Open Recommendations

Work with ARC and the SBA to resolve the reporting discrepancy of $10,000 for non-ARC matching costs.

The OIG recommends that the Executive Director for Operations establish a process to verify that all telework agreements are submitted and reviewed to maintain oversight and data integrity.

The OIG recommends that the Executive Director for Operations conduct periodic reconciliations between the telework agreements and the NRC’s payroll system to ensure the accuracy and completeness of employees’ telework statuses.

The OIG recommends that the Executive Director for Operations implement and document validation procedures to ensure submitted telework agreements are complete and records are maintained in compliance with NRC procedures.

The OIG recommends that the Executive Director for Operations require all official duty station changes resulting from telework to be supported by an approved agreement and ensure all relevant documentation is retained within the telework records.

The OIG recommends that the Executive Director for Operations implement a process to track the completion of corrective actions for discrepancies and ensure any unresolved issues are properly addressed.

The OIG recommends that the Executive Director for Operations implement a tracking system to monitor telework agreements nearing expiration, ensuring that necessary updates, such as changes to official duty stations, are made promptly and in accordance with established procedures.

The OIG recommends that the Executive Director for Operations develop procedures to mitigate the risk of inaccurate locality pay resulting from employees not reporting to their official duty station as required by the terms of their telework agreements.

Incorporate all business-essential processes and related interfaces, as defined by product owners, during validation sessions, user acceptance testing, or equivalent procedures to accurately present system capability.

Enhance the test plan to incorporate a more robust, risk-based testing process that incorporates user-testing requirements for functional and nonfunctional business-essential processes related to interfaces.

Develop a process to confirm with affected administrative offices whether they are aware of needed changes to test environments and that they have sufficiently executed them before interface test events.

Develop a method to evaluate whether test deficiencies necessitate changes to the deployment schedule to ensure deficiencies are properly addressed before wave go-live and implement these changes.

The Overton Brooks VA Medical Center Director reviews and monitors compliance with Veterans Health Administration health professions trainee onboarding requirements, and takes action as indicated.

The Overton Brooks VA Medical Center Director makes certain that oversight of the intensive care unit physician credentialing and privileging process is completed prior to physicians being scheduled and providing patient care, and monitors compliance.

The Overton Brooks VA Medical Center Director ensures root cause analyses are completed according to Veterans Health Administration policy including team composition, root cause analysis process steps, and timeliness.

The Under Secretary for Health evaluates the additional root cause analysis concurrence step used within Veterans Health Administration medical centers to ensure alignment with National Center for Patient Safety guidance, and takes action as indicated.

In our August and September 2024 alerts, we recommended that the Chief, Business Continuity Operations Officer, should ensure that the identified primary and spare pad-paks that have expired are replaced immediately.

In our August and September 2024 alerts, we recommended that the Chief, Business Continuity Operations Officer, should ensure that where TIGTA identified missing spare pad-paks, they are replaced.

In our August and September 2024 alerts, we recommended that the Chief, Business Continuity Operations Officer, should ensure that where TIGTA did not conduct an inspection, an immediate assessment is conducted on AEDs across the IRS AED program to identify and replace AED pad-paks expired or missing.

The Chief, Business Continuity Operations Officer, should ensure that appropriate signage identifying the location of mounted AEDs is provided.

In our September 2024 alert, we recommended that the Chief, Business Continuity Operations Officer, should ensure that where TIGTA did not conduct an inspection, an immediate assessment is conducted of AED wall cabinets across the IRS AED program to identify and mount AEDs within an approved cabinet and comply with proper placement guidelines, as appropriate.

In our August 2024 alert, we recommended that the Chief, Business Continuity Operations Officer, should ensure that where TIGTA did not conduct an inspection, an immediate assessment is conducted of AEDs across the IRS AED program to identify, repair, or replace AEDs that are nonoperational.

In our September 2024 alert, we recommended that the Chief, Business Continuity Operations Officer, should ensure that an immediate assessment is conducted to ensure that AED trainer models are not distributed, mounted, and available for use in the event of an emergency. If any AED trainer models exist, they should be immediately removed and stored away from AED cabinets and signage to avoid confusion.

The Chief, Business Continuity Operations Officer, should ensure that AED site coordinators complete their monthly maintenance inspections as required.

In our September 2024 alert, we recommended that the Chief, Business Continuity Operations Officer, should determine whether AEDs have been implemented at these IRS PODs. If so, provide documentation that supports AEDs have been provided at these PODs, e.g., serial numbers and locations of AEDs.

