Federal Reports

Why This Report Was DoneThe Office of the Special Inspector General for Afghanistan (SIGAR) conducted a required external peer review of the EPA OIG’s compliance with the Council of Inspectors General on Integrity and Efficiency Quality Standards for Inspection and Evaluation, December 2020 (Blue Book). Summary of FindingsSIGAR determined that the EPA OIG’s policies and procedures generally were consistent with the Blue Book standards addressed in the external peer review.

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the Martinsburg VA Medical Center and multiple outpatient clinics in Maryland, Virginia, and West Virginia. This evaluation focused on five key operational areas:• Leadership and organizational risks• Quality, safety, and value• Medical staff privileging• Environment of care• Mental health (suicide prevention initiatives)The OIG issued three recommendations for improvement in two areas:1. Medical staff privileging• Ongoing Professional Practice Evaluations2. Environment of care• Expired/outdated inventory in clean and sterile stockrooms

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the VA Bedford Healthcare System, which includes the Edith Nourse Rogers Memorial Veterans’ Hospital in Bedford and three outpatient clinics in Massachusetts. This evaluation focused on five key operational areas:• Leadership and organizational risks• Quality, safety, and value• Medical staff privileging• Environment of care• Mental health (suicide prevention initiatives)The OIG issued five recommendations for improvement in four areas:1. Leadership and organizational risks• Institutional disclosures for applicable sentinel events2. Quality, safety, and value• Root cause analysis for patient safety events3. Environment of care• Patient care areas clean and free from undue wear• Inpatient mental health unit over-the-door alarm testing4. Mental health• Comprehensive Suicide Risk Evaluation completion

Our objective for this alert was to determine facility opening procedures and mail conditions at the South Houston Local Processing Center.Each year, increased mail volume during the Postal Service’s peak mailing season — Thanksgiving through New Year’s Eve1 — significantly strains the Postal Service’s processing and distribution network. The Postal Service opens peak season annexes to temporarily help with increased package volume at select processing facilities. As part of our peak season audit, we assessed the Postal Service’s acquisition and use of these peak season annexes. One such annex we identified was the South Houston Local Processing Center (LPC), which opened on November 18, 2023, and was associated with the North Houston Processing and Distribution Center (P&DC).

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the VA Salt Lake City Health Care System, which includes the George E. Wahlen VA Medical Center in Salt Lake City and multiple outpatient clinics in Idaho, Nevada, and Utah. This evaluation focused on five key operational areas:• Leadership and organizational risks• Quality, safety, and value• Medical staff privileging• Environment of care• Mental health (suicide prevention initiatives)The OIG issued six recommendations for improvement in three areas:1. Medical staff privileging• Focused Professional Practice Evaluation results2. Environment of care• Environment of care inspections• Inpatient Psychiatry Unit: • Panic and over-the-door alarm testing • Maintaining a safe environment3. Mental health• Comprehensive Suicide Risk Evaluation completion