Federal Reports

The VA Office of Inspector General (OIG) conducted a healthcare inspection in response to an allegation that a thoracic surgeon (surgeon) provided poor quality of care to five patients. Two other allegations received were addressed in an OIG report published in 2018, Inadequate Intensivist Coverage and Surgery Service Concerns (Report No. 17-03399-150). The surgeon was no longer at the facility. Care concerns identified in two of the five patients had been addressed. The OIG determined that before hiring the surgeon, facility leaders were aware of licensure and malpractice issues, including the relinquishing of a state medical license to prevent continued prosecution in a disciplinary case. Facility leaders were deficient in granting and continuing the surgeon’s clinical privileges without required evidence of competency. Errors during the removal process for the surgeon prevented reporting to the National Practitioner Data Bank and delayed reporting to state licensing boards. The OIG noted weaknesses in quality management processes including the credentialing and privileging of other providers, documentation of basic and advanced cardiac life support certification, administrative closure of electronic health record notes, posting of confidential data to the facility’s internal website, adverse event reporting, completion of institutional disclosure, and administrative investigation board timeliness. The OIG made 18 recommendations related to professional practice evaluation processes, National Practitioner Data Bank and state licensing board reporting, documenting sufficient detail in committee meeting minutes to reflect decision-making, and protecting certain confidential information. Recommendations also centered on reporting events to the Patient Safety Committee, reporting surgery patients’ deaths as required, completing proactive risk assessments, and institutional disclosure and administrative investigation board review processes

Our audit objectives were to determine whether DeVry University completed verification of applicant data in accordance with Federal requirements and accurately reported verification results to Federal Student Aid. We found that DeVry University’s policies and procedures for verifying applicant data, reporting verification results, and disbursing Title IV funds for students selected for verification complied with Federal requirements established by Title 34 Code of Federal Regulations (C.F.R.) § 668.53. We also found that We also found that DeVry University completed verification of applicant data in accordance with Federal requirements (34 C.F.R. § 668.54 through § 668.57 and 81 Federal Register 18843-18847) and accurately reported verification results to the Central Processing System and Common Origination and Disbursement System for all 60 students included in our statistical random sample.

What We Looked AtPerformance-Based Navigation (PBN) is a top investment priority for the Federal Aviation Administration (FAA) and the aviation industry under the Next Generation Air Transportation System (NextGen). PBN delivers new routes and flight procedures that primarily use satellite-based navigation aids and on-board aircraft equipment to navigate with greater precision and accuracy. To accelerate PBN, FAA began the Metroplex program in 2010 to increase efficiencies in congested, metropolitan areas with multiple airports. Chairmen Bill Shuster and Frank LoBiondo of the House Committee on Transportation and Infrastructure and its Subcommittee on Aviation requested that we examine the Metroplex program, including whether FAA has delivered new routes and procedures that yield measurable benefits to airspace users and resolved obstacles to PBN. Accordingly, our objectives were to (1) assess FAA's progress in implementing its Metroplex program, including its efforts to resolve key barriers to PBN; (2) compare planned to actual benefits for PBN identified by FAA; and (3) assess the soundness of the methods used by FAA to estimate PBN benefits.What We FoundFAA has made progress in implementing its Metroplex program but has experienced difficulties meeting timelines and has yet to fully resolve key obstacles. While FAA has completed 7 of 12 Metroplex locations, the Agency does not expect to complete all remaining locations until 2021, 4 years later than originally planned. Delays have occurred largely due to increased community concerns about aircraft noise. In addition, other previously identified PBN obstacles remain, including a lack of automated decision support tools for controllers, unclear terminology used by pilots and controllers for referring to flight paths, and the lengthy procedure amendment process. Further, Metroplex benefits to airspace users have fallen well short of predictions--in post‐implementation reports, FAA estimated annual benefits of $31.1 million, which is $30.5 million (49.5 percent) less than the minimum amount initially expected when FAA first planned each Metroplex site. Finally, FAA's methods for estimating benefits overly rely on judgment and are not well documented, limiting the ability to readily test the estimates' robustness and replicate results.RecommendationsFAA concurred with all five of our recommendations. However, FAA's response does not meet our intent for the recommendation related to the need for better documentation, so we are asking FAA to reconsider its actions.