In our September 2024 alert, we recommended that the Chief, Business Continuity Operations Officer, should identify where AEDs have not been implemented at IRS PODs with more than 100 employees and determine whether an AED program will be implemented at these PODs, e.g., recruiting and training volunteers, installing AEDs, etc.

We recommend that OCP develop and implement monitoring activities to assess USDA agencies’ compliance with CPARS requirements, including CPARS training requirements, performance evaluation quality requirements, and timely reporting requirements.

We recommend that OCP develop and implement performance measures to evaluate the quality and timeliness of CPARS evaluations.

USDA OIG has determined that this recommendation contains sensitive information and will not be publicly released due to privacy concerns.

USDA OIG has determined that this recommendation contains sensitive information and will not be publicly released due to privacy concerns.

USDA OIG has determined that this recommendation contains sensitive information and will not be publicly released due to privacy concerns.

USDA OIG has determined that this recommendation contains sensitive information and will not be publicly released due to privacy concerns.

Take corrective actions to ensure that facilities and programs remove unauthorized sensitive information from collaborative application sites.

Expand roles and responsibilities of facility and program information system security officers and privacy officers to include the routine review of SharePoint and Teams site permissions and content.

Implement automated tools and policies, supported with training, to enable the timely and routine detection and correction of improper sharing and unauthorized content throughout VA.

Mandate standardized training for SharePoint administrators and owners to clarify and reinforce data security requirements.

Take corrective actions to ensure that facilities and programs remove unauthorized sensitive information from collaborative application sites.

Expand roles and responsibilities of facility and program information system security officers and privacy officers to include the routine review of SharePoint and Teams site permissions and content.

Implement automated tools and policies, supported with training, to enable the timely and routine detection and correction of improper sharing and unauthorized content throughout VA.

Mandate standardized training for SharePoint administrators and owners to clarify and reinforce data security requirements.

We recommend the Senior Vice President, Grid, update configuration management processes to improve periodic reviews.

Establish metrics to determine whether its implemented deliverables are improving efficiency and accuracy of the Agency’s disability programs, as intended.

Establish a plan of when and how it will implement the remaining deliverables provided under the contract, as well as how SSA will track progress of the implementation to determine whether the analyses, prototypes and recommendations provided in those deliverables improve SSA’s disability programs.

The VA Eastern Kansas Healthcare System Director ensures the chief of primary care reviews, strengthens, and implements system Patient Aligned Care Team processes for tracking and following up on community care consults ordered, particularly diagnostic consults, to verify patients receive care and to review and act upon consult results, as clinically indicated.

The VA Eastern Kansas Healthcare System Director reviews institutional disclosures conducted by the system over the past 12 months, including the patient’s institutional disclosure, and ensures these disclosures fully adhere to Veterans Health Administration Directive 1004.08, Disclosure of Adverse Events to Patients, October 31, 2018, including documenting the details of the adverse event and discussion points of the disclosure, and takes action needed to remediate disclosures that do not meet these standards.

The VA Eastern Kansas Healthcare System Director ensures community care staff make the required three attempts to obtain patients’ community care records within 90 days of completed appointments, and monitors for compliance.

The VA Eastern Kansas Healthcare System Director collaborates with the Kansas City VA Medical Center Director to review the frequency and circumstances of community care records being sent to the incorrect VA facility, develops, and implements a process for ensuring community care records are delivered to the correct ordering VA facility, educates staff on the process, and monitors for compliance.

The Under Secretary for Health establishes and monitors compliance with a process that ensures the Veterans Health Administration ordering provider receives urgent non-life-threatening abnormal test results from care obtained in the community, such as the diagnostic positron emission tomography scan results described in this report, within a time frame that allows timely attention and appropriate action to be taken.

The Veterans Integrated Service Network Director, in conjunction with the Veterans Health Administration National Center for Lung Cancer Screening Program Office, evaluates the VA Eastern Kansas Healthcare System’s Lung Cancer Screening Program to ensure operational adherence to the Lung Cancer Screening Program requirements, and takes action as needed.

The VA Eastern Kansas Healthcare System Director ensures the chief of primary care reviews, strengthens, and implements system Patient Aligned Care Team processes for tracking and following up on community care consults ordered, particularly diagnostic consults, to verify patients receive care and to review and act upon consult results, as clinically indicated.