Federal Reports

The VA Office of Inspector General (OIG) assessed the stewardship and oversight of funds by the Durham VA Health Care System in North Carolina and identified potential cost efficiencies in carrying out medical center functions from October 1, 2020, through March 31, 2021. The healthcare system had 309 inactive obligations totaling $81.7 million. Of these 309 obligations, 200 (totaling over $74 million) had no activity for 181 days or more. In a subsample of 20 obligations, VA staff had not reviewed 17, as required. If inactive obligations are not reviewed, these funds cannot be reobligated and used in that fiscal year to support veterans. The OIG also found that, contrary to VA policy, healthcare system staff used purchase cards instead of contracts for 21 of 40 sampled transactions (53 percent), totaling approximately $328,000. These 21 transactions were missing required supporting documentation to verify that the transactions were approved and payments were accurate, resulting in $308,000 in questioned costs. Furthermore, the purchase card coordinator did not conduct required quarterly audits. The healthcare system had 105 more administrative full time equivalent staff than the expected number, which suggests the potential opportunity to improve efficiency. The healthcare system could improve pharmacy efficiency by narrowing the gap between the facility’s observed drug costs and expected drug costs, bringing the turnover rates closer to the Veterans Health Administration–recommended level, and meeting requirements for noncontrolled drug line audits. The OIG made nine recommendations to the healthcare system director and one recommendation to the director of contracting for Network Contracting Office 6, VA Mid-Atlantic Health Care Network.

SB & Company found that the lack of off-site data backups increases the CSB’s risk of losing significant data.

We conducted a limited review of nursing home owners to identify their operational challenges and needs of nursing homes in responding to the Coronavirus Disease 2019 (COVID-19) pandemic. Our objective was to determine the biggest challenges operators of Section 232 nursing home facilities face related to the COVID-19 pandemic and whether nursing homes are prepared to meet their future financial obligations. Most of the owners who responded to our survey indicated that nursing homes experienced financial and operational challenges during the pandemic. These challenges included staffing shortages; COVID-19 infections in residents and staff; large fluctuations in occupancy levels; rising operating costs; and difficulties in responding to local, State, and Federal requirements.

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report provides a focused evaluation of VHA facilities’ selected medical staff privileging program requirements. The report describes related findings from healthcare inspections performed at 36 VHA medical facilities from November 4, 2019, through September 21, 2020. Each inspection involved interviews with facility leaders and staff and reviews of clinical and administrative processes. The OIG reviewers evaluated meeting minutes and other relevant documents.The OIG found general compliance with many of the selected requirements. However, the OIG identified weaknesses with focused professional practice evaluation criteria, reprivileging decision processes, ongoing professional practice evaluations, processes for recommending continuing privileges, timely completion of and required signatures for provider exit review forms, and state licensing board reporting.The OIG issued six recommendations, including three repeat recommendations related to:• minimum specialty criteria for focused professional evaluations,• inclusion of service-specific criteria in ongoing professional practice evaluations, and• use of professional practice evaluation results in executive committee recommendations to continue licensed independent practitioners’ privileges.