Federal Reports

This Newsletter provides a bimonthly summary of selected investigative accomplishments.

EAC OIG, through the independent public accounting firm of McBride, Lock & Associates, LLC, audited $30.4 million in funds received by the Maryland State Board of Elections under the Help America Vote Act. The objectives of the audit were to determine whether the Board: 1) used payments authorized by Sections 101, 102 and 251 of the Grant in accordance with Grant and applicable requirements; 2) accurately and properly accounted for property purchased with Grant payments and for program income; 3) met HAVA requirements for Section 251 funds for creation of an election fund, providing required matching contributions, and meeting the requirements for maintenance of a base level of state outlays, commonly referred to as Maintenance of Expenditures (MOE).

On the basis of our review of 100 sampled deficiencies, we determined that the Kansas Department of Aging and Disability Services, Survey, Certification and Credentialing Commission (State agency), did not always verify nursing homes' correction of deficiencies identified during surveys in calendar year 2014 in accordance with Federal requirements. We estimated that the State agency did not obtain the nursing homes' evidence verifying correction of deficiencies in accordance with Federal requirements for 52 percent of the deficiencies identified during surveys in CY 2014. We also estimated that the State agency could not provide sufficient evidence that corrective actions had been taken for 13 percent of the deficiencies identified during those surveys. In addition, the State agency did not always conduct required standard surveys within 15 months of the previous standard surveys in CY 2014 in accordance with Federal requirements.

OIG conducted a healthcare inspection in response to complaints regarding consults at the Central Texas Veterans Health Care System (system), Temple, TX. The complainant provided 14 examples of patients at the Olin E. Teague Veterans’ Medical Center (facility) for whom he/she believed Physical Medicine and Rehabilitation Services (PMRS) consults were not scheduled timely and appointments were delayed as a result. We substantiated the allegation that 12 of the 14 patients experienced delays in scheduling consult appointments and in receiving care. Although patients experienced delays in PMRS consults, primary care teams continued to manage patients. We found the problem of delayed consult appointments was a systemic problem within PMRS. Some of the facility’s PMRS consult procedures did not comply with system policy and could have contributed to the delay in appointment scheduling. Multiple provider and managerial positions were filled by temporary personnel, and an absence of a fully staffed department affected the functioning of the service and contributed to the delays. Facility managers were aware of these problems and attempted to correct them by forming a Consult Management Committee to review consult data, and by requesting another Veterans Health Administration (VHA) facility review PMRS. Although facility managers provided Advanced Medical Support Assistants who scheduled appointments with additional scheduling training, they continued to be confused about scheduling procedures and did not meet scheduling competency evaluation requirements. We recommended that the Facility Director ensure that (a) consult clinical reviews and appointment scheduling for patients are conducted in compliance with VHA directives and policies, (b) PMRS have sufficient staffing to arrange for timely consults and appointments within the service, and (c) facility staff who schedule PMRS patient appointments receive annual scheduling competencies to ensure understanding of the correct process for compliance with VHA directives and staff are monitored for compliance.