The OIG conducted this audit to determine whether medical facilities followed VHA’s process to plan, request, and approve nonexpendable medical equipment purchases. Nonexpendable equipment typically has a useful life of two years or more and costs at least $300. Ventilators, radiology equipment, and vital sign monitors are examples. VHA’s process requires facilities to use the Strategic Equipment Planning Guide and Enterprise Equipment Request portal, designed to support streamlined planning and expedite approval of equipment orders. From FY 2022 through May of FY 2024, VHA staff entered requests into the guide to buy about $2.1 billion in medical equipment.
The OIG found that VHA facilities did not effectively plan for, request, or approve nonexpendable medical equipment purchases as required. This aligned with supply chiefs’ own finding that facilities did not use the process during FY 2024. Specifically, medical facilities did not use the required process for all planning and approval, and some VHA facilities still had not fully implemented the process (mandated in FY 2017) as of FY 2024. The OIG identified two reasons for the noncompliance: VHA had developed guidance but lacked a requirement for staff to use the material, and staff were unclear on what equipment needed to be entered and approved.
A lack of proper planning and approval increases the risk of staff buying items that facility leaders are not aware of or that do not fit in the desired location. The latter scenario happened when the VA medical facility in Tampa, Florida, purchased $500,000 scrubEx machines in June 2021. Consequently, staff have stored and not used the equipment.
The OIG made five recommendations to increase use of VHA’s process and achieve its purpose.