Scheduling data altered at VA’s Las Vegas-area mental health clinics, report says

Schedulers for VA mental health services in the Las Vegas area altered wait time data in 2013, months before a national scandal erupted over similar practices at a VA hospital in Arizona, according to a long-delayed report by the agency’s inspector general.

A report summary by the Veterans Affairs Office of the Inspector General, published this week, did not conclude that the practices were a deliberate attempt to fool a tracking system of wait times.

But it noted that “several of the (medical support assistants) interviewed indicated that they were directed by supervisors to manipulate scheduling data.”

Other employees indicated that they used improper procedures because of unclear guidelines, miscommunications from other employees or incorrect training, it said.

The VA’s Southern Nevada Healthcare System attributed the incorrect data entry to improper practices that were not intentional and said that scheduling policy changes long ago eliminated the problem.

The investigation was launched after the VA’s Office of the Inspector General received a complaint from a former medical support assistant alleging that wait times for appointments were being improperly recorded at mental health clinics in the Las Vegas area when he worked there between 2012 and 2013.

That was months before a national scandal erupted over similar practices at a VA medical center in Phoenix.

The complaint by the Las Vegas assistant indicated he was asked to make “the numbers look good” on patient wait times by adjusting records to give the appearance patients were receiving care on the same day they called or wanted to receive treatment.

Numerous workers at the clinic told investigators that patients who requested a mental health appointment on a day when none were available were offered the next available appointment. In that case, the patient’s “desired appointment date” entered in the VA tracking system was listed as the date of the available appointment — even if it was months after the initial request — making it appear that the wait time was zero days.

The original complaint also alleged workers falsely changed the date of the scheduled appointment to the date of a patient’s contact with the VA, making it appear that the patient received immediate care.

Another employee alleged that, in one instance, patients who waited 45 to 60 days for an appointment had their desired appointment dates changed, resulting in official wait times of zero days.

The inspector general’s office interviewed the man who filed the original complaint and 11 other employees, including supervisors, and also reviewed emails, the report said.

In response to the report, the VA Southern Nevada Healthcare System on Wednesday disputed the allegation that the wait times were deliberately manipulated to fool the tracking system, saying the Inspector General’s Office found no hard evidence to support the claims.

“The VA Office of Accountability reviewed the … findings and concluded there were no accountability issues that warranted action and that revised training addressed the scheduling deficiencies discovered,” the organization said in a statement.

A representative of the VA Office of Accountability, which received the inspector general report in February for review, did not respond Thursday to a request for comment on the findings or the delay in publishing the report.

Chuck Ramey, a spokesman for the VA Southern Nevada Healthcare System, said confusion over guidelines and changing input rules led to the errors and that the problem has been corrected.

“Much has changed in scheduling nationwide since the time frame mentioned in this report and our leadership has no doubts that we are inputting and providing reliable scheduling data,” he said by email.

According to the most currently available data, the local VA wait time for mental health appointments is under four days in the SNHS, he said.

The local VA also said that it has established a management team to track challenges and resource issues and implemented new scheduling policies to reduce wait times.

Rep. Dina Titus, D-Las Vegas, released a statement Thursday calling the allegations in the initial complaint troubling and requesting a briefing on steps taken to ensure the problems have been resolved.

“I have been assured for years that this was not happening in our state,” Titus said in the statement. “Such behavior is shameful and unacceptable.”

The conclusions of the inspector general’s report echo the national scandal, which erupted on April 30, 2014, when CNN reported that at least 40 U.S. military veterans had died while waiting for care at the VA’s Phoenix medical center. The resulting investigation found that similar scheduling practices were employed at numerous other VA hospitals around the country and led to substantial changes in scheduling policies at the facilities.

Contact Pashtana Usufzy at pusufzy@reviewjournal.com or 702-380-4563. Follow @pashtana_u on Twitter.