FORT COLLINS, Colo. — Henry P. Leweling's chest hurt.
He suffers from high cholesterol — and a family history of heart disease — and he has an aneurysm. When his chest hurts, he pays attention.
It hurt enough for the former Air Force serviceman to start popping nitroglycerin to relieve the pain.
"If the aneurysm bursts, you've got four, maybe five minutes to live," he said. "So when you have chest pain like that, you don't ignore it."
That pain in August pushed the 68-year-old from Fort Collins, Colo., to drive to the Cheyenne, Wyo., Veterans Affairs Medical Center to receive treatment. Doctors saw him through urgent care and he was sent from Cheyenne to his primary care physician at the Fort Collins VA clinic.
He remembers walking into Fort Collins, chest still aching, and telling staff he just came from Cheyenne with orders to see his doctor. He also remembers the staff's response: "We can see you in three or four months."
He said he was "obnoxious" and called a "trouble maker" but was seen the next day in Fort Collins. Between that visit and one to his specialist in Wisconsin, he learned his aneurysm had expanded and the pain stemmed from another blocked vein.
At the Fort Collins clinic, he said everything would take three or four months, no matter the urgency. Getting blood work he described as routine a few years back so he could get needed medications was the same story.
Interviews scheduled with VA officials Friday concerning the problems and solutions at the clinic were canceled by the VA at the last minute and officials were made unavailable.
According to a recently released report from the federal Office of the Medical Inspector, scheduling problems at the Fort Collins VA clinic led to record fixing so staff appeared to meet internal goals. Veterans such as Leweling, despite wanting immediate care, could face weekslong wait times that wouldn't appear in status reports.
Staff in Fort Collins also would schedule appointments without notifying veterans, according to the Office of the Medical Inspector.
In March 2013, "the clinic was having problems with scheduling, employee morale and professionalism, and lack of teamwork between the (medical support assistants)," the report states.
To address those issues, employees were changed between Cheyenne and Fort Collins, according to the report. The transfers to Fort Collins reported that scheduling there was "fixed" by having staff change appointment dates to be within two weeks of the desired appointment date, an agency goal.
Also in March, VA-reported wait times for vets that fell in that two-week period spiked from the low 70% range to close to 100%. Staff that failed to record appointments within that 14-day period had their names appear on a "bad boy" list, according to the report.
The practice made it impossible to know how long veterans in Fort Collins waited for appointments.
'Gaming the system'
A June e-mail that was made public Friday details instructions on how to meet that 14-day window, regardless of when the patient wanted service. The apparent author of the e-mail, a telehealth coordinator out of Cheyenne, was placed on administrative leave. In essence, it involved the scheduler telling the veteran when times were available instead of letting the veteran pick, painting an inaccurate picture of how promptly service was provided, according to a report in USA TODAY.
"Yes it is gaming the system a bit," the e-mail says, according to USA TODAY. "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 short news conference May 5 in Cheyenne to address the claims was dominated with administrators insisting policies were "misunderstood" and problems had been fixed. When pressed, they provided little more explanation for what went wrong. Officials provided a copy of a four-page plan to fix it.
Leweling said after reports on the scheduling malpractice surfaced, service in Fort Collins changed for the better — a lab test could have been done the day he walked in to make an appointment and a CT scan was scheduled within a week.
"That wouldn't have happened a year ago," he said.
Health at risk
A site visit to the Fort Collins clinic to highlight the changes was canceled at the last minute Friday, apparently by VA officials in Washington, D.C. The day before, the House Veterans' Affairs committee voted to subpoena Veterans Affairs Secretary Eric Shinseki over these allegations and that of a Phoenix hospital delaying appointments. Almost two dozen deaths were linked to the Phoenix delays.
While the nation's largest veterans group and U.S. Rep. Mike Coffman, R-Colo., demand his resignation, Shinseki is calling for a "face-to-face audit" of every VA clinic, according to media reports.
Multiple VA spokespeople in Washington did not return phone messages left by the Fort Collins Coloradoan on Friday to ask why access to the clinic was shut off.
The OMI investigator wrote that they could not substantiate that errors resulted in a danger to public health and safety.
Leweling isn't so sure.
In addition to VA coverage, he uses Medicare and a supplemental plan he describes as excellent. Extensive coverage coupled with an ability to "hammer through" red tape for care at the VA and elsewhere mean he personally feels less jeopardized because of problems at the clinic.
But others without his resources? "Their care will be impacted," he said.
In 2010, the VA in Cheyenne discovered his high cholesterol. The clinic in Fort Collins gave him the standard answer: We can see you in three or four months.
Leweling opted to see his long-time specialist in Wisconsin instead and was treated almost immediately, albeit 1,000 miles away. His speculation turns dark when it comes to what could have been.
"Let's say, 2010, I'm having all that blockage, and I can't see a doctor for three months," he said. "Some of that blockage breaks loose and I could have had a serious stroke."