Across the entire Veterans Health Administration System, which encompasses 171 medical centers and 1,100 clinics, more than one-third of hospitals reported a severe shortage of police officers last year.

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The understaffing contributes to situations where public entryways aren’t manned and security cameras aren’t monitored sufficiently, according to the report.

Roughly 388,000 employees of the Veterans Health Administration provide medical care and services to 7.3 million patients each year, according to the VA. In 2022, there were 36 "serious incidents" reported at 32 VA medical centers, defined as events that would draw attention or cause harm, such as major theft of VA property, injury to people or property, display of a firearm by someone on the property, or a shooting by a police officer.

The incidents included a bomb threat -- later determined to be a hoax -- at the Robert J. Dole VA Medical Center in Wichita, Kansas, in February that prompted the evacuation of building occupants and response by local emergency units.

In May, a man at the Ravenna VA Clinic in northeastern Ohio brought a shotgun to the facility and fired a round into the ground outside, leading to a lockdown of both the clinic and a nearby high school.

And in July, at the San Diego VA Medical Center, a patient grabbed an officer's gun and fired it, missing the officer but striking a wall next door, endangering the patient in that room.

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The incidents, and ongoing concern from veterans and members of Congress about security at VA hospitals, prompted the OIG to conduct the audit, officials said.

"All 36 incidents presented significant concerns and highlight VA's need to protect its property and systems, as well as secure its facilities to help ensure the safety of staff, patients, and visitors," wrote Larry Reinkemeyer, VA's assistant inspector general for audits and evaluations, in the report.

Auditors found that police shortages weren't limited to a geographic area or size of facility. In one location in the South, 20 of 32 positions were vacant, or 63%; a hospital in a large northeastern city showed that 57 of its 90 positions were vacant, also 63%.

And although the VA now has a requirement that all emergency departments have a visible security presence by May 2023, the inspectors, who did their review in September 2022, found that 58% of facilities had not yet met the requirement.

Following release of the OIG report, VA officials sought to reassure veterans and visitors that they are safe on VA grounds. They noted that they have embarked on a modernization of the VA police force, including adding new positions.

“We are always aggressively recruiting for high-quality VA police candidates. Law enforcement is currently a highly competitive market in the country, with more vacancies than applicants,” a VA spokesman wrote in an email to Military.com

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“Previous to this report, VA took steps to attract more high-caliber and diverse applicants. This includes enhanced salaries, recruitment and retention incentives, and continuous job postings on USA Jobs. We have also partnered with DoD in [an initiative] that places qualified transitioning service members in VA Police positions,” the spokesman wrote.

The inspections reported that not only were the police understaffed, they were overworked. In 2022, VA police officers worked 292,000 overtime hours in the 70 facilities reviewed, at a cost of $13.4 million. At more than half the sites, the VA police chiefs said overtime was mandatory at their facilities as a result of staffing issues.

Other issues that contributed to staffing troubles included low pay compared with other police departments and high turnover -- the result of new hires getting training and leaving for other jobs, the VA OIG said.

While the shortages meant that many public doors went unmanned by security personnel, the VA OIG also found opportunities for improving security at doors intended for use only by staff or approved visitors. The audit found that 17% of more than 2,500 nonpublic doors were unlocked and/or lacked security cameras.

In one case, a door to a surgical intensive care unit was not locked and, in others, VA inspectors were able to walk into a pharmacy where controlled substances were stored, a nuclear medicine clinic, a women's health clinic, and an emergency care clinic.

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"VA medical facilities are meant to be welcoming. They're meant to be easy to access and, as a result, have many entrances. On top of that, there are 171 geographically diverse medical facilities in the VA network, and each of them come with their own unique challenges. It's important to understand that there is not one [security] template that can be applied. There are 171 templates that need to be applied," said Shawn Steele, director of the VA OIG's Office of Audits and Evaluations Healthcare Infrastructure Division in the VA's Veteran Oversight Now podcast, released Thursday.

Keeping security cameras working at VA facilities has been a long-standing problem, with lawmakers calling for change after several high-profile incidents, including the assault of a Navy veteran and congressional staffer at the VA Medical Center in Washington, D.C., and the murder of seven veterans at the Louis A. Johnson VA Medical Center in Clarksburg, West Virginia, at the hands of a nurse.

The OIG teams found that 19% of all cameras were not working, and more than 20% of cameras at 24 facilities were inoperable. One facility in a large northeastern city said only 50% of its cameras were operational.

“The OIG acknowledges that the presence of operational security cameras results in a large amount of footage to review, and many facilities may not have sufficient personnel to do so. However, having this footage available to review would help facilities and other authorities investigate any reported incidents,” the report stated.

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For the most part, the office found that VA Police Services were adequately trained and equipped and had policies and procedures in place to respond to an emergency.

VA OIG officials also said that at the facilities, where they were taking photographs, attempting to open locked doors and seeking out security cameras, they were approached and challenged by security at 38 of the 70 sites.

The OIG made several recommendations for the VA to improve the safety and security of all its medical facilities, to include assessing staffing needs and using hiring incentives to attract recruits; ensuring that VA facilities have budget to maintain security measures; directing all VA police chiefs to develop plans to identify and fix security weaknesses; and requiring policies that standardize security camera footage review and retention.

The VA concurred with the recommendations, estimating the fixes would be completed by June.