Legislators Promote Unlimited Salary Cap Waivers for Some Specialties
Earlier this year, the North Florida/South Georgia Veterans’ Health System announced it was hiring registered nurses, licensed practical nurses, certified nursing assistants, health technicians and intermediate care technicians in the Florida locations of Lake City, Gainesville, Ocala, Jacksonville, Middleburg, St. Augustine, Tallahassee, The Villages, Marianna and St. Marys in Georgia. Source: From NFSGVHA Facebook page.
WASHINGTON, DC — According to the annual Office of Inspector General (OIG) staffing report, VA hospitals are facing an increase in hiring challenges compared to last year, with facilities reporting a total of 4,712 severe staffing shortages spread across 389 occupations. This is up from 4,434 in fiscal year 2025.
While the new report shows less turmoil in VA staffing than in recent years, there was a notable increase in potential difficulty hiring specialists as well as which professions made the top of the list.
In the context of the report “severe staffing shortage” is a measure of the difficulty a facility believes it would experience should they need to fill a particular role and not a measure of existing vacancies at that facility.
The watchdog’s annual report found that all of VA’s 139 medical centers reported a severe shortage in at least one profession, with 97% of facilities reporting shortages for medical officer occupations and 86% for nurse occupations, up from 94% and 79% the year prior.
Practical nurses, also known as licensed practical nurses (LPNs), were the most frequently reported clinical shortage and the most frequently reported shortage in general, with 59% of facilities listing them, up from 50% in 2025. This bumps them above psychology (58%) and psychiatry (54%), both of which remained steady from last year.
There also was a significant increase in facilities reporting a severe shortage in social workers (51%) and nursing assistants (50%), bringing both professions into the clinical top five.
While the report highlights the most reported professions, the biggest increases were seen farther down the list among medical specialties. Gastroenterology went from 35% to 41%; anesthesiology from 32% to 42%; diagnostic radiology from 35% to 49%.
Responding to the report, VA Press Secretary Quinn Slaven said that it’s not a reliable indicator of staffing shortages, because it’s based on the expected challenge to fill a role rather than actual vacancies.
“When it comes to staffing, VA continues to outperform most other healthcare organizations, with VA-wide vacancy rates for doctors and nurses that are 15% and 9%, respectively,” Slaven said. “These are lower than most other healthcare systems [and] in line with normal VA historical averages.”
VA has been transparent about its challenges in hiring physicians, especially in high-demand medical specialties. In testimony before Congress last spring, Secretary Doug Collins put much of the blame on federal salary caps that limit VA doctors’ salaries to $400,000.
“When you have starting salaries of $600,000 for anesthesiologists in the community, and I can’t pay that … I don’t blame them for going somewhere else,” he told the House VA Committee.
One of the provisions of the 2024 Elizabeth Dole Act provides waivers that allow VA to pay some doctors more than the $400,000 cap, but the department has made little use of them. Collins explained to lawmakers that the number of waivers was too few and that using them would create feelings of inequity between VA physicians.
Taking that note, some lawmakers are now looking to give VA unlimited salary cap waivers. If passed, the bipartisan VA Salary Cap Waiver Adjustment Act would allow VA to issue as many waivers as necessary to VA medical directors.
“Hiring and retaining skilled physicians is a serious challenge within the VA, and it needs to be addressed now,” said bill co-sponsor Sen. Deb Fischer (R-NE). “Giving the VA flexibility to retain medical professionals will help it compete with private-sector salaries and ensure veterans receive high-quality care.”
“VA’s current salary cap is outdated and counterproductive,” added Sen. Richard Blumenthal (D-CT). “As the cost of living continues to skyrocket, VA needs this authority to recruit and retain the best doctors around to serve veterans.”
While VA does not comment on pending legislation, Slaven said, “VA looks forward to working with Congress to address this long-standing pay disparity, which directly harms the recruitment of healthcare professionals.”
The OIG report also looked at severe shortages in nonclinical occupations. As in previous years, the top ranked occupation was police (57%), followed by custodial worker (53%), medical support assistance (49%) and food service (42%). The department recently overhauled the leadership and oversight structure of its police force, which they believe will lead to a better understanding of staffing needs, higher morale and better overall retention.