Federal Reports

What We Looked AtWe contracted with the independent public accounting firm Allmond & Company, LLC, to audit the National Transportation Safety Board’s (NTSB) financial statements as of and for the fiscal years ended September 30, 2019, and September 30, 2018, and to report on internal control over financial reporting and compliance with laws and other matters. The contract requires the audit to be performed in accordance with U.S. generally accepted Government auditing standards, Office of Management and Budget audit guidance, and the Government Accountability Office’s and Council of the Inspectors General on Integrity and Efficiency’s Financial Audit Manual. In connection with the contract, we performed a quality control review of Allmond’s report dated November 6, 2019, and related documentation, and inquired of its representatives. What We FoundOur quality control review disclosed no instances in which Allmond did not comply, in all material respects, with U.S. generally accepted Government auditing standards. RecommendationsAllmond made no recommendations.

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This Comprehensive Healthcare Inspection Program (CHIP) provides a focused evaluation of the quality of care delivered at the Carl Vinson VA Medical Center, covering leadership, organizational risks, and key processes associated with promoting quality care. Focused areas were Quality, Safety, and Value; Medical Staff Privileging; Environment of Care; Medication Management: Controlled Substances Inspections; Mental Health: Military Sexual Trauma Care; Geriatric Care: Antidepressant Use among the Elderly; Women’s Health: Abnormal Cervical Pathology Results; and High-Risk Processes: Emergency Department/Urgent Care Center Operations. The facility’s leadership team was not stable, with vacancies for director and chief of staff. Employee satisfaction and patient experience surveys results were similar to or lower than VHA averages. The OIG’s review of institutional disclosures identified an opportunity to ensure timely notification to patients and accurately maintain information and data on disclosures. The leaders should continue to take actions to improve care and performance of measures contributing to the Strategic Analytics for Improvement and Learning “3-star” and community living center “1-star” quality ratings. The OIG issued 22 recommendations for improvement: (1) Quality, Safety, and Value • Interdisciplinary utilization management data reviews • Root cause analyses • Resuscitative episode reviews (2) Medical Staff Privileging • Focused and ongoing professional practice evaluation processes • Privileging action reporting to National Practitioner Data Bank (3) Environment of Care • Panic alarm testing (4) Medication Management • Reconciliation of dispensing and return of stock • Verification of hard copy prescriptions • Monthly controlled substances inventory verification • Medication override process (5) Mental Health • Communication of issues, services, and initiatives to leadership • Military sexual trauma training (6) Geriatric Care • Patient/caregiver education and understanding of medications (7) Women’s Health • Designated women’s health medical director/clinical champion • Women Veterans Health Committee processes • Cervical cancer screening data tracking process • Patient notification of abnormal results (8) High-risk Processes • Backup call schedule for urgent care center providers

This is our final report on the audit of the National Oceanic and Atmospheric Administration (NOAA) Office of Marine and Aviation Operations (OMAO) ship fleet recapitalization effort. Our objective was to determine whether NOAA OMAO performed effective acquisition planning for its construction of new ships. Based on our review, we found that the initial acquisition planning for two Class A ships was not adequate.

This final memorandum addresses the results of our attempt to audit $5,030,452 that the Gulf States Marine Fisheries Commission (the Commission) paid to its subrecipient, the Gulf and South Atlantic Fisheries Foundation (GSAFF), under financial assistance award NA10NMF4770481 from the National Oceanic Atmospheric Administration (NOAA). Our audit report OIG-19-021-A includes the results of three other subrecipients’ claimed costs and other objectives audited under award NA10NMF4770481.

To fulfill our responsibilities under Chief Financial Officers Act of 1990 (CFO Act) (Pub. L. No. 101-576) and related legislation, we monitored Grant Thornton LLP's audit of the Social Security Administration's (SSA) Fiscal Year (FY) 2019 financial statements to ensure the quality of the audit work performed was adequate.