Recommendations
2056
| ID | Report Number | Report Title | Type | |
|---|---|---|---|---|
| 23-02994-224 | Cardiothoracic Services Contracting at the Captain James A. Lovell Federal Health Care Center in North Chicago, Illinois, Needs Improvement | Review | ||
1 Ensure the Network Contracting Office 12 contracting officer develops a cardiothoracic services contract solution that meets the Medical Sharing/Affiliate National Program Office threshold for review.
Closure Date:
2 Establish procedures to regularly identify and review healthcare resources contracts that have been modified resulting in contract values that exceed the threshold and determine if any further action by Regional Procurement Office Central leaders or the head of contracting activity is necessary.
Closure Date:
3 Ensure the Network Contracting Office 12 contracting officer makes the sole-source contract justifications publicly available as required.
Closure Date:
4 Ensure corrective actions are taken to resolve the issues identified in the Medical Sharing/Affiliate National Program Office fact-finding investigation.
Closure Date:
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| 23-01624-243 | VHA Needs to Establish Controls for Its Ambulatory Care Budget Estimate | Audit | ||
1 Establish and implement guidance for quality assurance measures over the data used to develop and justify the ambulatory care budget estimate.
2 Ensure the deputy under secretary for health provides oversight and holds the Office of Finance accountable for developing, documenting, and implementing standard operating procedures to include defining roles and responsibilities and requirements for oversight and quality assurance for development of the ambulatory care budget estimate.
3 Implement the Veterans Health Administration Data Governance Council, to include developing policies and processes for data management across the Veterans Health Administration.
4 Ensure the Veterans Health Administration Data Governance Council identifies authoritative data sources and nominates data stewards for approval by the VA Data Governance Council.
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| 23-03128-213 | Alleged Mismanagement of Contracts for Wheelchair-Accessible Transportation Services by the Health Administration Service at the Dallas VAMC in Texas | Review | ||
1 Coordinate with the Health Administration Service chief to develop local policy and standard operating procedures to ensure wheelchair-accessible transportation service invoices are adequately reviewed before certification for payment in accordance with financial policy and contract documentation.
Closure Date:
2 Recover approximately $3.7 million from the contractor for transportation overcharges.
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| 24-00601-254 | Healthcare Facility Inspection of the VA Hudson Valley Healthcare System in Montrose, New York | Healthcare Facility Inspection | ||
1 The OIG recommends that facility leaders submit a plan to the OIG detailing steps to address snow removal on pathways leading to and from buses during and after snowstorms.
Closure Date:
2 The OIG recommends that facility leaders consider clarifying signage by identifying the services located in each building to help direct veterans.
Closure Date:
3 The OIG recommends that facility leaders implement navigation tools and cues that accommodate visually impaired veterans to help them enter the main doors.
Closure Date:
4 The OIG recommends that facility leaders consider distributing toxic exposure screening information where veterans can easily obtain it when entering the facility.
Closure Date:
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| 24-00585-246 | Healthcare Facility Inspection of the VA Orlando Healthcare System in Florida | Healthcare Facility Inspection | ||
1 The OIG recommended the Facility Director work with Veterans Integrated Service Network leaders to reevaluate the current bed level capacity and submit the bed change request as required.
Closure Date:
2 The OIG recommended the Facility Director ensures staff secure the pneumatic tube system to prevent unauthorized access to medications.
Closure Date:
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| 22-03591-231 | VA Needs to Strengthen Controls to Address Electronic Health Record System Major Performance Incidents | Audit | ||
1 Assess electronic health record major performance incident data needs and contractually commit to real-time data sharing that will provide greater awareness of system operations.
2 Develop a formal procedure for verifying performance metrics and associated credits to ensure the department receives the remedies it is due under the contract.
3 Update the process for prioritizing major performance incidents to ensure that notification and resolution occur in a consistent manner.
4 Develop effective notification and resolution metrics that consistently capture results for all major performance incidents, regardless of the owner, and enforce them.
