The first comprehensive review of the medical care system for veterans found widespread scheduling abuses, data falsification and long waiting times at dozens of hospitals and clinics across the country.
In its audit of 731 medical facilities, the Department of Veterans Affairs reported Monday that 57,436 veterans have been waiting more than 90 days for an initial medical appointment.
Thirteen percent of schedulers told VA auditors that supervisors or other co-workers had instructed them to enter a different date in the appointment system than the one requested by a veteran.
"This audit is absolutely infuriating and underscores the depth of the scandal," Paul Rieckhoff, founder of Iraq and Afghanistan Veterans of America, a New York-based advocacy group, said in a statement. "Our vets demand action and answers."
The medical facility with the longest average wait time for a new patient to see a primary care physician was the VA medical center in Honolulu, at 145 days, while the VA hospital in Harlingen, Texas, topped the list for waits to see specialists, also at 145 days on average.
The VA hospital in Durham, N.C., had the longest average wait for veterans seeking mental health care, at 104 days.
Among other VA hospitals with long wait times for various types of care were the William Jennings Bryan Dorn VA Medical Center in Columbia, S.C., and VA centers in Dallas and Fayetteville, N.C.
Eight percent of schedulers said pressure had been placed on them to bypass the VA's official Electronic Wait List system and maintain unofficial lists in order to make waiting times appear shorter than they actually were, according to VA interviews with 3,772 clinical and administrative staff.
Retired Army Gen. Eric Shinseki resigned May 31 as head of the Department of Veterans Affairs after acknowledging that inordinate wait times and scheduling data falsification were more widespread than he'd believed.
Before his exit, Shinseki in mid-April directed the Veterans Health Administration to conduct the agency-wide audit.
A key finding of the audit was that the 14-day target for waiting times Shinseki established in 2011 was unrealistic and "not obtainable."
That problem was exacerbated by tying hospital managers' bonuses to meeting the 14-day target.
Setting such an unrealistic waiting-time target and linking it to performance bonuses created "an organizational leadership failure," the audit found.
Sloan Gibson, named by President Barack Obama as acting VA secretary, said Monday that the agency is eliminating the 14-day scheduling goal and suspending all performance awards for senior executives of the Veterans Health Administration.
Gibson said the VA also will deploy mobile medical units to provide care to some of the vets who've been waiting a long time for care.
Gibson ordered a hiring freeze at the Washington headquarters of the Veterans Health Administration and at 12 of its regional offices, except for critical positions to be approved by him on a case-by-case basis.
"This data shows the extent of the systemic problems we face, problems that demand immediate action," Gibson said in a statement. "Veterans deserve to have full faith in their VA, and they will keep hearing from us until all our veterans receive the care they've earned."
Gibson said the VA has contacted 50,000 vets nationwide to get them off waiting lists.
The scandal erupted at the VA hospital in Phoenix, where Gibson acknowledged during a visit last week that 18 veterans had died while waiting for medical appointments.
A probe by the agency's inspector general found that vets waited an average of 115 days for their first medical appointment at the Phoenix hospital, 91 days longer than the center reported in its logs.
The new audit flagged 112 VA medical centers and clinics for further review.
White House spokesman Josh Earnest said Obama had tasked his deputy chief of staff, Rob Nabors, to work at the Veterans Affairs Department in order to assess the scope of the problem and propose more reforms.
Earnest said Obama is focused on appointing a replacement for Shinseki soon.
"Clearly, having some new leadership in the VA is a top priority," Earnest told reporters.
House Speaker John Boehner, R-Ohio, branded the audit results "a national disgrace."
Boehner said the House of Representatives is considering legislation that would allow any vet who waits longer than 30 days for medical care to see private doctors with subsequent treatment covered by the government.
Iraq and Afghanistan Veterans of America, whose members include 177,000 vets who fought in one or both of the two post-9/11 wars, wants a criminal investigation of VA employees who allegedly falsified data on how long veterans waited to see doctors.
The group is also pushing the Democratic-controlled Senate to pass the Veterans Affairs Management Accountability Act, which the Republican-ruled House approved May 21 by a wide bipartisan margin.
The bill would give the new VA chief more power to swiftly remove hospital managers who falsify data and take other steps to sidestep civil service rules.
Senate Majority Leader Harry Reid, D-Nev., said Monday that Sens. Bernie Sanders, a Vermont independent, and John McCain, R-Ariz., had reached agreement on bipartisan legislation to reduce waiting times at VA hospitals and increase management accountability.
The measure also would allow veterans facing long health care delays to seek care outside the VA, at private doctor's offices, community health centers or military bases, Reid said.
"Although the details of the agreement are still being crafted, the legislation's comprehensive approach will ensure that veterans are getting the care they deserve," Reid said in a statement.
Anita Kumar of the Washington Bureau contributed.
By James Rosen
McClatchy Washington Bureau