Federal Reports

At the time of our onsite work in July 2017, Box Elder County had not awarded any contracts under this grant. Therefore, we could not determine whether the County had complied with Federal procurement regulations. However, in reviewing Box Elder County’s written procurement policies and procedures we noted the County did not include procedures to ensure opportunities for small and minority businesses, women’s business enterprises, and labor surplus area firms to bid for federally funded work. In addition, Box Elder County’s procurement policies did not require federally mandated provisions be incorporated in all contracts funded by Federal grants. In response to our review, Box Elder County revised its procurement policies and procedures to include these Federal procurement requirements. Consequently, we made no recommendations.

The VA Office of Inspector General (OIG) conducted a healthcare inspection to assess allegations involving ophthalmology equipment-related maintenance and repair issues and other concerns at the James A. Haley Veterans’ Hospital in Tampa, Florida. Ophthalmology equipment is often expensive and delicate; maintenance and repairs require detailed precision. The facility has a Medical Equipment Management Program (MEMP) to ensure operational reliability, assess and minimize risks, and respond to failures of medical equipment. In Veterans Health Administration facilities, equipment maintenance activities, including preventive maintenance, are the responsibility of the Biomedical Section. The OIG did not substantiate allegations related to specific ophthalmology equipment. Preventive maintenance was performed according to the manufacturers’ recommendations and the facility’s MEMP plan. The team found no evidence that biomedical support specialists lacked competencies to perform assigned tasks. The OIG was unable to determine whether eye clinic procedures were canceled due to equipment issues. Available documentation did not include the reason a community referral was made. The OIG substantiated an increase in eye care-related community care consults; however, the increased volume was largely the result of changes in access to ambulatory surgery services and clinic scheduling practices. The OIG substantiated that Prosthetic and Sensory Aids Service took four to six weeks to issue a purchase order, resulting in patients waiting six to eight weeks for eyeglasses. The two facility purchasing agents, designated to process purchase orders for eyeglasses, retired. The OIG was unable to determine if facility leaders had not responded to complaints for at least 15 years. Facility leaders made management decisions in consideration of financial priorities, which excluded preventive maintenance contracts. The OIG made four recommendations related to Biomedical Section staff work order documentation; equipment corrective maintenance timeliness and communication; timeliness of eyeglass purchase order processing; and addressing the backlog of open eyeglass purchase order requests.

The Office of Inspector General examined the completeness, timeliness, quality, and accuracy of NASA’s financial and award data as required under the DATA Act.

This Comprehensive Healthcare Inspection Program (CHIP) provides a focused evaluation of the quality of care delivered at the Fargo VA Health Care System. The inspection covers leadership and organizational risks and key clinical and administrative processes associated with promoting quality care. For this inspection, the areas of focus were Quality, Safety, and Value; Medical Staff Privileging; Environment of Care; Medication Management: Controlled Substances Inspections; Mental Health: Military Sexual Trauma Follow-Up and Staff Training; Geriatric Care: Antidepressant Use among the Elderly; Women’s Health: Abnormal Cervical Pathology Results Notification and Follow-Up; and High-Risk Processes: Emergency Department and Urgent Care Center Operations. The facility’s executive leadership team appeared relatively stable with all four positions permanently filled for longer than one year prior to the OIG’s visit. For selected employee and patient experience survey scores, the OIG noted that employees and patients were generally satisfied. The facility leaders appeared actively engaged and were working to sustain and further improve employee and patient engagement and satisfaction. The OIG’s review of the facility’s accreditation findings, sentinel events, disclosures, and patient safety indicator data did not identify any substantial organizational risk factors. The leaders were knowledgeable about selected Strategic Analytics for Improvement and Learning (SAIL) and community living center (CLC) metrics but should continue to take actions to sustain and improve performance of measures contributing to the SAIL “4-star” and CLC “2-star” quality ratings, respectively. The OIG issued five recommendations for improvement: (1) Quality, Safety, and Value • Interdisciplinary review of utilization management data (2) Medical Staff Privileging • Use of ongoing professional practice evaluations for reprivileging decisions (3) Mental Health: Military Sexual Trauma Follow-up and Staff Training • Military sexual trauma training (4) High-risk Processes: Emergency Departments and Urgent Care Center Operations • Emergency department registered nurse staffing • Backup call schedule for emergency department providers

The Office of the Inspector General (OIG) contracted with ATC Group Services LLC (ATC) to conduct a review of groundwater monitoring activities at Shawnee Fossil Plant to determine the quality of the program and adherence to regulatory standards. ATC stated that in their opinion, monitoring activities performed at Shawnee Fossil Plant are in adherence with guidelines for the Environmental Protection Agency. Furthermore, ATC stated the work performed appears to be of high quality and does not likely result in any discrepancies for the program. However, ATC identified an omission from a plan that did not impact groundwater monitoring. TVA management completed actions to address the omission.