Department of Veterans Affairs

The VA Office of Inspector General (OIG) investigated an allegation that an employee in the VA Office of General Counsel’s District Contracting National Practice Group was approved to move his/her office from Pittsburgh to Altoona, Pennsylvania, but continued to improperly receive the higher...

In response to a congressional request, the VA Office of Inspector General (OIG) conducted a review to examine the Community Living Center (CLC) rating system (Compare), the rating system’s limitations, and what information from the system can reasonably be used to understand the long-term care...

The OIG examined whether disability benefit adjustments were calculated accurately for veterans who served in the Reserve or National Guard. These veterans may have been eligible for military training pay, or “drill pay.” However, they are not entitled to receive drill pay and disability benefits in...

The VA Office of Inspector General (OIG) conducted a healthcare inspection to evaluate allegations regarding a patient death following a urology procedure and conflicts of interest in hiring urologists at the facility. A facility urologist performed extracorporeal shock wave lithotripsy (ESWL) on a...

The OIG substantiated an anonymous allegation that an employee at the VA Regional Office (VARO) in Little Rock, Arkansas, established and decided claims for disability benefits inaccurately. The review team found that 11 of 19 claims and decisions were in error because the employee granted benefits...

This Comprehensive Healthcare Inspection Program provides a focused evaluation of the leadership performance and oversight by the Veterans Integrated Service Network (VISN) 1: VA New England Healthcare System, covering leadership and organizational risks and key processes associated with promoting...

This Comprehensive Healthcare Inspection Program provides a focused evaluation of the quality of care delivered at the Alaska VA Healthcare System,covering leadership and organizational risks and key clinical and administrative processes associated with promoting quality care. For this inspection...

The VA Office of Inspector General (OIG) conducted a healthcare inspection to evaluate concerns related to deficiencies in the Women Veterans Health Program; Quality, Safety and Value (quality management) in patient safety and clinical events leading to resuscitation attempts; and leaders’ responses...

The VA Office of Inspector General (OIG) conducted a healthcare inspection to determine the validity of allegations regarding a hospitalist’s interactions with a patient and family when obtaining consent for do-not-resuscitate (DNR) status and determining discharge plans at the facility. The OIG was...

The VA OIG conducted a healthcare inspection to assess allegations of delays in providing patient test results, communication issues between providers and paramedics related to transporting patients to a community hospital emergency department, violations of the Emergency Medical Treatment and Labor...