WASHINGTON — In his opening statement at a heated Senate hearing, Veterans Affairs Secretary Eric Shinseki admitted cover-ups of patient deaths may be more widespread than previously feared.

Referring to allegations the VA hospital in Phoenix may have used an elaborate scheme to cover-up dozens of patient deaths because of long wait times, Shinseki said he has ordered a nationwide access review of all other facilities. He said he has already received reports that compliance is under question at some of those facilities.

He did not say which, or how many facilities, may not to be in compliance. That means the problems alleged in Phoenix could be happening at an unknown number of other VA facilities around the country.

Asked if people were cooking the books, Shinseki testified he was not aware of that, except in isolated cases. But, he said, that is reason to take a thorough look.

Senators told Shinseki he had already ignored repeated warnings that his department was in trouble.

Sen. Patty Murray, D-Wash., clearly frustrated and angry, pointed out that the committee had been told two years ago that gaming the system at the VA was so widespread, employees would look to get around regulations as soon as the rules were implemented.

Murray sharply warned Shinseki: “We have come to the point where we need more than good intentions.”

The VA chief said he was “mad as hell” and would like to use even stronger language to express how he felt about the possibility that veterans had died due to neglect.

Senate Veterans’ Affairs Committee Chairman Bernie Sanders, I-Vt., said he was troubled by reports that some veterans have to wait up to six months to see a doctor. He pointedly warned the VA chief that “a pattern of intimidation and cover-up has to change today.”

Sanders said if he discovered the VA was running an illegal second set of books, the committee would “deal with it.”

Speaking to reporters after the hearing, Shinseki was asked if he had abandoned veterans.

“I have not abandoned you,” he told vets, and said the vast majority of patients were receiving good care, mentioning VA facilities handled 85 million outpatient appointments last year.

VA Secretary Eric Shinsheki meets the press

Shinseki was asked about reports that whistleblowers at VA facilities were afraid to come forward.

He replied that the VA is encouraging employees to tell investigators “what’s really going on.”

Shinseki said the law protects whistleblowers and he will follow the law.

Asked if he wanted Attorney General Eric Holder to look into the allegations, the general said he first wanted to see a report from the VA Office of Inspector General, or OIG, which is currently investigating the Phoenix facility.

Shinseki said he will support an FBI investigation if that’s what the OIG recommends.

The scandal began when CNN reported allegations last month by a former VA doctor who said the department’s Phoenix health clinic developed a secret system to hide treatment delays.

As many as 40 patients may have died while waiting for treatment at the Phoenix facility, according to a former clinic director.

Other whistleblowers have since come forward to verify the claims.

Also, USA Today has reported the VA’s Office of the Medical Inspector said the Fort Collins, Colorado, medical center falsified appointment records to give the impression that staff doctors had seen patients within the department’s goal of 14 to 30 days.

VA facilities in South Carolina, Florida, Pennsylvania, Georgia and Washington state are also known to be under review.

Some Republican lawmakers have called for Shinseki to resign, as has American Legion National Commander Daniel Dellinger.

Dellinger said the Phoenix scandal was not the only reason for a leadership change, but it was the last straw.

The most pointed question came when Sen. Dean Heller, R-Nev., asked, given all the VA chief has learned, why should he not resign?

The retired four-star army general replied “this is not a job” but a mission for him to provide the critical care needed by those with whom he has gone to war.

Shinseki vowed to continue until he has reached his goal or until the commander in chief tells him his time is up.

Sen. Jerry Moran, R-Kan., who has called for Shinseki’s resignation, accused him of conducting “damage control” rather than taking steps to fix his department.

On Wednesday, President Obama assigned White House deputy chief of staff Rob Nabors to review policies for patient safety rules and the scheduling of patient appointments.

The Senate committee will convene again once the OIG report is completed, to review the findings.

Shinseki wouldn’t tell senators what changes the VA plans to make, because the Office of Inspector General has “advised VA against providing information that could potentially compromise their ongoing review.”

But, two senior executives at the Phoenix VA already have been placed on administrative leave until further notice.

The VA system is the largest health care system in the country, treating 9 million veterans a year at 152 hospitals and more than 1,500 other facilities.

Patients are generally satisfied with their care at VA hospitals, according to surveys.

The Phoenix VA Health Care System serves about 80,000 veterans.

Sanders noted “there are going to be problems” with any system so large.

But the questions, he said, are, “Do we have enough doctors and nurses and nurse practitioners at that site?” and, “If not, why not?”

Follow Garth Kant on Twitter @DCgarth

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