Financial Efficiency Inspection of the VA Tampa Healthcare System

Report Information

Issue Date
Report Number
24-00103-27
VISN
State
Florida
District
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Audits and Evaluations
Report Type
Financial Inspection
Report Topic
Financial Management
Major Management Challenges
Stewardship of Taxpayer Dollars
Recommendations
12
Questioned Costs
$110,042,700
Better Use of Funds
$5,900,000
Congressionally Mandated
No

Summary

Summary

The VA Office of Inspector General (OIG) conducted this inspection to assess the oversight and stewardship of funds by the VA Tampa Healthcare System. This inspection assessed four financial activities and administrative processes to determine whether appropriate controls and oversight were in place: use of managerial cost accounting information, open obligations oversight, purchase card use and oversight, and supply chain management operations.

The OIG found the healthcare system could use managerial cost accounting information more effectively to help spend more efficiently and improve its performance measurement process for identifying and correcting cost inaccuracies.

The healthcare system did not always perform monthly reviews and deobligate funds no longer needed. The healthcare system appeared to use funds from the wrong fiscal year to pay for services, which may have violated the “bona fide needs” rule. The OIG estimated $6.3 million in open obligations was invalid due to the healthcare system’s lack of monthly follow-up and reconciliations and found that an estimated $5.9 million in invalid obligations should have been deobligated for better use.

The healthcare system did not always process purchase card transactions in accordance with VA policy. The OIG found violations involving a lack of prior approvals, supporting documentation, and segregation of duties.

Furthermore, the healthcare system did not meet the days-of-stock-on-hand metric or maintain accurate supply chain data. Officials also did not fulfill their duties to ensure that Medical Surgical Prime Vendor (MSPV) ordering officers and a facility contracting officer’s representative were nominated and delegated to ensure the MSPV program achieved its goals and objectives and effectively safeguarded the government’s interests and resources.

The OIG made 12 recommendations for improvement to the healthcare system director. The recommendations address issues that, if left unattended, may eventually interfere with financial efficiency practices and the strong stewardship of VA resources.
 

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Open Recommendation Image, Square
to Veterans Health Administration (VHA)

Establish a plan to use VA’s cost accounting system information to identify additional ways to reduce costs, enhance efficiency, and inform business decisions as identified by VA financial policy.

No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
Closure Date: 7/14/2025

Ensure the facility has a process to identify cost outliers, such as using the Intermediate Product Cost Outlier report to identify cost outliers that may occur at the healthcare system on a regular basis.

No. 3
Open Recommendation Image, Square
to Veterans Health Administration (VHA)

Ensure healthcare system service lines review and update the national labor mapping tool to the Veterans Integrated Service Network managerial cost accounting team as required by VA financial policy to ensure workload is being captured correctly.

No. 4
Open Recommendation Image, Square
to Veterans Health Administration (VHA)

Ensure that healthcare system staff and responsible finance office staff review all open obligations to ensure balances are valid and should remain open or are closed in a timely manner as required by VA Financial Policy, “Obligations,” as updated in March 2024.

No. 5
Open Recommendation Image, Square
to Veterans Health Administration (VHA)

Ensure that the healthcare system uses appropriated funds in the manner intended by Congress, as required by the VA Financial Policy, “Obligations,” as updated in March 2024.

No. 6
Open Recommendation Image, Square
to Veterans Health Administration (VHA)

Consult with the Office of General Counsel and the Office of Acquisitions, Logistics, and Construction to determine whether a bona fide needs or other appropriations law violation occurred and, if any violations did occur, take appropriate remedial and preventive actions to address them.

No. 7
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
Closure Date: 7/14/2025

Ensure cardholders comply with prior approval, segregation of duties, and record retention requirements as required by VA Financial Policy, volume 16, chapter 1B, “Government Purchase Card for Micro-Purchases.”

No. 8
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
Closure Date: 7/14/2025

Ensure cardholders and approving officials are aware of the requirement to review purchases and determine when it is in the best interest of the government to use strategic sourcing.

No. 9
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
Closure Date: 7/14/2025

Develop and implement a plan to ensure data accuracy and reliability in the Generic Inventory Package and ensure processes are in place to monitor performance metrics in accordance with Veterans Health Administration policy.

No. 10
Open Recommendation Image, Square
to Veterans Health Administration (VHA)

Develop and maintain an effective standardized training program for new and current inventory staff and monitor the staff’s knowledge and skill level.

No. 11
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
Closure Date: 7/14/2025

In coordination with the Strategic Acquisition Center, ensure that the Medical Surgical Prime Vendor facility-level contracting officer’s representatives and ordering officers are appointed and delegated properly and perform all required duties according to the scope and limitation of the designee’s authority.

No. 12
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
Closure Date: 7/14/2025

In coordination with the Strategic Acquisition Center, submit ratifications for any Medical Surgical Prime Vendor unauthorized commitments in accordance with the Federal Acquisition Regulation.

Total Monetary Impact of All Recommendations
Open: $ 5,935,700.00
Closed: $ 110,007,000.00