Federal Reports

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.

Audit of the Controls on the DATA Act FY2019 First Quarter Submission

Audit of FY2019 First Quarter Data Submitted Under the DATA Act

Postal Service transportation costs have increased $1.7 billion (or about 25 percent) since fiscal year (FY) 2014 despite an overall decline in mail volume of 8.8 billion pieces (or about 6 percent), as well as several initiatives to reduce transportation costs. Our objective was to analyze practices and cost trends and identify risk areas within the Postal Service’s transportation network.

In accordance with the statutory requirements of the Digital Accountability and Transparency Act of 2014 (DATA Act) and standards established by the Office of Management and Budget (OMB) and the U.S. Department of the Treasury, we audited the U.S. Department of Housing and Urban Development (HUD), Office of the Chief Financial Officer’s (OCFO) compliance with the DATA Act for the first quarter of fiscal year 2019. The audit was part of the activities included in our 2019 annual audit plan. Our objectives were to assess the (1) completeness, accuracy, timeliness, and quality of the financial and award data submitted for publication on USASpending.gov and (2) HUD’s implementation and use of the governmentwide financial data standards established by OMB and Treasury.HUD OCFO generally complied with the reporting requirements of the DATA Act. The information it submitted for inclusion on USASpending.gov for the first quarter, fiscal year 2019, was complete, accurate, timely, and in accordance with the governmentwide data standards established by OMB and Treasury. Although we determined that HUD’s overall data quality was high, we identified a few exceptions. Specifically, we determined that data were not initially complete and the data elements could not always be traced to source documentation. In addition, HUD had DATA Act procedures documents that contained inconsistent information. The weaknesses occurred because (1) some program activity codes were disabled in HUD’s Oracle Federal Financials system, (2) data such as Data Universal Numbering System (DUNS) numbers and zip codes was missing or invalid, (3) HUD could not provide source documentation or the data elements did not match the source documents, and (4) there was a lack of coordination among the HUD offices to ensure that policies and procedures for the DATA Act were consistent. As a result, HUD could improve the accuracy, completeness, and timeliness of its data submitted to USASpending.gov.We recommend that HUD’s CFO and senior accountable official continue to work to improve data quality and ensure that (1) required data are complete, accurate, and reported in a timely manner, (2) all data elements are traceable to the source documentation, and (3) procedures for DATA Act reporting are consistent among its various offices.