Federal Reports

Retention is a shared responsibility between the U.S. Department of Housing and Urban Development’s (HUD) Office of the Chief Human Capital Officer (OCHCO) and HUD’s other program offices. OCHCO sets the departmentwide retention strategy, while the program offices have responsibility for managing retention within their offices. Our evaluation determined that HUD’s departmentwide retention strategy in fiscal years (FY) 2019-2022 mostly aligned with best practices and that OCHCO had a proactive approach to retention. We found that OCHCO had taken the initiative to conduct an exit survey of all departing HUD employees, but also that HUD could better leverage the data it was collecting to address causes of attrition identified in the survey.We met with retention leads from seven of HUD’s program offices and found that those program offices varied in their strategic management of retention. All seven program offices had access to attrition data, which they used to identify positions or grade levels in which it was particularly challenging to retain employees or in which attrition caused greater risks to the mission. Four program offices described specific retention activities or strategies they worked on with OCHCO. However, the seven program offices varied in whether they identified the underlying causes of low retention and addressed them with specific actions, as well as in how they measured the effectiveness of retention activities.Our analysis showed that HUD’s overall voluntary attrition rate was below the average rate of the three comparable agencies. However, when we analyzed the voluntary attrition rates by subgroups, we noticed several significant trends. For example, support-focused offices had the top four highest voluntary separation rates. Additionally, the voluntary attrition rate for governmentwide mission-critical occupations rose during the period FY 2019-2022, while the average of the comparable agencies decreased. HUD’s voluntary attrition rate for employees in field offices in large cities also rose during the period, compared to Washington, DC, and field offices in midsize and small cities. During our analysis, we also determined that HUD had room to improve the quality of its data about HUD-specific mission-critical occupations and position titles.The use of retention incentives varies across HUD. HUD offers coaching, mentoring, and career development programs. We observed that some program offices used remote work to improve retention in hard-to-fill positions. Retention incentives that make use of compensation and special pay rates have U.S. Office of Personnel Management requirements that limit their applicability to HUD employees.We provided HUD with five recommendations. Three recommendations are related to improving the quality and usefulness of retention-related data. Two recommendations relate to determining causes behind higher than benchmarked attrition in subgroups within HUD and addressing those causes. We closed recommendations 1 and 2 before issuance of the final report based on documentation OCHCO provided to us.

Objective: To determine whether the Social Security Administration issued payments to beneficiaries who were deceased according to Puerto Rico vital statistics records.We referred 225 records of beneficiaries in current or suspended payment statuses who had matching Puerto Rico death records – 155 to OIG Office of Investigations in November 2023 and 70 to SSA in December 2023. (Questioned costs is the total of payment amounts made to the beneficiaries after their deaths through September 2023. Funds put to better is an estimated future loss calculated by multiplying the monthly payment amount each beneficiary in current pay received in September 2023 by 12.)

We found the PRIA Fund’s financial statements to be fairly presented and free of material misstatement.

We performed audits at the North Houston Processing and Distribution Center (P&DC) and three delivery units serviced by the P&DC in the Houston, Texas region during the week of September 11, 2023. The delivery units included the Fairbanks Station, New Houston, TX; Oak Forest Station, Houston, TX; and Conroe Main Post Office, Conroe, TX.We issued individual reports for the three delivery units and the P&DC we visited. We also issued another report summarizing the results of our audits at all three delivery units with specific recommendations for management to address.

The VA Office of Inspector General (OIG) conducted a healthcare inspection to review allegations of a delay in diagnosis of a patient’s prostate cancer and lung cancer at the Central Texas VA Health Care System (facility) in Temple, Texas.The OIG substantiated a delay in the diagnosis of the patient’s prostate cancer, identified concerns with the quality of care provided by two nurse practitioners in the urology clinic, and found facility leaders failed to ensure the competency of nurse practitioners to practice independently. The OIG was unable to substantiate a delay in the patient’s lung cancer diagnosis. However, the OIG identified a related concern regarding leaders’ failure to communicate expectations that providers offer patients low-dose computed tomography (CT) scans in the community for lung cancer screening.Two nurse practitioners failed to offer the patient a prostate biopsy despite elevated prostate-specific antigen levels and an abnormal prostate exam. Additionally, facility leaders did not complete required focused professional practice evaluations when the nurse practitioners were granted independent privileges and ongoing professional practice evaluations did not include any urology-specific indicators. Finally, although facility leaders informed providers about low-dose CT for lung cancer screening, the communication lacked clear expectations and direction for which patients should be screened.The OIG made four recommendations to the Facility Director: (1) to review the care both nurse practitioners provided to the patient, (2) to review the care both nurse practitioners provided to other urology patients, (3) to review the privileging and professional practice evaluation processes and performance indicators for nurse practitioners granted full practice authority in specialty care clinics, (4) and to ensure that facility leaders communicate expectations related to low-dose CT to facility primary care providers.