It shouldn’t be a surprise that officials at the Veterans Affairs hospital in Maine may have manipulated treatment information. The same has happened, to differing degrees, at VA facilities throughout the country, and Togus, as the Maine hospital is known, is under the same pressures, with the same rising demand for health care amid the same staffing shortages.

The allegations are a further reminder of how widespread the problems at VA hospitals were before the scandal was unearthed earlier this year. More than simply the fault of a few bad apples, the shortcomings at the VA were the result of a systemwide failure that was diverting care, and would have needed fixing even if hospitals had not started fudging the numbers.

As reported Sunday in the Kennebec Journal, officials from the VA Office of the Inspector General visited Togus late last month. They were at the hospital — which had avoided the nationwide scandal, with an audit showing better-than-average service — to investigate allegations that administrators instructed staff to engage in practices meant the hide the hospital’s inability to provide mental health services in the time prescribed by the VA.

If true, that’s similar to what occurred throughout the VA system, where perhaps as many as 110 hospitals and clinics were falsifying appointment data so that it appeared patients were getting care within time guidelines set by the VA.

The delays were driven by an explosion in veterans seeking care. Outpatient visits to the VA system rose from 46.5 million in 2002 to 83.6 million a decade later. The number of veterans receiving mental health treatment grew from less than 900,000 in 2006 to more than 1.2 million in 2012.

The problem was exacerbated by the lack of physicians and other medical personnel. For instance, in the past three years, the VA says, primary-care appointments have increased by 50 percent, while the number of primary care doctors has risen only 9 percent. Robert McDonald, the new secretary of the VA, said the department needs to hire 28,000 new clinical staff workers.

That mirrors what was happening in the mental health department at Togus, where requests for appointments rose 30 percent from 2011-2014. The size of the staff has stayed roughly the same; it is now at 79, close to a high for the last three years, and still 10 positions remain vacant.

In that environment, VA facilities were asked to meet unrealistic performance targets, such as seeing all new patients within 14 days. That led many hospitals to record appointment dates that were not actually occurring. At Togus, it is alleged that treatment options were cut back or eliminated altogether if a mental health patient couldn’t be seen in a timely manner.

Under that system, it became worse to see a patient late than to not see them at all.

That’s not an excuse, but it is a reason. The VA health care system was broken and no one was immune, not even, perhaps, in Maine.

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