WHITE CITY — A national audit tagged Southern Oregon Rehabilitation Center and Clinics with low marks in handling some medical cases for veterans, but it also showed a strong record for dealing with established patients.

WHITE CITY — A national audit tagged Southern Oregon Rehabilitation Center and Clinics with low marks in handling some medical cases for veterans, but it also showed a strong record for dealing with established patients.

The audit of U.S. Department of Veterans Affairs operations, released Monday, ranked the facility third-worst in the nation in waits veterans endured to see specialists and seventh-worst nationally for access to mental health services.

However, the audit also showed that once they're established patients, veterans making appointments at SORCC see a medical staff member within 30 days 97 percent of the time.

The systemwide audit of VA facilities, conducted May 15 through June 3, showed the White City site performed admirably in scheduling appointments within 30 days. Only 295 of 10,452 appointments were pushed beyond a 30-day window. The facility met a 14-day window for 9,993 patients, more than 95 percent.

But only two Texas facilities had longer waiting periods in the country than SORCC for newcomers to get an appointment with specialists and just a half-dozen take more time in making first-time mental health dates.

A SORCC administrator said the difficulty lies in staffing shortages, with some positions going unfilled despite prolonged efforts to make new hires.

"We had positions open for psychiatrists for quite some time and closed them out; there were no applicants," said David Indest, associate chief of staff for mental health at SORCC.

That seemed to have the biggest impact on new patients and those who hadn't been to a clinic in 24 months; both groups often had to endure longer waits, especially to see specialists or to get mental health help. The audit showed new patients took nearly seven weeks to see a primary care doctor, compared with less than three days for established patients.

When it came to seeing a specialist, the wait for a new patient jumped to nearly three months, compared with less than two days for those in the system. Likewise, the wait for incoming mental health patients to get an appointment was eight weeks versus less than two days for established patients.

SORCC is not a hospital, and unlike the VA facility in Portland, it has no surgery department, no emergency room, or urgent care component.

"We're not a medical center, so we don't have many of the specialty care doctors in-house that veterans require," said SORCC spokesperson Anna Diehl. "We refer them to a sister VA facility and if they don't have the capacity, then we fee it out (pay for a local doctor) in the community."

It's in mental health where the days can really pile up.

SORCC offers an array of treatment, ranging from psychiatric evaluations and addictions help to vocational rehabilitation, served by a staff of 135.

In the past year, Indest said, SORCC has lost five prescribing psychiatrists, psychiatric nurse practitioners and psychotherapists, limiting the number of available patient visits. Nonetheless, Indest said, his staff sees 800 to 1,000 clients annually and his prescribing staff sees 4,500 outpatients yearly.

One of the departing staff members, he said, went to a different VA facility and another left the area.

"It's difficult to recruit and retain people to a Level III (non-hospital) facility, partly because they tend to be rural in nature," Indest said.

Finding a caregiver for mental health patients elsewhere in Jackson County isn't necessarily easier, Indest said.

"Mental health providers in the area are having trouble providing prescribers as well," he said. "We looked into contracting in the community so we could send the veterans to them; our insurance carriers couldn't find providers who could do the fee work."

Diehl said the VA is continually recruiting, both locally and nationally.

"We're finding the academic institutions just aren't turning out the number of mental health providers that are needed, not just for our agencies, but in the public sector, too," Diehl said. "The public sector is in desperate need of mental health professionals, too."

The result, nonetheless, when positions go unfilled: Veterans sit and wait for care.

"Whether it's private or federal when a doctor leaves, the work load is assumed by other doctors," she said. "That's where the challenge comes in, especially when you lose five of them in mental health."

Elsewhere in Oregon, the Portland VA Medical Center had the nation's fifth-longest wait time for new patient primary care. New patients had to wait an average of 80 days before they could be seen, far longer than the department's stated 14-day goal.

Portland VA Medical Center public affairs officer Dan Herrigstad said Monday that the delay in primary care is directly related to staffing. The facility had 21 physician vacancies in May out of a total of 75 primary-care physicians.

The audit also said further reviews and investigations are necessary at the Portland VA Medical Center and the Roseburg VA Medical Center.

Reach reporter Greg Stiles at 541-776-4463 or business@mailtribune.com. Follow him on Twitter @GregMTBusiness, friend him on Facebook and read his blog at www.mailtribune.com/Economic Edge.