OIG Determination of Veterans Health Administration’s Severe Occupational Staffing Shortages Fiscal Year 2023

Report Information

Issue Date
Report Number
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Healthcare Inspections
Report Type
National Healthcare Review
Questioned Costs
Better Use of Funds
Congressionally Mandated



The VA Choice and Quality Employment Act of 2017 (VCQEA) requires the VA Office of Inspector General (OIG) to determine, annually, a minimum of five clinical and five nonclinical Veterans Health Administration (VHA) occupations with the largest staffing shortages within each VHA medical center (facility). The OIG conducted a review to identify those severe staffing shortages by occupation. The OIG also compared the number of severe occupational staffing shortages against the previous four years’ reports to assess changes.

The OIG surveyed VHA-identified facility points of contact to determine severe occupational staffing shortages at each facility. Among the most significant findings in this year’s staffing report were the following:

• Facilities reported 3,118 severe occupational staffing shortages across 282 occupations in fiscal year (FY) 2023. This was an increase from 2,622 severe occupational staffing shortages across 285 occupations in FY 2022, following annual decreases during FY 2018–FY 2021.

• Eighty-eight percent of facilities reported severe occupational staffing shortages for Medical Officer, and 92 percent of facilities reported severe shortages for Nurse.

• Practical Nurse was the most frequently reported clinical occupation with severe staffing shortages, and Medical Support Assistance was the most frequently reported nonclinical occupation with severe staffing shortages. Medical Support Assistance was also the most frequently reported Hybrid Title 38 severe shortage occupation.

• All 139 facilities surveyed reported at least one severe occupational staffing shortage.

The Veterans Access, Choice, and Accountability Act and VCQEA provide a mechanism for the VA Secretary to grant VHA direct-hire authority, expanding the candidate pool for Hybrid Title 38 occupations based on severe shortages. In FY 2023, more severe occupational staffing shortages were reported by more facilities than in recent FYs. The total number of severe occupational staffing shortages increased by 19 percent relative to FY 2022.

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