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Suter, 62, had just started a new job scheduling patients at a Southern 蜜柚直播 VA Health Care System primary care clinic on South Sixth Avenue. Wait times were often one to three months long, but revealing the true wait times in the computer system meant the doctor missed out on bonus pay, Suter鈥檚 nurse manager told her.

鈥淪he said, 鈥榊our appointments are over two weeks out and you鈥檙e costing your doctor money,鈥欌�� Suter said. The manager showed her how to 鈥渮ero out鈥� wait times on their computerized scheduling system: Suter was told to input a patient鈥檚 desired appointment date as the same day as the scheduled appointment date, so it would appear there was no wait time, she said.

Suter complied after her manager strongly implied she鈥檇 be fired if she refused. But her dogged whistleblower complaints to VA regulators and legislators contributed to the Department of Veterans Affairs Office of Inspector General鈥檚 decision to investigate the 蜜柚直播 VA starting in April.

The resulting Office of Inspector General report substantiated much of what Suter alleged about wait-time manipulation and misconduct at the Southern 蜜柚直播 VA Health Care System.

The report, released Nov. 9, recommended disciplinary action for staff who encouraged the falsifications. The report found:

• Between December 2013 and August 2014, 76 percent of appointments in the Ocotillo Primary Care Clinic 鈥� where Suter worked 鈥� had a zero-day wait time.
• In fiscal year 2013, Ocotillo clinic physicians got bonuses based in part on the percentage of patients with appointments scheduled within 14 days of their requested date. Doctor pay did not appear to be based on wait times in the following three fiscal years.
• Training materials from 2014 advised staff workers to mark the patient鈥檚 desired appointment date as the same as the actual appointment date in some scenarios, in violation of VA policy. Some time after the fallout from the Phoenix VA wait-time scandal in mid-2014, the training materials were updated to align with VA scheduling policy.

蜜柚直播 VA spokesman Luke Johnson said in an email the practices described in the report 鈥渁re inappropriate and are not consistent with our ... core values of integrity, commitment, advocacy, respect and excellence.鈥�

The OIG also issued a separate report on Nov. 8 dating to 2012, and subsequent investigations. Among the report鈥檚 conclusions: 蜜柚直播鈥檚 VA staff kept 400 orthopedic and 600 urologic appointment requests on pieces of paper, instead of in the electronic scheduling system.

A staff member who told senior leaders about these practices said that her concerns were dismissed, the report said.

Johnson said the VA apologizes to veterans for these practices, which are no longer occurring.

鈥淭hese reports are related to practices dating as far back as 2008, and we have made significant changes since then,鈥� he said.

Two years ago the Phoenix VA Health Care System was at the and dangerously long wait times for veterans seeking care.

An OIG report found 1,700 patients at the Phoenix VA hospital were put on unofficial waiting lists. Veterans there waited an average of 115 days for their first appointment, but the facility reported an average wait time of 24 days, which could have led to bonuses for Phoenix VA leadership, the report said.

At the time, an OIG review at the Southern 蜜柚直播 VA Health Care System.

Doctors鈥� and nurses鈥� performance pay is no longer tied to wait times, Johnson said.

Even before the recent OIG report was released, the Southern 蜜柚直播 VA Health Care System reviewed scheduling practices and has trained staff to be in compliance with federal VA procedures. Johnson encourages VA staff to speak up if unethical practices are still happening.

鈥淚f there are any scheduling issues or concerns, leadership wants to know about them so they can be addressed,鈥� he said.

An underlying systemic problem is physician staffing issues at VA hospitals, including difficulty recruiting specialists, Johnson said. In the past couple of years, the Southern 蜜柚直播 VA Health Care System has hired 100 new staff members and is reviewing physician compensation to improve recruitment and retention, he said.

鈥淭hese initiatives have helped enhance access to care for our veterans,鈥� he said.

Johnson said that in September, wait times for primary care appointments at the 蜜柚直播 VA averaged less than four days; specialty care wait times were about six days; and mental health appointments were less than three days.

Vietnam War veteran Ray Murphy, 67, said Friday he was 鈥渁 little shocked鈥� by the news of the wait-time fraud at 蜜柚直播鈥檚 VA. He鈥檚 had only positive experiences there getting treatment for hearing problems, and his wait times are usually less than 30 days, he said. But Murphy said he has a couple of friends who have experienced very long wait times to see specialists.

鈥淚 think personally that the 蜜柚直播 VA is really good,鈥� said Murphy, who served three tours in Vietnam as a member of the U.S. Navy and still deals with the effects of exposure to Agent Orange. But for veterans in need of timely urgent care, he said, 鈥渋f they鈥檙e not getting it, that鈥檚 not good.鈥�

Rep. Ann Kirkpatrick, D-Ariz., said in a Friday email that she asked the OIG to investigate the 蜜柚直播 VA after hearing from Suter. In a statement, she called the results of the OIG report 鈥渋nfuriating and unacceptable.鈥�

鈥淚 don鈥檛 see how the VA can earn back the trust of our veterans until these systemic problems are fixed once and for all,鈥� she said.

After Suter objected to unethical scheduling practices, she suffered retaliation and a hostile work environment, leading her to leave the VA in August 2014 and seek treatment for post-traumatic stress disorder, she said.

The nurse manager who compelled her to falsify wait times still works at the 蜜柚直播 VA, Suter said.

Johnson said the Southern 蜜柚直播 VA Health Care System has appointed an 鈥渁dministrative investigative board鈥� to review the practices identified in the OIG report.

鈥淭he scope and level of necessary personnel actions will be determined based upon the findings of this board,鈥� he said.