Federal Reports

The VA Office of Inspector General (OIG) conducted a healthcare inspection to assess allegations concerning delays in interpreting electrocardiograms (ECGs) and event monitor tracings, failure to schedule cardiac procedures for over one year, failure to scan pacemaker data into the electronic health record (EHR), high cardiologist turnover, and the lack of proper supervision in the Device Clinic at the Richard L. Roudebush VA Medical Center (facility). The OIG reviewed an additional allegation that Surgery Service maintained an unauthorized wait list for an electrophysiology procedure. The OIG did not substantiate that ECG or cardiac event tracings reports were not interpreted timely, patients requiring cardiac surgery procedures were not scheduled for over a year, or improper supervision of the Device Clinic. Pacemaker tracings were not scanned into the EHR; however, the facility’s practice of entering tracing information as EHR notes was acceptable according to the VA Director of the National Cardiology Program. After the OIG’s site visit, the Cardiology Department initiated a process to scan pacemaker tracings into the EHR despite the lack of a requirement. The OIG substantiated that cardiologist turnover has been high at the facility but did not find evidence of adverse clinical outcomes resulting from staff turnover. The OIG substantiated that Cardiology and Surgery Services staff did not utilize the required consult process and maintained an unauthorized wait list for the electrophysiology procedure. The OIG found electrophysiology providers were not using the Veterans Health Administration consult process for electrophysiology procedures prior to February 2019. The OIG did not find evidence of adverse clinical outcomes related to the use of wait lists or failure to use the consult process. The OIG made four recommendations related to cardiologist turnover, staff understanding of authorized and unauthorized patient wait lists, and the training of staff on consult process and wait list policies.

We conducted a limited scope audit of The Writer’s Center (Center) for the period of February 1, 2016 through January 31, 2019. Limited scope audits involve a limited review of financial and non-financial information of the National Endowment for the Arts (Arts Endowment) award recipients to ensure validity and accuracy of reported information, and compliance with Federal requirements. Based on our limited scope audit, we concluded that the Center generally complied with financial management system and recordkeeping requirements established by Office of Management and Budget and the Arts Endowment. We identified areas requiring improvement. A summary of our findings is as follows. The Center: did not meet Federal requirements for allocating employee compensation costs to Arts Endowment awards; included unallowable costs on its Federal Financial Report (FFR) for Award No. DCA 2016-02; included unallowable travel costs on its FFRs for Award Nos. DCA 2016-02 and DCA 2017-15; included excess travel costs on its FFRs for Award Nos. DCA 2015-03 and DCA 2017-15; did not verify debarment and suspension eligibility of potential recipients of Federal funds; did not maintain a Section 504 Self-Evaluation on file during the audit period; and did not fully comply with financial management award requirements.

In a previous report - the Audit of USCP Off-Site Deployments, Report Number OIG-2009-06, dated August 2009 - the Office of Inspector General (OIG) found that the United States Capitol Police (USCP or the Department) needed to establish policies and procedures defining what constituted an off-site deployment, document its internal decision-making process for off-site deployments, and establish a process to collect and evaluate off-site deployment costs and benefits.  OIG conducted a follow-up analysis of the Department's implementation of recommendations contained in Report Number OIG-2009-06. Our objective was to confirm the Department took the corrective actions in implementing the recommendations. Our scope included existing controls related to implementation of recommendations as outlined in our previous report.

For fiscal year 2019, the Department of Health and Human Services (HHS), Office of Inspector General (OIG) received $5 million in congressional appropriations to conduct oversight of the National Institutes of Health (NIH) grant programs and operations. Among the issues of interest to Congress were matters pertaining to cybersecurity protections and NIH compliance with Federal requirements.

In 2016, we began a series of audits in accordance with our goal to review the U.S. Department of Housing and Urban Development’s (HUD) multifamily housing programs. We issued five reports detailing violations found at Project-Based Rental Assistance (PBRA) properties in HUD’s Southwest Region. This assignment is a rollup of those five reports. In addition, we reviewed HUD’s controls to ensure that its housing assistance payment subsidies were based on accurate and supported information. Our audit objective was to determine whether HUD had adequate oversight of its PBRA program in the Southwest Region during the 5 years in which it suspended its project-based contract administrators’ management and occupancy reviews. We found that HUD did not have adequate oversight of its PBRA program in the Southwest Region during the 5 years in which it suspended its project-based contract administrators’ management and occupancy reviews. Specifically, during that time, HUD paid subsidies to property owners for nonexistent and unsupported tenants based on falsified, inaccurate, and unverified information. These conditions occurred because when HUD suspended the reviews of the assisted properties, it removed a major tool used by the contract administrators to verify housing assistance payment subsidies. Further, HUD’s contract amendment process created instability in the contract administrator’s operations. HUD did not adequately implement replacement procedures or its own onsite monitoring to reduce the deterioration and mismanagement risks to the properties it subsidized. This lack of monitoring resulted in owners’ not meeting contract requirements and incurring more than $5.6 million in questioned costs. When HUD reinstated the reviews, contract administrators faced many compliance issues resulting from the lack of onsite monitoring for 5 years. We recommend that the Office of Multifamily Housing Programs (1) enforce its written policies and procedures to ensure that the verification and payment of housing assistance payment subsidies for properties it subsidizes are based on accurate and supported information; (2) establish and implement policies to ensure effective contract administration, including providing project-based contract administrator contract amendments in a timely manner; and (3) develop contingency policies and procedures to ensure that the properties it subsidizes receive adequate and verifiable continuous monitoring.