Open Recommendations

OIG recommends that the Bureau of Administration modify the State Assistance Management System user training to include guidance on documenting the Grants Officer and Grants Officer Representative workflows within the State Assistance Management System using the Post-Award Activities function.

Following implementation of Recommendation 5, OIG recommends that the Bureau of Administration analyze the results of the survey to identify the reasons hindering the use of State Assistance Management System Domestic's Post-Award Activities function, including technical issues that need to be addressed and if appropriate, develop and implement a corrective action plan to increase the use of the State Assistance Management System Domestic's Post-Award Activities function.

OIG recommends that the Bureau of Administration develop and implement a communications strategy that provides Grants Officer Representatives with specific and detailed requirements for financial monitoring to improve their understanding of and compliance with those requirements. This communications strategy should underscore the importance of reviewing the Federal Financial Report to ensure that the amount of funds expended is commensurate with the work accomplished on the award.

OIG recommends that the Bureau of Administration develop and implement a communications strategy that provides Grants Officers with specific and detailed requirements for financial monitoring to improve their understanding of and compliance with those requirements. This communications strategy should underscore the critical importance of reviewing and approving the Federal Financial Report in a timely manner within the Payment Management System, rather than allowing a default approval. It should further remind Grants Officers that Grants Officer Representatives could be delegated Federal Financial Report approval responsibility within the Payment Management System to ensure timely approval of reports.

OIG recommends that the Bureau of Administration develop and implement a communications strategy that provides Grants Officers with specific and detailed audit requirements for foreign for-profit organizations to improve their understanding of and compliance with those requirements. This communications strategy should underscore the critical importance of requiring, obtaining, and reviewing audit reports to inform risk assessments and to formulate monitoring plans.

Update the AHTF Program application guide with the revised performance measures and implement processes to assess the outcome of its AHTF Program performance measures.

Establish procedures to enhance the review process of progress reports to analyze the completeness, accuracy, and success of the AHTF Program.

Rec. 2.b: The DoD OIG recommended that the Director of the Federal Electronic Health Record Modernization Program Office, in coordination with the Director of the Defense Health Agency; Program Executive Director for Electronic Health Record Modernization Integration; and Program Manager for DoD Healthcare Management System Modernization develop and implement a plan for migrating legacy patient health care information needed for a patient's complete electronic health record once the Federal Electronic Health Record Modernization Program Office determines the health care data domains of patient health care information that constitutes a complete patient electronic health record.

Rec. 2.c: The DoD OIG recommended that the Director of the Federal Electronic Health Record Modernization Program Office, in coordination with the Director of the Defense Health Agency; Program Executive Director for Electronic Health Record Modernization Integration; and Program Manager for DoD Healthcare Management System Modernization develop and implement a plan for creating interfaces that would allow medical devices to connect and transfer patient health care information to Cerner Millennium.

Rec. 2.d: The DoD OIG recommended that the Director of the Federal Electronic Health Record Modernization Program Office, in coordination with the Director of the Defense Health Agency; Program Executive Director for Electronic Health Record Modernization Integration; and Program Manager for DoD Healthcare Management System Modernization develop and implement a plan to modify Cerner Millennium user roles to ensure users are granted access to only the patient health care information necessary to perform their job responsibilities.

Rec. 1: The DoD OIG recommended that the Director of the Defense Health Agency, in coordination with DoD health care providers, assess the functionality of Military Health System GENESIS to determine whether the concerns identified by the survey respondents still exist, and if the concerns still exist, develop and implement plans of action to address the concerns.

CMS should update and broaden its lists of hospital-acquired conditions to capture common, preventable, and high-cost harm events.

CMS should explore expanding the use of patient safety metrics in pilots and demonstrations for health care payment and service delivery, as appropriate.

CMS should develop and release interpretive guidance to surveyors for assessing hospital compliance with requirements to track and monitor patient harm events.

AHRQ should, with support from HHS leadership, coordinate agency efforts to update agency-specific Quality Strategic Plans.

AHRQ should optimize use of the Quality and Safety Review System (QSRS), including assessing the feasibility of automating data capture for national measurement and to facilitate local use.

AHRQ should develop an effective model to disseminate information on national clinical practice guidelines or best practices to improve patient safety.

AHRQ should continue efforts to identify and develop new strategies to prevent common patient harm events in hospitals.

Record death information on the Numident, as appropriate, for the 40 deceased beneficiaries in our sample.

Take action, as appropriate, to record death information in the Numident for the 15,714 beneficiaries identified by our current audit.

Take appropriate action to record death information to the Numident for the 595,514 beneficiaries identified by our prior audits.

Working with the Office of the Secretary and “group of four” oversight entities as appropriate, identify and implement changes to thereview and dissemination process for I&A’s election-related intelligence products to ensure they are in accordance with applicable policies andguidelines.

We recommend that the FWS work with the Department to require the electronic system for volunteer work to limit the number of hours that can be claimed on a specific day to ensure hours are reported daily.

We recommend that the FWS work with the Department to update policies and procedures to include guidance for daily entry of hours.

We recommend that the FWS work with the Department to develop and implement training for supervisors and volunteers to ensure proper documentation and approval of volunteer time.