Financial Efficiency Inspection of the VA Tampa Healthcare System

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Title Full

Date Issued

Thursday, February 13, 2025

Submitting OIG

Department of Veterans Affairs OIG

Agencies Reviewed/Investigated

Department of Veterans Affairs

Components

Veterans Health Administration

Report Number

24-00103-27

Report Description

The VA Office of Inspector General (OIG) conducted this inspection to assess the oversight and stewardship of funds by the VA Tampa Healthcare System. This inspection assessed four financial activities and administrative processes to determine whether appropriate controls and oversight were in place: use of managerial cost accounting information, open obligations oversight, purchase card use and oversight, and supply chain management operations.

The OIG found the healthcare system could use managerial cost accounting information more effectively to help spend more efficiently and improve its performance measurement process for identifying and correcting cost inaccuracies.

The healthcare system did not always perform monthly reviews and deobligate funds no longer needed. The healthcare system appeared to use funds from the wrong fiscal year to pay for services, which may have violated the “bona fide needs” rule. The OIG estimated $6.3 million in open obligations was invalid due to the healthcare system’s lack of monthly follow-up and reconciliations and found that an estimated $5.9 million in invalid obligations should have been deobligated for better use.

The healthcare system did not always process purchase card transactions in accordance with VA policy. The OIG found violations involving a lack of prior approvals, supporting documentation, and segregation of duties.

Furthermore, the healthcare system did not meet the days-of-stock-on-hand metric or maintain accurate supply chain data. Officials also did not fulfill their duties to ensure that Medical Surgical Prime Vendor (MSPV) ordering officers and a facility contracting officer’s representative were nominated and delegated to ensure the MSPV program achieved its goals and objectives and effectively safeguarded the government’s interests and resources.

The OIG made 12 recommendations for improvement to the healthcare system director. The recommendations address issues that, if left unattended, may eventually interfere with financial efficiency practices and the strong stewardship of VA resources.

Report Type

Inspection / Evaluation

Location

FL
United States

Number of Recommendations

Questioned Costs

$110,042,700

Funds for Better Use

$5,900,000

Report updated under NDAA 5274

External Link

https://www.vaoig.gov/reports/financial-inspection/financial-efficiency-inspect…

Open Recommendations

This report has 12 open recommendations.

Recommendation Number	Significant Recommendation	Recommended Questioned Costs	Recommended Funds for Better Use
01	No	$0	$0
Establish a plan to use VAs cost accounting system information to identify additional ways to reduce costs, enhance efficiency, and inform business decisions as identified by VA financial policy
02	No	$0	$0
Ensure the facility has a process to identify cost outliers, such as using the Intermediate Product Cost Outlier report to identify cost outliers that may occur at the healthcare system on a regular basis.
03	No	$0	$0
Ensure healthcare system service lines review and update the national labor mapping tool to the Veterans Integrated Service Network managerial cost accounting team as required by VA financial policy to ensure workload is being captured correctly.
04	No	$0	$0
Ensure that healthcare system staff and responsible finance office staff review all open obligations to ensure balances are valid and should remain open or are closed in a timely manner as required by VA Financial Policy, Obligations, as updated in March 2024.
05	No	$0	$0
Ensure that the healthcare system uses appropriated funds in the manner intended by Congress, as required by the VA Financial Policy, Obligations, as updated in March 2024.
06	No	$0	$0
Consult with the Office of General Counsel and the Office of Acquisitions, Logistics, and Construction to determine whether a bona fide needs or other appropriations law violation occurred and, if any violations did occur, take appropriate remedial and preventive actions to address them.
07	No	$0	$0
Ensure cardholders comply with prior approval, segregation of duties, and record retention requirements as required by VA Financial Policy, volume 16, chapter 1B, Government Purchase Card for Micro-Purchases.
08	No	$0	$0
Ensure cardholders and approving officials are aware of the requirement to review purchases and determine when it is in the best interest of the government to use strategic sourcing.
09	No	$0	$0
Develop and implement a plan to ensure data accuracy and reliability in the Generic Inventory Package and ensure processes are in place to monitor performance metrics in accordance with Veterans Health Administration policy.
10	No	$0	$0
Develop and maintain an effective standardized training program for new and current inventory staff and monitor the staffs knowledge and skill level.
11	No	$0	$0
In coordination with the Strategic Acquisition Center, ensure that the Medical Surgical Prime Vendor facility-level contracting officers representatives and ordering officers are appointed and delegated properly and perform all required duties according to the scope and limitation of the designees authority.
12	No	$0	$0
In coordination with the Strategic Acquisition Center, submit ratifications for any Medical Surgical Prime Vendor unauthorized commitments in accordance with the Federal Acquisition Regulation.