Healthcare Inspection – Reported Primary Care Staffing at St. Cloud VA Health Care System, Veterans Integrated Service Network 23, Eagan, Minnesota

OIG conducted an inspection to assess allegations made regarding a September 14, 2015 letter from Veterans Integrated Service Network (VISN) 23 Acting Director to Congressman Timothy J. Walz (VISN 23 Response 2) concerning primary care at the St. Cloud VA Health Care System (facility), St. Cloud, MN. While we substantiated that part of the VISN 23 Response 2 did not accurately represent facility gains and losses of physicians and mid-level providers, it appeared to be an inadvertent error. We substantiated that VISN 23 Response 2 inaccurately represented primary care provider panel sizes at the facility. The reported facility average primary care panel size was based upon a simple average of panel sizes across all facility providers and did not include adjustment for factors such as whether the provider was a part-time employee. VISN and facility leadership acknowledged that no data validation steps were taken prior to submitting VISN Response 2 to Congressman Walz. We found that most primary care providers had panel sizes outside the Veterans Health Administration expected panel sizes range, which affects the timeliness of patients seeing a provider. Staff reported that patients are redirected to urgent care when a primary care provider is not available to see them on the same day. We found that facility staff distributed a news release with data reporting similar errors to those found in VISN 23 Response 2 related to reported primary care average panel sizes for physicians and mid-level providers. We also reviewed the accuracy of data provided in a response from the VISN to the OIG Hotline Case at issue. We found that the facility-reported average panel size for November 2013 was generally accurate compared to the historical facility Primary Care Management Module data for November 2013. We made one recommendation.