VA leaders in New York accused of delaying critical medical visits

Veterans Affairs leaders removed two senior officials from their posts at a New York hospital late last week after a damning inspector general report accused them of delaying radiation therapy and neurosurgery appointments, which resulted in excess pain and injury to multiple patients.

Republican lawmakers decried the findings as abhorrent and evidence that department planners are still improperly preventing veterans from getting quick medical care outside of the VA healthcare system.

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

The report, released Friday afternoon, focused on veterans receiving care through the VA Western New York Healthcare System over the last two years.

Investigators found that local leaders “failed to resolve significant community care scheduling delays for patients with serious health conditions, despite providers’ and community care staff’s efforts to advocate on the behalf of patients.”

Community care — where veterans can receive medical appointments and treatments at private-sector clinics but have the expenses covered by VA — has been a controversial topic in recent years, with conservatives claiming that department bureaucrats unnecessary limit those outside options.

In the New York investigation, the inspector general found that at least 42 patients had significant delays in accessing that care, despite facing serious health conditions that mandated fast action.

“For three of the 42 patients, the scheduling delay affected the provider’s management of the patient’s condition, and for 9 of the 42, the delay affected the patient’s clinical status or condition,” the report states.

In one case, a veteran with esophageal cancer had radiation therapy incorrectly denied for several months before dying from the illness. Investigators said the treatments would not likely have saved the individual, but a faster response “would likely have decreased the level of pain and improved the quality of life in the patient’s final months.”

In another case, a young veteran experiencing seizures waited more than 300 days for a consult to be scheduled, even as the patient was hospitalized several times a month for related health issues.

“Leaders failed to consistently focus on patients, respond to staff concerns, get to the root cause of concerns regarding delayed scheduling of urgent consults, and predict and eliminate risks before causing patient harm,” the report stated.

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

“It is unacceptable for any veteran to have their care delayed, which is why we are taking immediate corrective actions to prevent this from happening again.”

Republican lawmakers demanded a full detailing of what that promise means.

“Community care is VA care, and I won’t let VA bureaucrats restrict it,” House Veterans’ Affairs Committee Chairman Mike Bost, R-Ill., said in a statement. “It is unacceptable that VA is allowing its own leadership and failures to yet again lead to patient harm.”

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

“The lapses in care described in this report cannot be ignored,” he said in a statement. “VA must answer to Congress, veterans and the American people by acting without delay to hold leadership and staff accountable through conducting an immediate national review of backlogged consults everywhere.”

In fiscal 2023, VA approved more than 7.8 million community care appointments, totaling more than $31 billion. That was up about 17% from the previous year, and represented nearly one in every six medical appointments covered by VA that year.

But Republicans and Democrats on Capitol Hill have sparred in recent years over whether VA is doing enough to ensure that veterans are presented with non-department medical options when facing delays in care.

The inspector general said in the New York cases they reviewed, the delays occurred because “the community care team lacked a process to address time-sensitive, high-risk consults and had no standard operating procedures.”

They also said officials “were unfamiliar with community care basic processes and were not following all national standards” for approving such care.

The report recommends a full review of system leaders’ decisions regarding the delays, as well as overhauling procedures for approving such requests in the future.

The full report is available on the inspector general’s website.