A top Department of Veterans Affairs official and a White House appointee successfully pressed for changes in an inspector general's report on the Phoenix VA medical center.
According to newly released documents, the report was amended to add a finding that there was no conclusive evidence that delays in care resulted in veteran deaths.
In recent congressional testimony, acting VA Inspector General Richard Griffin adamantly denied that changes in the final report, which downplayed links between delayed care and up to 40 veteran deaths, had been "dictated" by VA headquarters.
But e-mails released Friday by the House Committee on Veterans' Affairs show that Sloan Gibson, who had been acting VA secretary, personally corresponded with Griffin in early August, asking him to amend the report.
Specifically, Gibson asked the inspector general to add findings about a Phoenix whistle-blower's claim that up to 40 veterans died awaiting care.
E-mails show White House deputy chief of staff Rob Nabors, appointed by President Barack Obama this summer to monitor the VA scandal, also urged the change. The e-mails also asked the OIG to share its planned "message" to the media about veterans' deaths.
Once the report was revised to include new language, records show,Assistant Inspector General John Daigh sent an e-mail to a VA administrator, asking, "Was the message on the deaths well received by leadership?"
Later, Gibson sent a note to Griffin, whom he addressed as "Griff."
"Thanks on all counts!" for changes in the Phoenix report, he wrote. "I appreciate the focus on the 40 deaths ..."
Robert McDonald was confirmed as the new VA secretary in July; Gibson returned to his post as deputy secretary.
On Friday, VA officials released a statement saying the agency had no role in deciding what would be in the final report.
"VA does not and cannot dictate the final content of any reports to the independent entity that authors them," the statement said.
Rep. Jeff Miller, R-Fla., chairman of the House committee, sent a letter to the president this week asking Obama to expeditiously replace Griffin with a permanent inspector general. The position has been vacant since George Opfer retired Dec. 31.
"In the midst of the largest and most damaging scandal in VA's history," Miller wrote, "it is vitally important that VA Office of Inspector General have an independent and objective leader in place to combat waste, fraud and abuse."
In a separate letter to Griffin, Miller asked that his oversight committee be provided all drafts and other versions of investigations in the future.
OIG spokeswoman Joanne Moffett said correspondence about the Phoenix report does not reflect "dubious motives" or indicate Gibson was trying to improperly influence the OIG.
Instead, she said, it shows he was trying to ensure a thorough report. Moffett noted that inspector-general probes over the past decade repeatedly exposed scheduling fraud, yet VA administrators failed to correct the problem.
As an agency leader, Gibson moved "to address wait-time issues once and for all," she said.
The language with regard to 40 deaths was inserted because media had widely reported on alleged fatalities, she said, and the topic needed to be addressed publicly. It was "not at the request of VA," she added, but based on internal deliberations among OIG staffers.
With regard to Miller's letters, Moffett said VA officials could not respond because they had not seen them Friday.
The Aug. 26 OIG report confirmed that Phoenix VA Health Care System systematically falsified appointment records and provided untimely care to thousands of patients, some of whom suffered adverse affects.
With regard to allegations that 40 veterans had died, however, the report said inspectors "were unable to conclusively assert that the absence of timely quality care caused the deaths of these veterans."
In subsequent press interviews, Gibson recited that phrase as a vindication for the VA; some media reported that the finding debunked allegations by the Phoenix whistle-blower, Dr. Sam Foote.
Foote never asserted that patients had died "because" of untimely treatment. He said they died while awaiting care in a dishonest system, and he asked the inspector general to investigate a potential linkage.
No previous OIG report has ever listed untimely care as the cause of a death, and medical experts say that would be an impossibility: Death is caused by a disease or injury, and delayed care could only be a contributing factor.
Foote testified that the OIG finding was a "whitewash" and a retaliatory smear that would discourage other potential whistle-blowers. Members of Congress also expressed skepticism about the finding, and grilled VA officials during hearings.
In testimony before the House Committee on Veterans' Affairs, Griffin repeatedly was asked if his office was pressed to revise the Phoenix report by VA headquarters. He acknowledged some "minor things" were changed as a result of consultation, but insisted no revisions were "dictated" by VA administrators.
