VA Secretary Eric Shinseki on Friday placed on administrative leave a nurse in a Wyoming medical center after seeing an e-mail containing explicit directions on how to "game" the system and hide long delays in treating veterans for medical and mental health issues.
Shinseki earlier this week promised "swift and appropriate" action if wait-time records were falsified as a widening scandal over treatment delays brought congressional action.
The nurse, David Newman, works at the Cheyenne VA Medical Center, which was investigated late last year by the Department of Veterans Affairs Office of Medical Inspector in connection with allegedly falsified wait-time records at a VA clinic in Fort Collins, Colo.
An e-mail dated June 19, 2013, that appears to be drafted by Newman, a Cheyenne Medical Center telehealth coordinator, explained how to alter records to show that veterans saw doctors within a 14-day goal established by the VA.
"Yes, it is gaming the system a bit," the e-mail said. "But you have to know the rules of the game you are playing, and when we exceed the 14-day measure, the front office gets very upset."
A copy of the e-mail obtained by USA TODAY was provided to the VA Friday. Within a few hours, Shinseki issued a statement saying that Newman had been placed on administrative leave and that the VA inspector general was being asked to investigate.
"VA takes any allegations about patient care or employee misconduct very seriously. If true, the behavior outlined in the e-mail is unacceptable," Shinseki said.
Newman answered his office phone when a reporter called him earlier Friday, referring queries to the VA public affairs office.
The controversies in Cheyenne and Fort Collins are part of a broader pattern of delays in health care at VA hospitals that have been linked to 23 veteran deaths over the past three or four years. More recently, a retired VA doctor in Phoenix alleged that dozens of patients died while awaiting care at a VA hospital there and that wait-time records were falsified.
The e-mail also explained how to "fix" existing records showing delayed instances of medical care. "You can still fix this and get off the bad boys list," the message advised.
The facts outlined in the message were largely investigated by the VA Office of Medical Inspector last year after a whistle-blower complaint. The report examined operations both at the Fort Collins clinic and the Cheyenne hospital that oversees it.
In response to those findings, a copy of which was provided to USA TODAY, VA officials said last week that no disciplinary action was taken despite conclusions by investigators that agency rules were violated and employees instructed at the clinic in how falsify records.
The VA said there was no "intentional violation" of policy and the supervisors were confused by the wait-time procedures.
Early this week, with outrage building over the accumulating reports of delayed care and patient deaths, the nation's largest veteran organization, the American Legion, and a few members of Congress called on Shinseki to resign.
Representatives of other major service groups met with Shinseki Tuesday, urging him to offer a more forceful response to the wait-time scandal. In a series of media interviews Wednesday, the VA chief promised "swift and appropriate" punishment for any employees involved in health care delays or cover-ups.
On Thursday, Shinseki revealed that he had begun a nationwide review at all medical facilities to ensure employees were carrying out policy appropriately.
The chairman of the House Veterans Affairs Committee, which has been investigating delays in health care at the agency, criticized Shinseki's swift move Friday to place the Cheyenne hospital nurse on administrative leave as "faux outrage."
"VA officials have known about intentional efforts to falsify patient wait time data," Rep. Jeff Miller, R-Fla., said. "Yet until today, department officials had not taken any steps whatsoever to discipline any employees."