The Department of Veterans Affairs is grappling with severe staffing shortages, according to a new watchdog report that warns the problem spans nearly every corner of the nation’s veterans’ health system.

The Office of the Inspector General released its annual report Tuesday, identifying 4,434 severe occupational shortages, a 50% jump from last year’s 2,959. All 139 Veterans Health Administration facilities surveyed reported at least some staffing gaps, with some citing more than 150 shortage designations.