SALISBURY, NC (WBTV) - An investigative summary released by the US Department of Veterans Affairs' Office of the Inspector General says employees at the Salisbury VA Medical Center manipulated appointments to make it appear as though veterans' wait timers were within 14 days.
The report was released on Tuesday, October 4 but detailed an investigation conducted by the VAOIG's Office of Investigations between May 2014 and March 2015.
The report says investigators concluded "over half of the schedulers who were interviewed were routinely "fixing" patient appointments at the request of their supervisors, so scheduled appointments would appear to fall within 14 days of a veteran's desired date."
Investigators said some employees were evaluated based, in part, on the number of appointments that were scheduled within 14 days of a veteran's desired date.
The amount of appointments scheduled within 14 days of a patient's desired date was also included in a list of evaluation criteria for the Salisbury VAMC director, the report said.
According to the investigative summary released Tuesday, investigators reviewed appointment records and interviewed a number of staff members and supervisors.
Management at the Salisbury VAMC told investigators they were unaware of the practice of 'fixing' appointments to fall within a 14-day range.
"In a meeting with the director, associate director, chief of staff, the executive nurse, chief of Management Support, Systems Redesign Coordinator, chief of Quality Management, and the risk manager regarding the allegation, the director stated that the week of May 11, 2013, a VA Team composed of VA employees from other Veterans Integrated Service Networks (VISNs) conducted interviews with VAMC Salisbury employees in order to determine if there were problems in scheduling at the facility," the summary said. "The director further stated that, at the conclusion of the visit, she was told no issues existed at VAMC Salisbury or any of the affiliated clinics other than a few employees at the Community Based Outpatient Clinic (CBOC) located in Charlotte, NC, who seemed to be confused about the desired date of the veteran and the correct application of the desired date when scheduling appointments."
But appointment data reviewed by investigators raised questions.
"VA OIG reviewed a report of all appointments scheduled by facility staff on May 15-16, 2014. Review of the report revealed that more than 7,500 appointments were made over the 2-day time period, and an abnormally large number of the appointments were made with a wait time of zero days, even appointments that were made several months into the future," the summary said.
And multiple employees interviewed by investigators said they were instructed by their supervisors to manipulate appointments. One employee in the Women's Health Clinic said a supervisor threatened to revoke her access to the scheduling system because of her refusal to not "fluff the numbers" and said it was documented on her performance review that she was "not a team player" because she regularly scheduled appointments outside of the 14-day window when a closer appointment was not available.
That same employee also told investigators about a secret list of patients who had not had appointments scheduled for them; some patients, the summary said, waited more than 500 days for an appointment.
"In late 2013, she learned of a "Consult List" for her clinic (Women's Health) that contained names of patients, who were never scheduled an appointment, to be seen in the clinic. She stated some of the patients on the list had been waiting over 500 days for an appointment to be scheduled. She and another nurse in her clinic scheduled appointments for patients on the consult list and reduced the list from over 5 pages to 1 page, with approximately 14 to 15 patients remaining to be scheduled for an appointment."
The administrative summary report does not include a response from the administrators at the Salisbury VAMC. An email seeking comment from a spokesperson for the medical center sent late Tuesday night was not immediately returned.
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