5 Identify the information needed in post-resolution reports, such as corrective and preventative actions, and require the contractor to consistently collect, verify, and report that information as a contract deliverable.
6 Develop a plan to ensure all clinicians are familiar with the national downtime procedures.
Closure Date:
7 Identify the appropriate backup system and develop a training strategy to ensure clinicians can use the system during downtime.
Closure Date:
8 Assess facilities’ patient safety reports identified during this audit to determine if additional actions need to be taken and, if so, provide an action plan.
9 Develop a mechanism to better identify major performance incidents and negative patient outcomes and provide a plan to prioritize and address their causes.
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| 24-00153-248 | Financial Efficiency Inspection of the VA Northeast Ohio Healthcare System | Financial Inspection | ||
1 Establish a plan to use VA’s cost accounting system information to identify alternative ways to reduce costs, enhance efficiency, and inform business decisions as identified by VA financial policy. This could include implementing federal financial accounting standard practices to use cost information for performance measurement, budgeting, cost control, and making economic choices.
Closure Date:
2 Consider requiring that the managerial cost accounting team review the Intermediate Product Cost Outlier report to identify cost outliers that may occur at the healthcare system.
Closure Date:
3 Ensure healthcare services are completing monthly data validation memos for their managerial cost accounting data.
Closure Date:
4 Ensure that healthcare system staff follow policy requirements; and that fiscal staff conduct reviews on all open obligations as required by VA Financial Policy, vol. 2, chap. 5, “Obligations” (2020), updated May 2023.
Closure Date:
5 Ensure that healthcare contracting staff follow federal acquisition regulations when terminating contracts for convenience to the government.
Closure Date:
6 Establish controls to ensure cardholders comply with record retention requirements, confirm approving officials and cardholders review purchases for VA policy compliance, and ensure contracting is used when it is in the best interest of the government.
Closure Date:
7 Require cardholders to submit a request for ratification for any unauthorized commitments identified.
Closure Date:
8 Develop and implement a plan to ensure data accuracy and reliability in the Generic Inventory Package.
Closure Date:
9 Develop and maintain a standardized training program for logistics and clinical staff on the proper recording of items as they are removed from primary and secondary inventory points.
Closure Date:
10 Ensure that MSPV facility-level contracting officer’s representatives are appointed and designated properly and perform all required duties according to the scope and limitation of the designee’s authority.
Closure Date:
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| 24-00122-247 | VA Continues Moving toward Full Compliance with Geospatial Data Covered Agency Responsibilities | Audit | ||
1 Reevaluate the risk determination for the Veterans Health Administration Geographic Information System and determine if the system should be set to a security categorization level of “moderate” based on the personally identifiable information and other sensitive data maintained in the system.
Closure Date:
2 Ensure the Data Breach Response Service director instructs staff associated with the incident response process that each security and privacy incident that occurs must be captured on a separate Privacy Security Events Tracking System ticket, confirms document investigation details are accurate, and reassesses whether the security incidents were a breach.
Closure Date:
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| 22-02161-200 | Independent Audit Report of a Dialysis Provider’s Contract Pricing and Billing Compliance | Audit | ||
1 Request that the contractor perform a self-audit of local VA claims.
Closure Date:
2 Verify that the contractor has completed the process of refunding local VA claims.
Closure Date:
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| 23-02610-226 | Additional Controls Are Needed to Improve the Reliability of Grant and Per Diem Program Data | Review | ||
1 Establish policies and procedures for Grant and Per Diem liaisons to obtain reliable discharge information from grantees when veterans exit from the Grant and Per Diem Program.
2 Implement controls, including enhanced medical facility and grantee guidance and training, to ensure grantee files and VA medical record documentation of veteran housing outcomes are consistent with Homeless Operations, Management, and Evaluation System data definitions and support the data in the Homeless Operations, Management, and Evaluation System.
3 Implement controls, such as quality reviews, to ensure Homeless Operations, Management, and Evaluation System outcome data are supported by and consistent with veteran medical records and grantee files.
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14921