lot," he said. "We've got to focus on that, and we got to keep the pressure on until they solve the problem so we don't get another surprise from the Inspector General."