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The Department of Veterans Affairs Montana Health Care System scored high in areas of patient satisfaction and call responsiveness, though it ranked near the bottom in patient wait times, employee satisfaction and turnover, according to a recent report by the VA inspector general.

Gail Wilkerson, the congressional liaison with VA Montana, said the system is taking steps to address the deficiencies, from pay raises to employee surveys.

Wait times can’t be resolved until the outcome of a national audit on the VA health care system and its network of outpatient clinics and medical facilities.

“The reviews are intended to help us improve,” Wilkerson said this week. “We hope to see some changes, of course.”

In the report, conducted in March and released last week, VA Montana received a low score – 118th among 128 facilities – for its high rate of turnover among registered nurses.

Coming off a federal pay freeze, Wilkerson said, VA Montana conducted market surveys across the state and awarded its RNs a salary increase that took effect in January.

Wilkerson said the increase brought RN salaries at VA Montana in line with the state’s private sector. Efforts also have been made to recruit and retain RNs, including student loan reduction programs, scholarships and hiring incentives.

“Patient Care Services (nursing) has created focus groups to look at the top five issues related to recruitment and retention,” Wilkerson said. “They’ve also been working a long time on other things, like improved scheduling.”

VA Montana also received low marks in employee satisfaction, receiving a score of 126 out of 128. Wilkerson said the state system has created opportunities for workers to offer recommendations regarding their work environment.

Monthly all-employee forums have been established, she said, and VA Montana leadership has been directed to recognize the contributions employees make in advancing the VA mission.

A committee was also formed to examine workplace satisfaction, one that includes management, employees and union partners.

“We’re looking closely at our RN and employee satisfaction,” Wilkerson said. “Our employee survey is going out annually.”


A Freedom of Information Act request by the Washington Post found that the VA inspector general told President Barack Obama’s transition team in 2008 of three audits dating back to 2005 when President George W. Bush was president.

The audits revealed problems with wait times and scheduling. More than two dozen VA facilities are now facing scrutiny on possible falsified wait-time data, including the VA hospital in Phoenix, where some 40 veterans reportedly died awaiting care.

In the recent report, VA Montana scored near the bottom in wait times. Out of 128 facilities, it scored 125th in specialty care wait times, 121st in primary care wait times, and 121st in mental health wait times.

Wilkerson said the ongoing national audit continues to play out. VA Montana will wait for the results of the national audit before acting on the issue, she said.

“They started doing the audits last week,” she said. “They’re reviewing the practices at all community based outpatient clinics and VA medical centers. We’re waiting to hear the results on that.”

Despite the challenges within the system, the recent report gave VA Montana a score of 69 out of 128 on call responsiveness, a score of 42 on mental health status, and 51 in patient satisfaction.

Wilkerson said VA Montana is promoting its online health portal for veterans, secure messaging, telephone care and a reminder to patients of scheduled visits.

“Patient satisfaction remains high,” she said. “VA Montana continues to implement strategies that improve the patient experience and increases access to care.”

VA Montana employs 908 people and maintains a $222 million medical care budget with the main hospital at Fort Harrison and its 12 outpatient clinics around the state. The system saw 30,270 unique visitors during the last fiscal year with 193,870 outpatient visits.

The report, which runs 31 pages in length, also made recommendations in five of seven VA activities that include quality management, medication management and coordination of care.

Sen. Jon Tester, D-Mont., and a member of Senate Veterans Affairs Committee, called the recent report a valuable tool on which to make improvements.

“VA Montana remains a strong health care facility, but we can always do better,” Tester said. “Recommendations for streamlining administrative procedures will only strengthen Fort Harrison and build on the VA’s commitment to improve.”

Rep. Steve Daines, R-Mont., also weighed in on the VA, directing his comments toward the national system.

On Thursday, Daines said he had cosponsored the VA Management Accountability Act, which gives the VA secretary the authority to remove top employees for poor system performance.

Reporter Martin Kidston can be reached at 523-5260, or at

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