The Department of Veterans Affairs appointed four senior leaders at facilities in Indiana, Ohio and Pennsylvania, though most are transfers and not promotions, the agency said Tuesday. The moves were quickly attacked by lawmakers outraged by the agency's years of scandals.

"At VA, we are constantly seeking ways to improve, and these personnel moves make us better across the board," VA Under Secretary for Health Dr. David J. Shulkin said in a statement. "Each individual is a proven leader who will be a strong advocate for veterans."

But House Veterans Affairs Committee Chairman Jeff Miller told the Washington Examiner that shuffling officials among facilities does not end the need for reform.

"This announcement only raises more questions regarding VA's handling of the scandal at the Cincinnati VA Medical Center. Chiefly, why is the Cincinnati VAMC director departing after less than a year on the job and why is the facility's chief of staff still employed even though a VA investigation found she engaged in serious misconduct by providing improper medical care and prescriptions to members of another VA employee's family?" Miller wrote.

John Gennaro will leave his position as director of the Cincinnati VA Medical Center to fill the same slot at the Erie VA Medical Center in Pennsylvania. The move — though technically a lateral one — is a downgrade for Gennaro, who goes from managing a $387 million facility and 43,000 veterans to overseeing $144 million center and 22,000 veterans.

Gennaro has been at the Cincinnati location for about eight months, and Shulkin said the facility thrived under his leadership. But two months ago, the VA announced the dismissals of two senior leaders at the facility due to a major scandal regarding patient care. That was followed by Gennaro's exit.

In addition, three other leaders were transferred to new locations.

Glenn Costie was transferred to the medical center in Dayton, Ohio, where he will serve as interim director. The move comes a year and a half after Costie, while acting director of the Phoenix VA Healthcare System in 2014, sent an email to staffers about a veteran's suicide, which was later highlighted in a political ad by Rep. Kyrsten Sinema, D-Ariz.

Mark Murdock, who had been on a temporary assignments as acting director of the Northern Indiana Health Care System for the past six months, will go back to the Dayton center as acting director.

Jay Miller, the associate director of the Northern Indiana Health Care System, will serve as interim director at that facility.