Muskogee VA struggles continue, report shows

MUSKOGEE — The Muskogee VA medical care system was taking an average of 2 minutes and 15 seconds to answer telephone calls during the early months of 2016 — prompting 8 percent of callers to abandon their calls before receiving assistance, according to a new report issued by the VA’s Office of Inspector General.

The inspector general also reported that two patients died in October 2015 after undergoing surgical procedures, prompting officials to suspend all intermediate-level surgical procedures for a period of time.

The deaths "exposed bad processes," the Muskogee VA's new chief of surgery was quoted as stating.

Orthopedic surgery cases were reauthorized at the facility during the second quarter of federal fiscal year 2016.

Staffing at the Muskogee VA has been a problem in some specialty areas, with leaders blaming the Eastern Oklahoma Health Care System's rural location and below-market pay for difficulty in recruiting and retaining specialty doctors, the

report said.

U.S. Sen. Jim Inhofe, R-Tulsa, asked the VA’s inspector general to scrutinize the operations of both the Muskogee and Oklahoma City VA medical centers after a December 2015 USA Today article documented cases of alleged poor care and management deficiencies at the Oklahoma medical facilities.

Monday’s report on the Muskogee VA system revealed several shortcomings. A detailed inspector general’s report on the Oklahoma City VA medical center is expected soon, but it has not yet been released.

When inspectors visited the Muskogee VA in May 2016, they found Human Resource Management System that was in “disarray” after several personnel changes over a two-year period.

The Muskogee VA has had trouble recruiting psychiatrists, which resulted in patient wait times to see a psychiatrist ranging up to 45 days, the report said.

The Muskogee VA also had trouble recruiting gastroenterologists and urologists, which resulted in even longer average wait times for those specialty care services.

A new VA program, called the Veterans Choice program, was supposed to help eliminate some of the long wait times. It authorizes veterans to seek government-paid care outside the VA health care system when wait times are longer than 30 days or they face excessive travel burdens, like living more than 40 miles from a VA medical care facility.

However, VA investigators found that requests for participation in the program overwhelmed the Muskogee VA staff, with requests for Veterans Choice and non-VA Care Coordination services jumping from about 4,400 requests in the first quarter of 2016 to more than 6,200 requests in the second quarter.

Despite staff volunteering to “help the program get up and running,” the acting chief of staff told investigators that the Muskogee VA system was “in over (its) head” and in need of assistance, the report said.

The inspector general also reported:

• The quality rating of the Muskogee VA slipped from a 4-star ranking to a 3-star ranking in the fourth quarter of federal fiscal year 2015.

• Sixty-seven employees told investigators they were aware of quality of care or patient safety issues that had occurred within the preceding 12 months that had placed a patient at risk.

• The Muskogee VA system had 7,368 active requests for participation in the Care in the Community program that had been pending for more than 90 days.

• Primary care team members failed to notify patients of selected abnormal test results within seven days 10.8 percent of the time.

• A number of employees of the system’s community based outpatient clinics expressed concern about the safety of their working environment.

Leadership at the Muskogee VA center was in flux at the time of the inspector general’s visit. The current director, Mark E. Morgan, was hired the following month.

The inspector general made 19 recommendations for improvements and Morgan issued a prepared statement Tuesday that indicates he is taking those recommendations seriously.

“I have reviewed the OIG’s findings and recommendations and concur with all of them,” Morgan said. “We have already implemented or completed 11 of the recommendations and are actively working to complete the last eight by the end of the year.”