In the aftermath of a poorly executed Colorado veterans’ hospital project that tripled in cost from $604 million to $1.7 billion and slipped from a 2013 opening to early 2018, the U.S. Government Accountability Office has taken a critical look at U.S. Dept. of Veterans Affairs facility planning and project delivery in two recent reports.

GAO said there are still opportunities for costs to increase at the Aurora, Colo., hospital, although the U.S. Army Corps of Engineers took over its troubled construction management in 2015 as well as oversight last October of half of VA’s 23 projects costing $100 million or more. VA still is responsible for Aurora’s completion of equipment installation and other projects. Those costs have increased from $272 million in 2012 to $341 million, said GAO. “However, the current estimate is not reliable,” the watchdog group said. VA officials did not say how they developed the cost and whether it meets GAO cost estimating criteria. Meanwhile, Rep. Michael Coffman (R), who represents the Aurora area and chairs the House Veterans Affairs subcommittee on oversight and investigations, said he is awaiting response to lawmakers’ request for an FBI criminal probe on whether VA managers lied to cover up the cost overruns, according to an April 18 website statement.

VA, which operates one of the largest U.S. health care systems with 168 medical centers and more than 1,000 outpatient facilities, has struggled to address pressing infrastructure needs. “Many of these facilities are underutilized and outdated,” said GAO. “A previous effort aimed at modernizing and better aligning facilities was not fully implemented.” GAO said many aging VA facilities are not designed for a shift to more outpatient care and are costly to retrofit. GAO found critical flaws in the VA process to review proposed projects equitably and consistently, and said agency master plans could result in overspending because they don’t include use of community facilities and changing veteran demographics.