Care in the Community Inspection of VA MidSouth Healthcare Network (VISN 9) and Selected VA Medical Centers

The Office of Inspector General (OIG) Care in the Community program evaluates selected performance elements of the Veterans Health Administration (VHA) Veterans Community Care Program. The resulting report describes selected care coordination activities required to initiate and process referrals for non-VA care (community care). The OIG reviewed community care processes in five VISN 9 medical facilities with a community care program from June 12 through July 13, 2023. The OIG evaluated the facilities’ processes for community care referral and care coordination in the following domains:
1. Leadership and Administration of Community Care
2. Community Care Diagnostic Imaging Results
3. Administratively Closed Community Care Consults
4. Community Care Provider Requests for Additional Services
5. Care Coordination: Scheduling and Communication with Veterans Referred for Community Care

The OIG issued 14 recommendations for improvement across all five domains as follows:
1. Leadership and Administration of Community Care
• Operating model staffing tool reassessment
• Patient safety event reporting
• Briefing the oversight council
• Document scanning
2. Community Care Diagnostic Imaging Results
• Diagnostic imaging result attachment to required note
• Significant findings alert use for abnormal results
3. Administratively Closed Community Care Consults
• Obtaining medical documentation
• Significant findings alert use when closing consults without documentation
4. Community Care Provider Requests for Additional Services
• Requests for services processing
5. Care Coordination: Scheduling and Communication with Veterans Referred for Community Care
• Level of care assignments
• Care coordination documentation
• Timely update of consult status to active
• Timely appointment scheduling
• Appointment attendance confirmation