Financial Efficiency Inspection of the VA North Texas Health Care System

The OIG conducted this inspection from June 2023 to January 2024 to assess the stewardship and oversight of funds by the VA North Texas Health Care System. This inspection assessed the following financial activities and administrative processes to determine whether appropriate controls and oversight were in place: managerial cost accounting information, open obligations oversight, purchase card use, and inventory and supply chain management.Though the healthcare system used managerial cost accounting information to compare budgeted amounts to actual results as VA policy requires, that information was not used to make effective economic choices.Further, the OIG found the healthcare system did not always perform monthly reviews and reconciliations of open obligations to release unneeded funds. As a result, an estimated $14 million in open obligations were invalid, of which $12.2 million could have been put to better use. The healthcare system also was using funds from future obligations to pay for current-year services, which may have violated law and regulations.Purchase card transactions at the healthcare system were not always processed as required. The team sampled 66 transactions totaling about $292,000 from May 1, 2022, through March 31, 2023, and found 20 did not comply. The OIG also found 12 sampled transactions where healthcare system officials could have considered using a contract.Finally, the healthcare system could benefit from improving the efficiency of inventory oversight by ensuring inventory values are recorded accurately. The OIG also found the healthcare system did not conduct thorough supply chain management oversight or establish and follow inventory procedures.The OIG made eight recommendations to the healthcare system director and one to the Veterans Integrated Service Network 17 director. The recommendations address issues that, if left unattended, may eventually interfere with financial efficiency practices and the stewardship of VA resources.