VA leaders in New York are accused of delaying important doctor visits

Veterans Affairs fired two top officials from their posts at a New York hospital late last week after a damning inspector general report accused them of delaying appointments for radiation therapy and neurosurgery, resulting in excessive pain and injury to several patients.

Republican lawmakers called the findings abhorrent and evidence that department planners are still unfairly blocking veterans from getting quick medical care outside the VA health care system.

But senior VA leaders said they were committed to providing patients with the best possible care and promised a full review of the incidents to correct the errors and potentially punish the administrators involved.

The report, released Friday afternoon, focused on veterans who received care from the VA Western New York Healthcare System over the past two years.

Investigators found that local leaders “failed to address significant delays in planning community care for patients with serious health conditions, despite efforts by providers and community nursing staff to advocate for patients.”

Community care — in which veterans can receive medical appointments and treatment at private clinics, but the cost of which is covered by the VA — has been a controversial issue in recent years, with conservatives claiming that department bureaucrats are unnecessarily restricting these outside options.

In the New York investigation, the inspector general found that at least 42 patients experienced significant delays in accessing this care despite facing serious health problems that required rapid action.

“For three of the 42 patients, the appointment delay impacted the provider's management of the patient's medical condition, and for nine of the 42 patients, the delay impacted the patient's clinical status or condition,” the report said.

In one case, a veteran with esophageal cancer was mistakenly denied radiation therapy for several months before he died of the disease. Investigators said the treatments likely would not have saved the patient, but a quicker response “likely would have reduced the extent of pain and improved the patient's quality of life in the final months.”

In another case, a young veteran with seizures waited more than 300 days for a consultation appointment, even though the patient was hospitalized several times a month for related health problems.

“Leaders failed to consistently focus on patients, respond to staff concerns, identify the source of concerns about delayed scheduling of urgent consultations, and predict and address risks before they harm patients,” it said Report.

In response to the findings, “the VA immediately moved the medical center director and chief of staff from their clinical and veteran-facing positions pending the results of an investigation,” VA press secretary Terrence Hayes said in a statement.

“It is unacceptable for a veteran’s care to be delayed. That’s why we’re taking immediate remedial action to prevent something like this from happening again.”

Republican lawmakers demanded a full explanation of the meaning of that promise.

“Community care is VA care, and I will not allow VA bureaucrats to restrict it,” House Veterans Affairs Committee Chairman Mike Bost, R-Ill., said in a statement. “It is unacceptable for VA to allow its own leadership and mistakes to once again result in patient harm.”

Senate Veterans Affairs Committee member Jerry Moran, R-Kansas, expressed similar concerns.

“The failings in care described in this report cannot be ignored,” he said in a statement. “VA must be accountable to Congress, veterans and the American people by acting immediately to hold leadership and staff accountable by conducting an immediate nationwide review of backlogs of consultations everywhere.”

In fiscal year 2023, VA approved more than 7.8 million community care appointments with a total value of more than $31 billion. That was about 17% more than last year and represented nearly one in six medical appointments covered by VA this year.

But Republicans and Democrats on Capitol Hill have clashed in recent years over whether VA is doing enough to ensure veterans are offered cross-departmental medical options when there are delays in care.

The inspector general said delays occurred in the New York cases they reviewed because “the community care team lacked a process to address time-sensitive, high-risk consultations and did not have standard operating procedures in place.”

They also said officials were “unfamiliar with the basic processes of community care and did not follow all national standards” to authorize such care.

The report recommends a full review of system leaders' decisions regarding the delays and an overhaul of procedures for approving such requests in the future.

The full report is available on the Inspector General's website.