Disarray at Department of Veterans Affairs imperils patient care, internal documents reveal

The Guardian

23-05-2025

The Department of Veterans Affairs, the nation's largest integrated healthcare system, has been plunged into crisis amid canceled contracts, hiring freezes, resignations, layoffs and other moves by the Trump administration and Elon Musk's so-called 'department of government efficiency' (Doge), internal agency documents obtained by the Guardian show.
The documents paint a grim picture of chaos across the department's sprawling network of 170 veterans affairs (VA) hospitals and more than 1,300 outpatient clinics, which serve 9 million US military veterans.
At the Danville VA medical center, in rural Illinois near the Indiana border, so many nurses resigned that hospital administrators were forced to close the acute care unit to new patients.
The dysfunction has also included a backlog of 2,298 unread radiology exams in Orlando, Florida, and the cancellation of a dozen rheumatology appointments in Montrose, New York. In Battle Creek, Michigan, a spate of resignations, early separation offers and a hiring freeze has led to a 'critical' shortage of police officers responsible for protecting VA patients.
The Guardian's investigation, based on a review of 'issue briefs' filed within the last month to the agency's central office by staff at more than a dozen hospitals, comes at a time of increased scrutiny of the Trump administration's handling of the VA.
In response to a detailed list of findings from the Guardian, the VA press secretary Peter Kasperowicz argued the conditions described didn't represent a problem.
'The only thing these documents show is that VA has a robust and well functioning system to flag potential problems and quickly fix them,' he said in an email. 'The Guardian's attempt to spin these outdated, routine reports to make VA look bad is dishonest.'
Kasperowicz did not dispute that the acute care unit in Danville, Illinois, had been closed, but said the hospital was 'actively recruiting replacement nurses'. In Orlando, he acknowledged the backlog of radiology 'after two radiologists quit', but said it had since been reduced by 40% – meaning nearly 1,400 veterans were still waiting.
The issues raised by the documents are 'typical in any large healthcare system' and 'have nothing to do with VA's reform plans', he said.
The VA secretary, Doug Collins, has promised to cut 80,000 jobs and has said he will do so without reducing the quality of care or the availability of benefits. Earlier media reports have revealed the administration's actions have imperiled life-saving cancer trials, suicide prevention research and treatments for opioid addiction.
Senator Richard Blumenthal of Connecticut, the ranking Democrat on the Senate committee of veterans affairs, said the Guardian's reporting showed the agency to be 'rash and reckless'.
Representative Mark Takano of California, the ranking Democrat on the House committee on veterans affairs, said the documents deepened the concerns of lawmakers who have already raised alarms over the potential impact of the Trump administration's policies. 'When we undercut an agency established to work for veterans, we fail them,' he said.
The agency has already dismissed 2,500 workers and canceled more than 500 contracts.
Blumenthal said those dismissals, which primarily targeted new hires, 'destroyed morale' and harmed recruiting. 'The ramifications are sweeping,' he said. 'It infects every aspect of the work environment', with 'potentially life-threatening consequences'.
Collins said the dismissals and large-scale staff contraction are designed to reduce bureaucracy that often keeps people from accessing healthcare.
However, Federal News Network reported on 20 May that more than 14,000 VA employees in healthcare positions had applied to leave their jobs through government-wide separation initiatives, citing an internal agency dashboard. Those requesting a buyout or early retirement included more than 1,700 nurses, nearly 900 advanced medical support assistants and more than 200 physicians.
The documents obtained by the Guardian show that some of the current disarray tracks back to the department's aggressive 'return to office' mandate, which prompted staff to depart before replacements were in place.
The National Teleradiology Center based at the South Texas Veterans Health Care System saw 'a substantial exodus' following the mandate, according to one document. As of 15 May, one-third of image reads did not meet the legally required response time. 'Operational capacity is continuing to diminish,' the document notes.
In interviews the week before the Memorial Day weekend, veterans expressed frustration with the dysfunction, which has resulted in lost jobs and delayed appointments, and a concern that the agency – which enjoys the trust of 92% of veterans, according to a 2024 survey – could be at risk.
'This isn't normal,' said Matthew Crescenzo, 32, an Afghanistan war veteran, who was laid off on 25 February after Doge canceled the contract he was working on that was meant to improve healthcare access to veterans who live in far-flung locations. The layoff prompted him to seek mental healthcare, but he hasn't been able to access it.
'We're seeing a unilateral movement on the part of the executive to dismantle services that benefit veterans,' said Christopher Purdy, an Afghanistan war veteran and founder of the Chamberlain Network, a non-profit that mobilizes veterans to protect democracy through organizing, education and community engagement.
A Unite for Veterans rally is planned for Washington DC on 6 June. Organizers say they are modeling it on the 1932 'Bonus Army' march on Washington – when thousands of first world war veterans gathered on the National Mall demanding promised benefits, only to have the US military deployed against them.
Purdy said organizers invoked the Bonus Army in planning the 6 June march, because 'we're in a moment where it's not clear that the country is still going to fulfill its obligations to the veteran community'. Gathering on the mall was necessary, he added, because the typical levers of accountability, including congressional oversight, had failed.
Crescenzo, who has been receiving VA healthcare since his discharge from the US army in 2017, said he had not seen this type of dysfunction before. Amid dismissals and threats of further job cuts, employees seem unable to focus, with the remaining providers under stress and less able to care for veterans.
On 28 February, three days after he was dismissed from his job as a VA contractor, Crescenzo requested a referral to a mental health provider. He wanted help managing the layoff, along with post-traumatic stress disorder he developed after his service and more newly diagnosed attention deficit hyperactivity disorder.
His primary care doctor requested that Crescenzo see a psychiatrist for 'possible medication management', but no one followed up to schedule the appointment. On 14 April, emails show, Crescenzo had still not received care – or even been given an appointment. 'I have been attempting to reach them for weeks with no success,' he wrote.
A nurse wrote back extending 'my apology for the above concerns', but after yet another follow-up from Crescenzo, stated he would need to wait an additional week or two to schedule the psychiatric appointment. 'Sorry for the delay,' the nurse wrote.
Crescenzo still hasn't seen a psychiatrist, but was finally able to schedule an appointment – for 15 July.