Follow-up Financial Efficiency Inspection of the Southeast Louisiana Veterans Health Care System in New Orleans

Submitting OIG:

Report Description:

The VA Office of Inspector General (OIG) inspected the Southeast Louisiana Veterans Health Care System in New Orleans, Louisiana, in 2021 and made six recommendations. This follow-up inspection found that issues had not been fully resolved in response to those recommendations. The follow-up inspection reassessed the same financial activities and administrative processes: Medical/Surgical Prime Vendor program use, purchase card use, administrative staffing levels, and pharmacy operations. The inspection team visited the Southeast Louisiana Veterans Health Care System in August 2023; interviewed healthcare system leaders and staff; and reviewed data, supporting documents, and processes related to the healthcare system’s financial efficiency. The OIG identified issues with Medical/Surgical Prime Vendor program use, purchase card use, and pharmacy operations. In each area, the healthcare system made limited progress improving issues identified in the OIG’s 2021 report. The inspection team found that the healthcare system improved administrative staffing efficiency, but more opportunities for improvement exist. The OIG reiterated four recommendations from the 2021 inspection where the plans to address the recommendations had not been fully implemented. The OIG also added seven new recommendations to the healthcare system director designed to help officials improve performance. The intent is for system leaders to use these recommendations as a road map to improve financial operations. The recommendations address issues that, if left unattended, may eventually interfere with effective financial efficiency practices and the strong stewardship of VA resources.

Date Issued:

Tuesday, September 3, 2024

Agency Reviewed / Investigated:

Department of Veterans Affairs

Submitting OIG-Specific Report Number:

23-02907-216

Component, if applicable:

Veterans Health Administration

Location(s):

United States

Type of Report:

Inspection / Evaluation

Questioned Costs:

$14,980,000

Funds for Better Use:

Number of Recommendations:

Report updated under NDAA 5274:

View Document:

Attachment	Size
vaoig-23-02907-216.pdf	2.78 MB

Additional Details Link:

https://www.vaoig.gov/reports/financial-inspection/follow-financial-efficiency-i…

Recommendation Number	Recommendation Status	Significant Recommendation
01	Open	No
Establish internal controls to help ensure the healthcare system monitors the Medical/Surgical Prime Vendor product list for updates and completes the item conversion process
02	Open	No
Ensure that prime vendor contract performance issues are routinely reported to the Medical Supplies Program Office and the Strategic Acquisition Center using established Veterans Health Administration reporting tools.
03	Open	No
In coordination with the Strategic Acquisition Center, submit ratifications for any unauthorized commitments following the Federal Acquisition Regulation.
04	Open	No
Ensure that the facility-level contracting officer’s representative and ordering officers are appointed and delegated properly and perform all required duties according to the scope and limitation of the designee’s authority.
05	Open	No
Establish internal controls to help ensure the healthcare system submits national contract requests for waiver and justifications prior to purchasing available product list items from nonmandatory procurement instruments.
06	Open	No
Ensure cardholders obtain a proper prior approval and maintain segregation of duties, and ensure that cardholders and approving officials perform prompt purchase card reconciliations as required by VA financial policy.
07	Open	No
Develop formalized processes and controls to ensure approving officials, cardholders, and the agency contracting office review repetitive open market purchases of goods and services and obtain contracts when it is determined to be in the best interest of the government.
08	Open	No
In coordination with the Strategic Acquisition Center, submit a ratification for an unauthorized commitment following the Federal Acquisition Regulation.
09	Open	No
Develop formalized processes for monitoring and achieving efficiency targets and using available pharmacy data to make business decisions.
10	Open	No
Develop and implement a plan to increase inventory turnover to meet or exceed the VHA-recommended level, and complete monthly B09 reconciliations consistently to ensure discrepancies are corrected in a timely manner.

Recommendation Number

Recommendation Status

Significant Recommendation

Additional Details

Open

Establish internal controls to help ensure the healthcare system monitors the Medical/Surgical Prime Vendor product list for updates and completes the item conversion process

Open

Ensure that prime vendor contract performance issues are routinely reported to the Medical Supplies Program Office and the Strategic Acquisition Center using established Veterans Health Administration reporting tools.

Open

In coordination with the Strategic Acquisition Center, submit ratifications for any unauthorized commitments following the Federal Acquisition Regulation.

Open

Ensure that the facility-level contracting officer’s representative and ordering officers are appointed and delegated properly and perform all required duties according to the scope and limitation of the designee’s authority.