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Inspector General Open Recommendations
01/14/2021
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Small Business Administration
Inspection of SBA's Implementation of the Paycheck Protection Program
[Report Details]
Inspection / Evaluation
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Open Recommendations
1
Review the loans identified as potentially ineligible to determine if the businesses met eligibility requirements. If not, take appropriate action related to loan guaranty and forgiveness.
2
For future rounds of PPP lending, assess vulnerabilities in internal controls and strengthen or implement necessary internal controls to address ineligible loans and potential fraud.
3
For future rounds of PPP lending, revise the borrower application to include the critical “jobs retained” field to ensure SBA reports accurate and complete job numbers.
4
For future rounds of PPP lending, revise the application to include the demographic information of borrowers.
5
For future rounds of PPP lending, update the PPP borrower application to include a field for the North American Industry Classification System code of the business and the business description to enable SBA to prevent potentially ineligible loan approvals.
6
Update the PPP forgiveness application to include North American Industry Classification System code to ensure that previously recorded information is accurate.
01/13/2021
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Department of Veterans Affairs
Thoracic Surgery Quality of Care Issues and Facility Leaders’ Response at the C.W. Bill Young VA Medical Center in Bay Pines, Florida
[Report Details]
Inspection / Evaluation
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Open Recommendations
01
The Under Secretary for Health designates a thoracic specialty leader who has the authority to review all aspects of the personnel and management actions and can provide unbiased, authoritative, and timely guidance to facilities on the most clinically sound course of action when a thoracic surgeon’s practice or outcomes are under review, in order to ensure that VA provides high quality care.
02
The Under Secretary for Health outlines general parameters and triggers for when facilities without local thoracic surgery expertise engage the thoracic specialty leader and how the thoracic specialty leader’s decisions and guidance will be documented.
03
The Under Secretary for Health clarifies Veterans Health Administration policy regarding providers’ responsibilities to document complications in operative reports.
04
The Under Secretary for Health reevaluates the eligible and mandatory assessment surgery cases reported to the National Surgery Office to determine if thoracic cases should be included in the list of mandatory assessment cases, and modifies the list as appropriate.
05
The Under Secretary for Health defines expectations for peer review committee members whose cases are being reviewed to leave the room during those deliberations, provides guidance on how that recusal is to be annotated in the Peer Review Committee minutes, and updates Veterans Health Administration policy, as needed.
06
The C.W. Bill Young VA Medical Center Director enhances processes to identify the existence of omissions or misrepresentations in operative note documentation and takes action based on identified deficiencies, if any.
07
The C.W. Bill Young VA Medical Center Director takes action to ensure that the surgeon is aware of, and complies with, expectations for professional communications and supporting staff to report adverse events and close calls.
08
The C.W. Bill Young VA Medical Center Director ensures the C.W. Bill Young VA Medical Center Surgical Work Group provides oversight as required by Veterans Health Administration policy and monitors for compliance.
09
The C.W. Bill Young VA Medical Center Director confirms processes are in place to ensure providers’ clinical privileges are specific to the facility and service, and are based on each provider’s clinical competence, and monitors for compliance.
10
The C.W. Bill Young VA Medical Center Director reviews whether the cases reflected in tables 1 and 2 in this report meet criteria for institutional disclosure and takes action as appropriate.
01/12/2021
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Department of Veterans Affairs
Deficiencies in Privileging a Urologist to Practice and Medication Management Processes at the VA Central Iowa Health Care System in Des Moines
[Report Details]
Inspection / Evaluation
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Open Recommendations
01
The VA Central Iowa Health Care System Director ensures sustained compliance of providers who order controlled substances maintaining an individual Drug Enforcement Administration registration.
02
The VA Central Iowa Health Care System Director ensures verbal medication orders given in the operating room comply with Veterans Health Administration and VA Central Iowa Health Care System policies to permit verbal orders in emergent situations.
03
The VA Central Iowa Health Care System Director ensures operating room verbal medication orders are entered in the Computerized Patient Record System pharmacy package in accordance with Veterans Health Administration and VA Central Iowa Health Care System policies.
04
The VA Central Iowa Health Care System Director ensures that verbal medication orders given in the operating room are reviewed by a pharmacist in accordance with VA Central Iowa Health Care System policy.
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