Federal Reports

What We Looked AtWe reviewed the Territory of American Samoa's single audit report for the fiscal year ending September 30, 2017, in order to identify findings that affect directly awarded Department of Transportation programs. An independent auditor prepared the single audit report, dated June 15, 2018.What We FoundWe found that the report contained equipment and real property management, and special tests and provisions (Buy American) findings that need prompt action from the Federal Aviation Administration's (FAA) management.RecommendationsWe recommend that FAA ensures that the Territory complies with the equipment and real property management, and special tests and provisions (Buy American) requirements. We also recommend that FAA recovers $264,077 from Territory, if applicable.

What We Looked AtWe reviewed Amtrak's single audit report for the fiscal year ending September 30, 2017, in order to identify findings that affect directly awarded Department of Transportation programs. An independent auditor prepared the single audit report, dated June 22, 2018.What We FoundWe found that the report contained an equipment and real property management finding that needs prompt action from the Federal Railroad Administration's (FRA) management.RecommendationsWe recommend that FRA ensures that Amtrak complies with the equipment and real property management requirements.

First Coast Service Options, Inc., overstated Medicare’s share of the Medicare segment pension liabilities by $6.6 million.

The Corporation for National and Community Service, Office of Inspector General (CNCS-OIG) conducted an evaluation of the Volunteers in Service to America (VISTA) program to assess its effectiveness. CNCS-OIG’s evaluation focused on member activity, project sustainability, and member attrition.CNCS-OIG found:•Documentation maintained during the execution of a project does not contain sufficient details to validate member activities are consistent with program purposes or are the same as the planned activities. •Project activities did not build capacity or enable projects to be fully sustained following VISTA support in 12 out of 27 organizations reviewed; •The VISTA program had an attrition rate of 16.8 percent in the time period evaluated (FY 2014 – 2015), with the primary causes of turnover identified as other employment/financial hardship (80 percent), dissatisfaction with the program (15 percent), and medical issues (5 percent).Based upon these findings, CNCS-OIG made 11 recommendations to help CNCS VISTA:•Enhance the existing monitoring program to provide greater insight into member activity and program effectiveness;•Develop a standard for capturing the capacity building and measuring sustainability during and after the VISTA project is completed;•Strengthen the VISTA member experience to improve member retention; and•Develop and implement a strategy for improving member retention.CNCS has taken some corrective actions since we issued the draft report. CNCS-OIG will review CNCS’s status of audit resolutions after CNCS issues its final management decision on the findings and recommendations.

This report presents the results of our self-initiated audit of Local Purchases and Payments - Old National Branch, Atlanta, GA. The Old National Branch is in the Atlanta District of the Capital Metro Area. This audit was designed to provide U.S. Postal Service management with timely information on potential financial control risks at Postal Service locations.

The Postal Service monitors service availability for Tier 1 business critical services. These services support core business functions, such as moving the mail, delivery, revenue, and customer service. For example, Click-N-Ship and PostalOne! are Tier 1 business critical services. Outages related to Tier 1 business critical services may potentially cause a loss of current or future revenue and brand value or diminished customer experience. Our objective was to determine if the Postal Service is accurately measuring service availability for its Tier 1 business critical services.

The VA Office of Inspector General (OIG) conducted a focused evaluation of the quality of care delivered at the Gulf Coast Veterans Health Care System (Facility). The review covered key processes associated with promoting quality care—Leadership and Organizational Risks; Quality, Safety, and Value (QSV); Credentialing and Privileging; Environment of Care (EOC); Medication Management: Controlled Substances (CS) Inspection Program; Mental Health Care: Post-Traumatic Stress Disorder Care; Long-Term Care: Geriatric Evaluations; Women’s Health: Mammography Results and Follow-Up; and High-Risk Processes: Central Line-Associated Bloodstream Infections. At the time of our site visit, the Facility leaders were still adjusting to the January 2018 assignment of the Director and Chief of Staff and were actively working to improve employee satisfaction and the patient experience. The leaders appeared to support efforts related to quality care, but the presence of organizational risk factors may contribute to future lapses in patient safety unless corrective processes are implemented and continuously monitored. The leadership appeared knowledgeable about selected Strategic Analytics for Improvement and Learning (SAIL) metrics but should continue to take significant actions to improve care and performance of selected Quality of Care and Efficiency metrics that are likely contributing to the “1-Star” rating. The OIG issued 13 recommendations that are attributable to the Director, Chief of Staff, and Associate Director. Identified areas with deficiencies are: (1) QSV • Interdisciplinary review of utilization management data • Annual patient safety reports (2) Credentialing and Privileging • Approval of clinical privileges by executive leaders • Focused and Ongoing Professional Practice Evaluation processes (3) EOC • EOC rounds attendance • Expiration statements on sterile surgical instruments (4) Medication Management: CS Inspection Program • Annual physical security survey • CS Coordinator position description • Monthly inspections of CS storage areas • Same day completion of CS physical inventories • CS monthly physical counts (5) Mental Health Care: Post-Traumatic Stress Disorder Care • Suicide risk assessments