Open Recommendations

We recommend that the Department continue to design policies to perform and document a risk assessment of new or revised accounting standards.

We recommend the Department implement a periodic retrospective review to verify the data, methods, and assumptions are accurate, complete, and consistent with established estimation methodologies.

We recommend the Department periodically assess the effectiveness of training and update materials as needed to reflect changes in personnel, processes, or reporting requirements.

We recommend the Department assign experienced personnel as the reviewer or a second review by a different employee when new employees are performing the control.

We recommend the Department provide ongoing guidance and training to process owners to ensure compliance with the standards.

We recommend the Department enhance risk assessment procedures to identify and implement changes needed to internal processes and controls to ensure ongoing compliance with SFFAS 54.

We recommend the Department establish and document a formal control requiring periodic review and validation of the application of the data used to generate the accounting estimate.

The New York/New Jersey VA Healthcare Network Director evaluates the circumstances that led to Network and Syracuse VA Medical Center leaders not following clinical restructuring requirements according to VHA Directive 1043.

The Syracuse VA Medical Center Director evaluates the implementation of high reliability organization principles when communicating changes to clinical operations that include stakeholders, service and section leaders, and staff input.

The Syracuse VA Medical Center Director evaluates facility contract processes and takes action to ensure leaders maintain adequate oversight of contracting milestones.

The Syracuse VA Medical Center Director evaluates the communication of established contingency plans and ensures alignment with high reliability organization principles.

The Syracuse VA Medical Center Director ensures the monitoring and evaluation of patient transfers according to Veterans Health Administration Directive 1094(1) and takes action as warranted.

The Syracuse VA Medical Center Director ensures annual procedural complexity designation infrastructure reviews are completed accurately and ensures administrative actions are performed as required.

The New York/New Jersey VA Healthcare Network Director evaluates fiscal year 2026 procedural complexity designation infrastructure reviews for all Veterans Integrated Service New York/New Jersey VA Health Care Network facilities and takes action to ensure reviews are accurate and deficiencies are addressed as required.

The Under Secretary for Health ensures a timeliness expectation for infrastructure waiver submissions pursuant to Veterans Health Administration Directive 1220(1).

The New York/New Jersey VA Healthcare Network Director evaluates the circumstances that led to Network and Syracuse VA Medical Center leaders not following clinical restructuring requirements according to VHA Directive 1043.

The Syracuse VA Medical Center Director evaluates the implementation of high reliability organization principles when communicating changes to clinical operations that include stakeholders, service and section leaders, and staff input.

The Syracuse VA Medical Center Director evaluates facility contract processes and takes action to ensure leaders maintain adequate oversight of contracting milestones.

The Syracuse VA Medical Center Director evaluates the communication of established contingency plans and ensures alignment with high reliability organization principles.

The Syracuse VA Medical Center Director ensures the monitoring and evaluation of patient transfers according to Veterans Health Administration Directive 1094(1) and takes action as warranted.

The Syracuse VA Medical Center Director ensures annual procedural complexity designation infrastructure reviews are completed accurately and ensures administrative actions are performed as required.

The New York/New Jersey VA Healthcare Network Director evaluates fiscal year 2026 procedural complexity designation infrastructure reviews for all Veterans Integrated Service New York/New Jersey VA Health Care Network facilities and takes action to ensure reviews are accurate and deficiencies are addressed as required.

The Under Secretary for Health ensures a timeliness expectation for infrastructure waiver submissions pursuant to Veterans Health Administration Directive 1220(1).

Provide remedial or refresher training to management handling grievances in areas of concern to include topics such as, but not limited to, knowledge of national bargaining and local agreements, grievance arbitration procedures, responding to union requests for information, and contending with challenges from union representatives.

Develop a platform to share best practices identified by individual districts on grievance management and require each district to provide a plan to implement applicable best practices.