His “State of VA” speech doesn’t shy away from the many problems still facing the department, even after several initiatives brought improvements.

“Our veterans and their families have benefited from our early success,” he said, “but have suffered due to the failures of the past to affect real change. My goal is to address these challenges head on.”

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He divided his assessment into several areas, including

Access to care: Same-day service is available at all 168 medical centers, yet “veterans are waiting more than 60 days for new appointments at about 30 of our locations nationwide.

Veterans suicides: “20 veterans a day are dying by suicide. This should be unacceptable to all of us. … We are also launching a new initiative this summer — Getting to Zero — to help us end Veteran suicide. This is my top clinical priority.”

Employee accountability: “We currently have around 1,500 disciplinary actions pending, meaning we are paying people who need to be fired, demoted, or suspended without pay for violating our core values. Our employee accountability processes are clearly broken.”

Staffing: “Currently it takes VA an average of 110 days to onboard a nurse and an average of 177 days for a Nurse Practitioner. This is absurd. … Low salaries for health care providers and prosthetics representatives make it difficult to recruit and retain critical positions.”

Quality of care: 14 medical centers have below acceptable ratings. “We are deploying teams and implementing performance plans at each of these centers.”

Disability claims: “Over 90,000 disability claims … are taking more than 125 days to process. Our goal is to cut this time by 50 percent over the next two years.” A new “Decision Ready Claims” program is being tested and will be introduced in September.

Buildings: “Our buildings and facilities are increasingly falling into disrepair.”

Despite the serious issues, Shulkin said he remains “confident that we will be able turn VA into the organization Veterans and their families deserve, and one that America can take pride in.”