Federal Reports

This grant was awarded to the Board to provide funding for the development and deployment of a wireless broadband network to serve Garrett county

This audit objectives were to determine whether program funds were managed in accordance with the ARC and Federal grant requirements.

The OIG investigated allegations that an official at a tribally controlled college bribed members of the college board of trustees, submitted false mileage claims for work-related travel, retaliated against employees who disagreed with his policies, and failed to report the theft of college funds by a former employee.We did not substantiate the allegations of bribery, false claims, or retaliation. We also found the official ensured the theft was properly reported to law enforcement and that the stolen funds had been repaid in full.The U.S. Attorney’s Office for the District of South Dakota declined to prosecute the former employee for the theft.

Medicare made improper payments of $8.7 million to providers for nonemergency ambulance transports to destinations not covered by Medicare, including the identified ground mileage associated with the transports. Medicare covers ambulance transports to only certain destinations, such as hospitals, skilled nursing facilities (SNFs), and beneficiaries' residences. Medicare also covers these transports from a SNF to the nearest supplier of medically necessary services (diagnostic or therapeutic sites) when the beneficiary is a SNF resident and those services are not available at the SNF. The majority of the improperly billed claim lines (59 percent) were for transports to diagnostic or therapeutic sites, other than a physician's office or a hospital, that did not originate from SNFs. As of the publication of this report, the total improper payment amount of $8.7 million included claim lines outside of the 4-year claim-reopening period.

The objective of the Council of the Inspectors General on Integrity and Efficiency purchase card initiative was to analyze and review Government purchase card data to determine the risks associated with purchase card transactions.

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 San Diego Healthcare 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 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 63 employees. The Facility has stable executive leadership. The OIG noted generally satisfied employees; however, opportunities exist to improve inpatient experiences. Organizational leaders supported patient safety, quality of care, and other positive outcomes. The OIG’s review of accreditation organization findings, sentinel events, disclosures, Patient Safety Indicator data, and Strategic Analytics for Improvement and Learning results did not identify any substantial organizational risk factors, but the executive leaders should continue to take actions to improve care and performance of selected Quality of Care and Efficiency metrics likely contributing to the “3-Star” rating. The OIG noted findings in four of the eight areas of clinical operations reviewed and issued five recommendations that are attributable to the Facility Director, Chief of Staff, Associate Director of Patient Care Services, Associate Director, and Assistant Director. The identified areas with deficiencies are: (1) Credentialing and Privileging • Ongoing Professional Practice Evaluations (2) Environment of Care • Environment of care rounds attendance • Environmental cleanliness (3) Medication Management: Controlled Substances Inspection Program • Controlled substances reconciliation (4) High-Risk Processes: Central Line-Associated Bloodstream Infections • Staff education

What We Looked AtThis report presents the results of our quality control review (QCR) on the single audit that Ricci & Company, LLC performed for the Rio Metro Regional Transit District's (District) fiscal year that ended June 30, 2016. During this period, the District expended approximately $14 million from the U.S. Department of Transportation's (DOT) grant programs. Ricci determined that DOT's major program was the Federal Transit Cluster.Our QCR objectives were to determine whether (1) the audit work complied with the Single Audit Act of 1984, as amended, the Office of Management and Budget's Uniform Guidance, and the extent to which we could rely on the auditors' work on DOT's major program; and (2) the District's reporting package complied with the reporting requirements of the Uniform Guidance.What We FoundRicco's audit work complied with the requirements of the Single Audit Act, the Uniform Guidance, and DOT's major program. We found nothing to indicate that Ricci's opinion on DOT's major program was inappropriate or unreliable. However, we identified deficiencies in the District's reporting package that required correction and resubmission.