Federal Reports

This report contains information about recommendations from the OIG’s audits, evaluations, and reviews that the OIG had not closed as of the specified date because it had not determined that the Department of Justice had fully implemented them. The information omits recommendations that the Department of Justice determined to be classified or sensitive, and therefore unsuitable for public release.The status of each recommendation was accurate as of the specified date and is subject to change. Specifically, a recommendation identified as not closed as of the specified date may subsequently have been closed.

The Office of Inspector General evaluated NASA’s management of extended temporary duty travel policies and procedures.

The VA Office of Inspector General (OIG) conducted a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the VA Maine Healthcare System. The review covered key clinical and administrative processes associated with promoting quality care—Leadership and Organizational Risks; Quality, Safety, and Value; Credentialing and Privileging; Environment of Care; Medication Management: Controlled Substances (CS) Inspection Program; Mental Health: Posttraumatic Stress Disorder Care; Long-term Care: Geriatric Evaluations; Women’s Health: Mammography Results and Follow-up; and High-risk Processes: Central Line-associated Bloodstream Infections. The Facility had generally stable executive leadership and active engagement with employees and patients to maintain high satisfaction scores. Organizational leadership supported patient safety, quality care, and other positive outcomes, but the presence of organizational risk factors, as evidenced by sentinel events, disclosures, and Patient Safety Indicator data may contribute to future issues of noncompliance and/or lapses in patient safety unless corrective processes are implemented and continuously monitored. Although the leadership team appeared knowledgeable about selected Strategic Analytics for Improvement and Learning metrics, the leaders should continue to take actions to improve care and sustain performance of selected Quality of Care and Efficiency metrics that are likely contributing to the improvement from the previous “3-Star” rating to the current “5-Star” rating. The OIG noted findings in five of the clinical operations reviewed and issued seven recommendations that are attributable to the Director, Chief of Staff, and Associate Director. The identified areas with deficiencies are: (1) Quality, Safety, and Value • Root cause analysis action feedback (2) Credentialing and Privileging • Privileging process • Focused and Ongoing Professional Practice Evaluation processes (3) Environment of Care • Safety data sheet accessibility (4) Medication Management: CS Inspection Program • Monthly CS inspections (5) Long-term Care: Geriatric Evaluations • Program oversight and evaluation

FEMA awarded the Chippewa Cree Tribe a $32.4 million Public Assistance Program grant for damages from a June 2010 flood disaster. The award provided 100 percent Federal funding to replace the Tribe’s severely damaged health clinic. The Tribe failed to manage a $32.4 million Public Assistance Program grant from FEMA according to Federal regulations and FEMA guidelines. As a result, FEMA has no assurance that expenditures the Tribe claimed for Project 2 (engineering and design), and plans to claim for Projects 132 (facility construction) and 133 (site preparation) are valid, allowable, or eligible. Therefore, FEMA should disallow about $22.3 million of the grant award for these three projects.

For our audit period (January 1, 2015, through December 31, 2017), Medicare should not have paid suppliers for any of the $34 million for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) that were provided during inpatient stays. In addition, beneficiaries were held responsible for unnecessary deductibles and coinsurance of $8.7 million paid to the suppliers for the DMEPOS items. Generally, Medicare should not pay a supplier for these items provided to a beneficiary during an inpatient stay. Instead, all items must be provided directly by the inpatient facility or under arrangements between the facility and the supplier. Medicare should pay the inpatient facility, through its inpatient claim, for all items provided to a beneficiary.

The OIG investigated allegations that two former employees of a tribally controlled school funded by the Bureau of Indian Education (BIE) did not repay payroll advances.We found that one employee failed to repay the school for more than $77,000 in payroll advances and the other failed to repay the school for more than $16,000 in payroll advances. Both employees admitted to owing the funds and that they made no attempt to repay the money when they were no longer employed by the school.We referred this matter to the U.S. Attorney’s Office for the District of New Mexico, which declined prosecution.

The audit objectives were to determine whether program funds were managed in accordance with the ARC and Federal grant requirements