The Department of Veterans Affairs faces a serious numbers problem - multiple, in fact.
It can't count how many veterans died while waiting to sign up for health care. It says some VA hospitals may have to close if the agency can't get $2.5 billion. And a year after scandal rocked the department, congressional Republicans want to know why the number of employees fired is so low.
Congress approved a sweeping overhaul of the department in response to headline-grabbing woes, but the VA continues to be plagued by missteps, including an internal report indicating that nearly one-third of veterans with pending applications for VA health care likely have already died. VA officials said they were unable to determine how many veterans died, whether they truly were seeking VA health care or had merely indicated interest in signing up.
To make matters worse, the VA said this week it may have to shut down some hospitals as soon as next month if Congress does not address a $2.5 billion shortfall for the current budget year. The VA says it needs to cover a budget gap caused by a sharp increase in demand by veterans for health care, including costly treatments for the deadly hepatitis C virus.
The VA's request has met with resistance from lawmakers in both parties, who fault officials for failing to act earlier on the impending shortfall or fix other problems, including a failed VA hospital project in Denver that is more than $1 billion over budget.
The VA is a "broken bureaucracy" that "continues to be plagued by a culture of neglect and mismanagement that is denying veterans ... across the United States access to the quality health care that they were promised," said Sen. John McCain, R-Ariz., chairman of the Senate Armed Services Committee.
Despite its ongoing problems, the VA says it has made significant progress in the past year to improve its health care system and service delivery and set the course for long-term reform.
"Veterans need VA and many more Americans benefit from VA," said VA Secretary Robert McDonald in a statement to The Associated Press.
House Republicans have a simple solution - fire more people at the department, and do it now.
Congress made it easier for McDonald to fire senior executives in the overhaul law approved last year, but House Speaker John Boehner, R-Ohio, and other lawmakers say McDonald has been slow to act.
"President (Barack) Obama promised reform at the VA. It hasn't happened. He promised accountability. It hasn't happened," Boehner said at a news conference this week, as leaders announced a House vote later this month on new VA legislation.
By Boehner's count, only two VA officials have been fired as a result of the uproar over long waits for veterans seeking medical care and falsified records to cover up the delays.
Not so, says the VA.
The VA has pushed for the removal of six senior executives, including four who were fired and two who retired, said spokeswoman Victoria Dillon. One of those fired was Sharon Helman, the former director of the Phoenix VA health care system, the epicenter of the wait-time scandal.
In addition, the VA has proposed disciplinary action related to data manipulation or patient care against more than 130 employees nationwide, Dillon said. In all, VA has fired nearly 1,500 of its nearly 340,000 employees since McDonald was confirmed as VA secretary on July 29, 2014, she said.
On Friday night, the VA announced it has immediately terminated a Georgia official's access to all VA computer systems and placed him on administrative leave following his indictment by the Justice Department. Cathedral Henderson, an official in the Augusta, Georgia, office, is accused of falsifying medical records of numerous VA patients. Additional administrative action may be taken based upon the indictment, the VA said.
Rep. Jeff Miller, R-Fla., chairman of the House Veterans Affairs Committee, is sponsoring a bill that would make it easier to fire or demote any VA employee based on performance or misconduct, expanding on a provision in the new law that targeted senior executives.
"There are some rotten people that work in the department that need to be fired, not protected," Miller said.
The VA and congressional Democrats say Miller's bill poses due-process concerns and could result in a loss of qualified VA staffers to other government agencies or the private sector.
Some of the VA's problems are of its own doing.
An internal report by the agency's Health Eligibility Center says about 238,000 of the 847,000 veterans with pending applications for VA health care are likely deceased. The applications go back nearly two decades and some applicants may have died years ago, although there is no way to tell for sure when or why the person died, the VA said.
The department said it has no way to purge the list of dead applicants, and that many of those listed on the report are likely to have used another type of insurance before they died. Officials are reviewing enrollment data to ensure integrity, said VA spokeswoman Walinda West.