Federal Reports

This Office of Inspector General Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the inpatient and outpatient care provided at the Overton Brooks VA Medical Center and multiple outpatient clinics in Arkansas, Louisiana, and Texas. This evaluation focused on five key operational areas:• Leadership and organizational risks• Quality, safety, and value• Medical staff privileging• Environment of care• Mental health (emergency department and urgent care center suicide prevention initiatives)The OIG issued 15 recommendations for improvement in three areas:1. Medical Staff Privileging• Focused Professional Practice Evaluation completion• Equivalent specialized training and similar privileges• Service-specific criteria• Privileging and reprivileging recommendations2. Environment of Care• Inspection frequency• Naloxone in Automated External Defibrillator cabinets• Expired supplies• Clean floors• Safe and functional environment• Furnishings safe and in good repair• Damaged walls• Stained ceiling tiles• Signage in areas with recording equipment3. Mental Health• Assessment of lethality of most recent suicide attempt

The U.S. Small Business Administration (SBA) Office of Inspector General (OIG) contracted with the independent certified public accounting firm KPMG LLP to conduct an audit of SBA’s consolidated balance sheets as of September 30, 2023 and 2022 and the related notes to these statements. Our contract with KPMG required that the audit be performed in accordance with auditing standards generally accepted in the United States of America, Government Auditing Standards issued by the Comptroller General of the United States, and Office of Management and Budget (OMB) Bulletin No. 24-01, Audit Requirements for Federal Financial Statements.In the audit, KPMG reported significant matters for which they were unable to obtain sufficient and appropriate audit evidence to provide a basis for an audit opinion on SBA’s balance sheet as of September 30, 2023. Accordingly, KPMG issued a disclaimer of opinion on the consolidated balance sheets as of September 30, 2023 and 2022.The basis for the disclaimer was that due to inadequate processes and controls, SBA was unable to provide adequate evidential matter in support of a significant number of transactions and account balances related to the Paycheck Protection Program, Economic Injury Disaster Loan program, the Restaurant Revitalization Fund, and Shuttered Venue Operators Grant program.As a result, KPMG was unable to determine whether any adjustments might have been necessary with respect to the following line items and the related notes:- Credit Program Receivables and Related Foreclosed Property, Net- Other than Intragovernmental Accounts Receivable, Net- Downward Reestimate Payable to Treasury- Loan Guarantee LiabilitiesFor the period ended September 30, 2023, KPMG identified six material weaknesses and three significant deficiencies in internal control over financial reporting. Appendices I and II of this report describe details of KPMG’s conclusions about the material weaknesses and significant deficiencies. Appendix III describes instances of noncompliance with applicable laws or other matters required to be reported under Government Auditing Standards or OMB Bulletin No. 24-01.

Results of the audit of the Commission’s financial statements for the fiscal year ended September 30, 2023 and 2022

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

This report summarizes what the inspector general considers to be “the most serious management and performance challenges facing the agency” and briefly assesses the Agency’s progress in addressing those challenges.

The objective of this independent evaluation was to assess the compliance of the Commission’s information security policies, procedures, and standards and guidelines with the Federal Information Security Modernization Act (FISMA).

The Office of Inspector General (OIG) contracted with the independent certified public accounting firm Harper, Rains, Knight, & Company, P.A. (HRK) to audit the Commission’s financial statements and related footnotes as of September 30, 2023, and for the year then ended.

The report presents information on independent audits with findings pertaining to the Higher Education Emergency Relief Fund (HEERF) and audit resolution activities conducted by the U.S. Department of Education. Our review focused on independent audits of HEERF recipients from April 2020 through June 2023. We found that the number of independent audits with findings pertaining to HEERF and requiring resolution by the Office of Finance and Operations (OFO) increased significantly over the past few years, as did the number of audits with complex findings as determined by OFO staff. However, the number of staff assigned to audit resolution activities remained relatively constant during this same period—resulting in a more than fourfold increase in the number of audits assigned for resolution per person. OFO is now facing a significant backlog of outstanding HEERF audits requiring resolution and without immediate action, the timeliness and effectiveness of the resolution of HEERF audit findings could be reduced. We recommended that OFO assess its workload demands and evaluate the sufficiency of the staffing level assigned to HEERF audit resolution activities.