AUSTIN - An internal Department of Veterans Affairs investigation found that schedulers in Texas routinely misreported when patients actually wanted to see a doctor or get some other type of care, making it impossible to track delays in the care they received.

The report released last week by the VA's Office of Inspector General tracks problems in clinics and medical facilities in central and South Texas.

The Amarillo VA Endoscopy Clinic was cleared of all wrongdoing in a report issued March 8. According to the investigation, the Amarillo VA's Endoscopy Clinic had such a "huge backlog that they placed patients on a paper list."

It was discovered that the clinic had been using two approved ledger books for a number of years: A Specimen-Pathology book and a "Black Book" the report said.

"We are pleased the OIG investigations completed for (the Amarillo VA) did not identify any intentional manipulation of scheduling or information," said Michael Kiefer, director of the Amarillo VA Health Care System. "None of the areas reviewed merited referral for further assessment. The report demonstrates the integrity and knowledge of (VA) employees I am honored to work with. Since 2014, (the VA) has been working diligently to increase access to care and enhance scheduling processes. We appreciate the work of the OIG. The feedback they provided has helped us to strengthen our processes to better serve veterans going forward."

After interviewing medical personnel and the VA director, the Office of Inspector General concluded that the paper records were being used to "ensure continuity of care and to track the tissue samples." There was no evidence of wrongdoing or manipulation of wait times.

The VA's internal watchdog has moved to increase transparency amid pressure from Congress and state officials. Scandal erupted in Phoenix nearly two years ago, following complaints that as many as 40 patients died while awaiting care at the city's VA hospital.

According to the report, schedulers often listed the first available date that a patient could be seen as the date that a patient had wanted to be seen. This meant there was no way to track how much longer those seeking care waited to get it.

VA employees reported to investigators that they sometimes engaged in misleading scheduling at the behest of their supervisors.

"Review of patient appointment data for facilities in San Antonio, Kerrville, and Austin revealed that the improper scheduling was systemic, and was not limited to a particular clinic or supervisor," the report said, though it found no evidence that VA employees received monetary bonuses or other awards for reporting shorter wait times.

An employee at an Austin clinic said her supervisor and another employee taught her how to make patient wait times equal zero by manipulating appointment dates, and that she was again trained to "zero out" wait times after moving to another facility. A Kerrville scheduler reported that a supervisor threatened to fire her if she didn't zero out wait time data.

A former employee at an Austin facility reported filing an administrative grievance charging that he didn't receive enough training on scheduling patients.

Supervisors and administrators at many facilities, however, denied that there was a systematic effort to manipulate wait time data. Some told investigators that schedulers may have misunderstood directives, others said employees had since been retrained to correct the practice, the report found.

Reporter Aaron Davis contributed to this report.