Federal Reports

In 2016, the Centers for Medicare & Medicaid Services (CMS) updated its life safety and emergency preparedness regulations to improve protections for all Medicare and Medicaid beneficiaries, including those residing in long-term care facilities (commonly known as nursing homes). The updates included requirements that nursing homes have expanded sprinkler systems and smoke detector coverage; an emergency plan that is reviewed, trained on, tested, and updated at least annually; and provisions for sheltering in place and evacuation. Our objective was to determine whether Illinois ensured that selected nursing homes in the State that participated in the Medicare or Medicaid programs complied with CMS requirements for life safety and emergency preparedness.

The OIG investigated allegations that a Bureau of Land Management (BLM) State Director used their Government position for the financial gain of two personal friends. We found no evidence that the State Director misused their Government position or violated any ethics regulations.

We found that Florida established and implemented systems of internal control thatprovided reasonable assurance that Restart program funds were allocated appropriatelyand sufficiently ensured that LEAs and nonpublic schools used Restart program funds forallowable and intended purposes, as described in the Finding.

The Office of the Inspector General conducted a review of the Enterprise Planning (EP) organization to identify factors that could impact EP’s organizational effectiveness. We identified behaviors that positively affected EP. These included leadership actions, relationships with team members, recognition programs, and a positive ethical culture. We also identified a risk to operations that, although minimal, if left unaddressed, could hinder EP’s effectiveness. This risk was related to effective collaboration with business partners.

The VA Office of Inspector General (OIG) examined whether the Veterans Health Administration (VHA) effectively used data from its National Surgery Office (NSO) to identify and address problems affecting operating room efficiency. The audit focused on four elements needed for efficient and timely surgeries: clinical service staff, sterile processing and logistics services, the environmental management service, and resource management. The OIG found that leaders of VHA’s regional networks and medical facilities did not consistently use NSO data to improve operating room efficiency. The audit team estimated (under non-pandemic conditions) that greater regional and facility oversight of surgical support elements would improve operating room efficiency and reduce surgical cancellations by 8,600 over five years, save an estimated $30 million, and improve surgical services for about 7,200 patients. Problems at less efficient facilities persisted for at least two years because regional and facility leaders did not effectively monitor operating room efficiency and follow up when less efficient facilities did not resolve underlying problems in surgical support elements. The surgical workgroups for the less efficient facilities focused primarily on surgical outcomes, while VHA’s more efficient facilities focused on both surgical outcomes and operating room efficiency. VHA concurred with the OIG’s six recommendations, including developing an oversight mechanism to ensure that regional networks monitor and hold medical facilities accountable for addressing persistent problems in operating room efficiency and surgical support elements. Other recommendations address periodic assessments of operating room efficiency data to identify medical facilities with persistent problems, clarifying and refining selected NSO performance measures, identifying best practices and implementing them when appropriate at less efficient facilities, and more broadly sharing efficiency data across medical facility service lines. One recommendation was closed at publication and all others will be monitored until completed.