Federal Reports

We audited the U.S. Department of Housing and Urban Development’s (HUD) grant closeout processes and compliance with the Grants Oversight and New Efficiency (GONE) Act. The GONE Act required that we conduct a risk assessment to determine whether an audit of HUD’s grant closeout process was warranted. We initiated this review based on the results of our risk assessment conducted in fiscal year 2018, which found that an audit was warranted. Our objectives were to determine whether HUD (1) implemented adequate grant closeout processes to ensure compliance with GONE Act requirements and (2) ensured that reports related to its compliance with the GONE Act were accurate.HUD did not implement adequate GONE Act grant closeout processes, and related data and reports were not always accurate. Specifically, it implemented bulk closeout procedures that bypassed requirements, and its data used to compile reports included inconsistencies and incorrect information. These conditions occurred because HUD (1) focused on closing its backlog of expired grants as quickly as possible; (2) did not have adequate controls over its GONE Act grant closeout, data, and reporting processes; and (3) had not developed and implemented clear and consistent guidance on GONE Act requirements for its program offices. As a result, HUD made errors in grant closeouts and was unable to ensure that related data and reports to Congress and other stakeholders were accurate. Although HUD’s reporting responsibilities under the GONE Act have ended, it should address the weaknesses identified to ensure future compliance with grant closeout requirements and consistent and accurate reporting of grant information to stakeholders.We recommend that HUD develop and implement controls (1) for use of the bulk grant closeout process going forward to ensure that grants are closed in accordance with all applicable requirements and (2) to ensure that future grant data reporting to stakeholders is consistent and accurate.

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report provides a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the Hunter Holmes McGuire VA Medical Center and associated outpatient clinics in Virginia. The inspection covered key clinical and administrative processes that are associated with promoting quality care. For this inspection, the areas of focus were Leadership and Organizational Risks; COVID-19 Pandemic Readiness and Response; Quality, Safety, and Value; Registered Nurse Credentialing; Medication Management: Remdesivir Use in VHA; Mental Health: Emergency Department and Urgent Care Center Suicide Risk Screening and Evaluation; Care Coordination: Inter-facility Transfers; and High-Risk Processes: Management of Disruptive and Violent Behavior.When the team conducted this inspection, the medical center’s leaders had worked together in their positions for 19 months. Employee survey results highlighted opportunities to improve employee attitudes toward leaders and the workplace, and reduce staff feelings of moral distress. Patient survey results identified opportunities to improve care experiences. Review of the medical center’s accreditation findings, sentinel events, and disclosures did not identify substantial organizational risk factors. The executive leaders spoke knowledgeably within their scope of responsibilities about VHA data and factors contributing to poorly performing quality and efficiency measures.The OIG issued nine recommendations for improvement in three areas:(1) Quality, Safety, and Value• Tracking of improvement capabilities and projects• Peer review processes• Surgical death reviews(2) Care Coordination• Inter-facility transfer monitoring and evaluation• Transfer form completion• Medical record transmission(3) High-Risk Processes• Disruptive behavior committee meeting attendance• Staff training

The objective was to evaluate I&A’s responsibility for providing intelligence to state and local officials in advance of the January 6 events, and whether and how I&A fulfilled its responsibility.

Reporting Required by Government Auditing Standards section is solely to describe the scope of our testing of internal control and compliance with selected provisions of applicable laws, regulations.