The internal VA audit provides a more complete picture of widespread problems at the agency's health care facilities -- as reported by CNN over the past seven months -- than its preliminary findings last month that led to the resignation of Veterans Affairs Secretary Eric Shinseki.
According to the audit findings released Monday, a 14-day deadline for providing care to newly enrolled veterans such as those coming back from Iraq and Afghanistan proved "simply not attainable" due to growing demand and a lack of capacity.
"Imposing this expectation on the field before ascertaining the resources required and its ensuing broad promulgation represent an organizational leadership failure," the audit said of the deadline imposed under Shinseki.
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It said 63,869 veterans enrolled in the VA health care system in the past 10 years have yet to be seen for an appointment.
"This data shows the extent of the systemic problems we face, problems that demand immediate actions," said acting VA Secretary Sloan Gibson, who took over after Shinseki stepped aside.
Gibson's statement said the VA has contacted 50,000 veterans "to get them off of wait lists and into clinics" so far.
Other steps he announced included:
• A new patient satisfaction measurement program.
• A hiring freeze at VA central headquarters in Washington and the 21 VHA regional offices, "except for critical positions to be approved by the secretary on a case-by-case basis."
• Removing the 14-day scheduling goal.
• Ordering an independent, outside audit of VHA scheduling practices across the system. This would differ from a review being conducted by the VA inspector general's office.
• Applying reforms announced for the Phoenix VA facility to others considered the "most challenged."
• Deploying mobile medical units to provide services to veterans awaiting care.
• Suspending all performance awards for VHA senior executives for fiscal year 2014, which runs through September.
CNN first reported the extensive problems at the Phoenix VA facility, including an interview with a whistleblower who said dozens of veterans died while waiting for care there.
The audit findings included information from 731 VA facilities nationwide and interviews with more than 3,700 staff members.
Reasons for the chronic problems include the increasing number of veterans returning from wars in Iraq and Afghanistan, and a bonus system that rewarded managers for meeting treatment goals.
According to CNN's previous reporting, managers in Phoenix and elsewhere used secret waiting lists to cover up the amount of time it took for veterans to get appointments.
However, the audit said that questions it posed "were not worded to ascertain the reason that policy may have been violated," adding that its findings "cannot be extended to identify deliberate deception, fraud, or malfeasance."
At the White House, spokesman Josh Earnest said the new audit showed "some personnel changes need to be made and some have already," in reference to Shinseki's departure and some top managers in Phoenix placed on administrative leave.
"It's also clear there need to be some management changes in terms of ... the procedures that the VA has in place to fulfill their responsibilities," Earnest said.
Some in Congress on both sides of the aisle have called for a criminal investigation, and 21 senators sent a letter Monday to Attorney General Eric Holder asking for the FBI to get involved.
"This challenge requires resources that only the Department of Justice can provide in developing and assessing evidence, pursuing leads, and initiating active prosecutions aggressively if warranted," said the letter from 10 Republicans and 11 Democrats.
The signers included Kay Hagan in North Carolnia, Mary Landrieu of Louisiana and Mark Pryor of Arkansas -- Democrats from traditionally conservative states who face tough re-election battles in November.
The Justice Department has been reviewing the matter but has not launched an investigation.
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