Federal Reports

We determined that U.S. Citizenship and Immigration Services’ (USCIS) site visits provide minimal assurance that H-1B visa participants are compliant and not engaged in fraudulent activity. These shortfalls exist for various reasons. USCIS does not ensure that petitioners who previously abused the program are denied new petitions. USCIS could also do more to prevent approving petitions for recurring violations and collaborate more with external stakeholders. The agency does not provide comprehensive guidance for how USCIS personnel resolve site visit findings. USCIS does not have a process to collect and analyze key data elements to help guide the H-1B site visit program. The agency lacks performance measures to show how site visits contribute to improving the H-1B Program. We recommended that the USCIS Deputy Director: (1) develop processes to collect and analyze H-1B site visit data, (2) share appropriate site visit data with external stakeholders, (3) re-assess the H-1B ASVVP, and (4) develop policies to ensure adjudicative action prioritizes fraudulent or noncompliant results from H-1B ASVVP and targeted site visits. We made four recommendations that will help USCIS improve the H-1B site visit program. USCIS concurred with all four recommendations and has begun corrective actions to address the findings in this report.

The New York State Department of Health, Division of Nursing Homes and Intermediate Care Facilities for Individuals with Intellectual Disabilities Surveillance (State agency) did not always verify nursing homes' correction of deficiencies identified during surveys in calendar year (CY) 2014 in accordance with Federal requirements. We estimated that the State agency did not obtain the nursing homes' evidence of correction for 72 percent of the deficiencies identified during surveys in CY 2014.

The Office of Inspector General assessed NASA’s progress in improving its information technology governance and security over the past 4 years.

OIG conducted a healthcare inspection in response to allegations made by a confidential complainant in 2015 regarding the Opioid Agonist Treatment Program (OATP) at the Baltimore VA Medical Center, one of three VA Maryland Health Care System campuses, located in Baltimore, MD. The complainant alleged the OATP lacked quality controls necessary to ensure patients received treatment planning and monthly counseling as required, which resulted in patient deaths. We substantiated that the OATP lacked effective quality controls necessary to ensure patients consistently received required treatment planning and monthly counseling. We determined the failure to provide consistent treatment planning and monthly counseling was due, in part, to a lack of counseling staff supervision. We did not substantiate that OATP patients died as a result. We also determined the OATP lacked a clear policy on cardiac risk management and quality controls to ensure appropriate cardiac monitoring. We identified a concern related to the role of the OATP Medical Director. 42 CFR § 8.12 (b) and the Substance Abuse and Mental Health Services Administration require that the medical director be responsible for ensuring regulatory compliance with all applicable Federal, State, and local laws and regulations. However, the OATP policy describing the medical director’s duties did not include regulatory compliance responsibility or define a sufficient number of hours to ensure regulatory compliance.