Federal Reports

At the request of the Tennessee Valley Authority's (TVA) Supply Chain, we examined the labor and labor markup rates included in a contract TVA has with a contractor. Our examination objective was to determine if the contract's labor and labor markup rates were fairly stated for a planned 5-year contract extension.In our opinion, the contract's labor and labor markup rates were fairly stated. However, we found the contract's current labor rate ranges are not reflective of the actual costs of the contractor's employees. We suggest that TVA request the contractor submit revised labor rate ranges that are more reflective of the actual minimum and maximum salary cost for each labor classification and incorporate these labor rate ranges into the contract.(Summary Only)

The VA Office of Inspector General (OIG) conducted a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the VA St. Louis Health Care System (Facility). The review covered key clinical and administrative processes associated with promoting quality care—Leadership and Organizational Risks; Quality, Safety, and Value; Credentialing and Privileging; Environment of Care; 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. The OIG also provided crime awareness briefings to 58 employees. The Facility has generally stable executive leadership and active engagement with employees as evidenced by satisfaction scores; however, multiple opportunities appear to exist to improve patient satisfaction with care provided. Organizational leaders support patient safety and quality care. The OIG’s review of accreditation organization findings, sentinel events, disclosures, Patient Safety Indicator data, and Strategic Analytics for Improvement and Learning (SAIL) results did not identify any substantial organizational risk factors. The senior leadership team appeared knowledgeable about selected SAIL metrics but should continue to take actions to improve care and performance of Quality of Care and Efficiency metrics likely contributing to the current “2-Star” rating. The OIG noted findings in four of the eight clinical operations reviewed and issued seven recommendations that are attributable to the Director, Chief of Staff, and Associate Director. The identified areas with deficiencies are: (1) Credentialing and Privileging • Focused and Ongoing Professional Practice Evaluation processes (2) Environment of Care • Participation in environment of care rounds (3) Medication Management: CS Inspection Program • Alternate CS Coordinator position description includes CS duties • Written CS Inspector appointments • Completion of CS monthly inspections (4) Women’s Health: Mammography Results and Follow-Up • Ordering providers’ notification of all mammography results

The OIG audited a contract between City Construction, LLC, and the National Park Service (NPS) to determine whether City Construction and the NPS complied with the applicable Federal regulations and contract provisions from August 29, 2016, through March 21, 2018. On August 29, 2016, the NPS issued a $9,369,601 firm-fixed-price contract (Contract No. P16PC00558), which later included four modifications for a total of $9,809,991 for City Construction—a small commercial construction company located in Washington, DC—to build a new law enforcement facility at the NPS’ National Capital Region Headquarters in Washington, DC.We found that City Construction and the NPS both complied with the applicable Federal regulations and contract provisions. We provided our report the NPS Deputy Director but did not require a response.

We reviewed two recommendations presented in our April 30, 2015 report, titled Evaluation of Security Features of the Stewart Lee Udall U.S. Department of the Interior Building, to verify that the Department and its bureaus have implemented them. We confirmed that both recommendations have been resolved and implemented.