Care in the Community Inspection of South Central VA Health Care Network (VISN 16) and Selected VA Medical Centers

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Date Issued

Thursday, March 20, 2025

Submitting OIG

Department of Veterans Affairs OIG

Agencies Reviewed/Investigated

Department of Veterans Affairs

Components

Veterans Health Administration

Report Number

24-00823-68

Report Description

This Office of Inspector General (OIG) Care in the Community healthcare inspection program report describes the results of a focused evaluation of community care processes at eight South Central VA Health Care Network Veterans Integrated Service Network (VISN) 16 medical facilities with a community care program.

This evaluation focused on six domains:
•    Leadership and Administration of Community Care
•    Community Care Diagnostic Imaging Results
•    Administratively Closed Community Care Consults
•    Community Care Provider Requests for Additional Services
•    Care Coordination Activities for Patients Referred for Community Care
•    Urgent Care in the Community

The OIG issued 13 recommendations for improvement in the six domains:
•    Leadership and Administration of Community Care
o    Community care oversight councils
o    Staffing needs
o    Patient safety event entry and briefing
o    Community care document importing
•    Community Care Diagnostic Imaging Results
o    Significant findings alert
•    Administratively Closed Community Care Consults
o    Medical documents after administrative closure
•    Community Care Provider Requests for Additional Services
o    Request processing
o    Approval and denial letters
•    Care Coordination Activities for Patients Referred for Community Care
o    Community Care–Care Coordination Plan note
o    Appointment confirmation
•    Urgent Care in the Community
o    Community Care–Urgent Care Record note

Report Type

Inspection / Evaluation

Location

AL
United States

AR
United States

FL
United States

LA
United States

MS
United States

MO
United States

OK
United States

TX
United States

Number of Recommendations

Questioned Costs

Funds for Better Use

Report updated under NDAA 5274

External Link

https://www.vaoig.gov/reports/care-community-healthcare-inspection/care-communi…

Open Recommendations

This report has 13 open recommendations.

Recommendation Number	Significant Recommendation	Recommended Questioned Costs	Recommended Funds for Better Use
01	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care oversight councils function according to their charters and meet the required number of times per fiscal year.
02	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, reassess community care staffing needs and act as necessary.
03	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff enter community care patient safety events into the Joint Patient Safety Reporting system.
04	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures patient safety managers or designees brief community care patient safety event trends, lessons learned, and corrective actions at community care oversight council meetings.
05	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility staff import all community care documents into the patients electronic health record within five business days of receipt.
06	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, requires facility community care staff to use the significant findings alert to notify the ordering provider of abnormal diagnostic imaging results.
07	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff make two additional attempts to obtain community providers medical documentation within 90 days of the appointment after administratively closing consults that are not low risk.
08	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff process community providers requests for additional services within three business days of receipt.
09	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff send approval or denial letters to community providers for requests for additional services.
10	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff send approval or denial letters to patients for requests for additional services.
11	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff create and use the Community Care"Care Coordination Plan note to document all care coordination activities for consults with an assigned level of care other than basic.
12	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff confirm patients attended their community care appointments.
13	No	$0	$0
The Veterans Integrated Service Network Director, in conjunction with facility directors, ensures facility community care staff create the Community Care"Urgent Care Record note in the patients electronic health record when they receive medical documentation from the community provider.