The Veterans Affairs health system has been plagued by leadership that lacks responsiveness overall and the ability to effectively run things and communicate to employees or veterans, said a report submitted to President Barack Obama on Friday.
The conclusions by Rob Nabors, who Obama dispatched to assess the situation at the troubled agency, also found that a "corrosive culture" has led to personnel problems that are affecting the timely delivery of care.
"There's a strong sentiment among many veterans and stakeholders that in general VA provides high quality health care 'once you get in the door' and that the current system needs to be fixed, not abandoned or weakened," Nabors said.
"However, I also believe that it is clear that there are significant and chronic systemic failures that must be addressed by the leadership at the VA," he said.
Nabors and acting VA Secretary Sloan Gibson met with Obama to deliver the update, which builds on startling revelations -- spearheaded by CNN investigative reporting -- over the past several months.
Those included delayed care -- sometimes with deadly results -- alleged cover-ups, and management shortcomings that have upended the agency that cares for millions of veterans and spurred public outrage, congressional investigations and legislation to address how the VA health system operates.
Other key findings of the report:
-- The 14-day scheduling standard for a medical appointment is "arbitrary, ill-defined, and misunderstood." The goal was deemed unrealistic and "is a poor indicator of either patient satisfaction or quality of care" and should be replaced.
-- The technology behind the basic scheduling system is "cumbersome and outdated."
-- Additional resources, including doctors, nurses, trained support staff and other health professionals, are needed.
-- Many of the resource issues facing the VA are similar to what exists in the private sector. But the VA has not clearly articulated its funding needs.
The VA health system is the nation's largest with more than 1,700 sites serving 8.76 million people annually.
Obama has asked Nabors to stay on at the VA temporarily. The agency is conducting its own nationwide audit of medical services. Its inspector general, a watchdog, is also investigating scheduling and management practices at 77 facilities, according to the report.