Federal Reports

Our Objective(s)To perform a quality control review (QCR) of Allmond & Company, LLC's management letter related to the audit of the Great Lakes St. Lawrence Seaway Development Corporation's (GLS) financial statements for fiscal year 2025. We reviewed Allmond's management letter, dated January 7, 2026, and related documentation.
About This ReportWe contracted with the independent public accounting firm Allmond & Company, LLC to audit GLS's financial statements. Allmond also issued a management letter discussing internal control matters that Allmond was not required to include in its audit report.
What We FoundThe independent auditor, Allmond, found five control deficiencies in GLS's internal controls over financial reporting:

Review of fund balance with treasury reconciliation did not identify errors and omissions,
Complementary user entity controls were not properly designed and implemented for the use of service organization systems,
Non-capitalized assets are not located during the performance of the annual property inventory,
Recording of transactions relating to prior year activity did not use the appropriate general ledger accounts for error corrections,
Accounts payable balance was incomplete.

Our QCR disclosed no instances in which Allmond did not comply, in all material respects, with U.S. generally accepted Government auditing standards.
RecommendationsWe agree with Allmond's 9 recommendations to help strengthen GLS's internal controls over financial reporting.

The VA Office of Inspector General (OIG) conducted a healthcare inspection at the Oklahoma City VA Medical Center (system) in response to an allegation that patients awaiting possible cancer diagnoses experienced delays in receiving pathology testing results. 

The OIG reviewed nine specimens from five patients and substantiated delays in four specimens from four patients. The chief of Pathology and Laboratory Medicine Service (P&LMS), who processed all four, attributed the delays to competing administrative duties. The OIG found that P&LMS quality staff did not conduct a comprehensive review of the delays and assess for patient harm, limiting leaders’ ability to evaluate risk and improve care.

The OIG also found that routine turnaround time (TAT) metrics for non-gynecological cytopathology reports were not met for 8 of 12 months in 2024. Although comments in quality reports noted plans to improve TAT, corrective actions and improvement plans were not documented, limiting facility leaders’ ability to identify effective interventions.

The chief of P&LMS consistently did not meet the two-day TAT benchmark. In 2024, the chief met the benchmark in 25 percent of cases from January through June and none from July through December. While facility leaders initiated actions to address performance, they did not assess the chief’s non-cytopathology cases to assess patient safety risks.

The OIG identified concerns in laboratory and patient safety event reporting. P&LMS staff did not report variance events or enter patient safety events in the Joint Patient Safety Reporting system despite completing required training.

The System Director concurred with the OIG’s five recommendations and shared plans and actions taken to review potential patient harm, improve documentation and monitoring of TAT metrics, address the chief’s performance, and train staff on event reporting processes. 

The VA Office of Inspector General (OIG) issued a preliminary result advisory memorandum highlighting significant barriers to veterans’ access to specialty care—particularly radiology and mental health—at VA medical facilities. In November 2025, the OIG began a national review to assess whether facilities meet performance standards for answering veterans’ calls. The OIG found that 13 of 15 reviewed facilities lacked essential call data, making it impossible to evaluate veterans’ timely access to care. 

VA facilities and regional Veterans Integrated Service Networks must track metrics like call volume, speed of answer, and abandonment rates (calls where the caller hung up before anyone answered). However, nearly one million of 2.1 million call attempts from August 2024 through July 2025 lacked critical call data. Furthermore, out of the nearly one million untracked calls, at least 338,000 were to radiology clinics and 109,000 were to mental health clinics, putting veterans who may need timely and critical care at risk. This occurred because VA lacks a system to capture call performance data for specialty clinics that use individual or shared phone lines.

Veterans reported delays, frustration, and in some cases, resorted to in-person visits to schedule appointments. One spouse described repeated unanswered calls for a critical cancer-related radiology appointment. Despite the OIG’s January 2026 communication of these findings, only 19 of the 49 clinics planned to reconfigure systems to capture call data, while seven facilities had no plans to do so.

The lack of call performance data undermines VHA’s ability to identify and address access issues, potentially delaying care for vulnerable veterans. This finding is being disseminated to ensure all VHA medical facilities are aware of and can proactively start collecting and overseeing specialty care call data. The OIG’s review is ongoing, and a comprehensive report will follow.