Federal Reports

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 Oklahoma City Health Care System (Facility). 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 Inspection Program; Mental Health Care: 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 since December 2017 and active engagement with employees as evidenced by satisfaction scores. However, opportunities exist to improve patient experiences. Although the OIG noted concern with the number of sentinel events and disclosures, Facility leaders reported reviewing each event, taking corrective actions, and developing preventive measures to improve performance. The OIG reviewed accreditation agency findings, Patient Safety Indicator data, and Strategic Analytics for Improvement and Learning (SAIL) results and did not identify any substantial organizational risk factors. The leadership team was knowledgeable about selected SAIL metrics but should continue to take actions to improve care and performance of selected Quality of Care and Efficiency metrics that are likely contributing to the “3-Star” rating. The OIG noted findings in two of the eight areas of clinical operations reviewed and issued two recommendations that are attributable to the Director. The identified areas with deficiencies are: (1) Quality, Safety, and Value • Utilization management data review (2) Long-term Care: Geriatric Evaluations • Program oversight and evaluation

Our prior reviews have found that some hospitals did not comply with Medicare coverage and documentation requirements for inpatient rehabilitation facilities (IRFs). CMS’s Comprehensive Error Rate Testing (CERT) program found that the error rate for IRFs increased, ranging from 9 percent in 2012 to a high of 62 percent in 2016. Our objective was to determine whether IRFs complied with Medicare coverage and documentation requirements for fee-for-service (FFS) claims for services provided in 2013.

Department of Homeland Security shall submit a report not later than October 15, 2017, to the DHS Office of Inspector General listing all grants and contracts awarded by other than full and open competition (OTFOC) during fiscal years 2016 and 2017. We contracted with Williams, Adley & Company-DC, LLC to review the OTFOC report and assess DHS compliance with applicable laws, regulations, and departmental procedures. Williams Adley concluded that DHS complied with applicable statutes, regulations, and policies governing grants and contracts awarded by OTFOC in FY 2017. During that year, DHS awarded 62 noncompetitive grants worth about $140 million and 121 noncompetitive contracts worth about $118 million through OTFOC. The independent auditors determined that DHS’ Report on OTFOC for FY 2017 as well as the information related to these grants and contracts in the Federal Procurement Data System – Next Generation and USASpending.gov were accurate. The auditors also found that DHS followed written policies and procedures and the requirements of the Federal Funding Accountability and Transparency Act of 2006 when awarding grants and contractsnoncompetitively.

Final FY 2018 OIG Management Challenges Report 09272018