Open Recommendations

We recommend the Senior Vice President, Generation Projects and Fleet Services, establish steps to verify implementation estimates include the complete scope of work and are developed using definitive costs.

We recommend the Senior Vice President, Generation Projects and Fleet Services obtain additional support for the five project change requests with insufficient details to determine if the approval amounts should be revised.

We recommend the Senior Vice President, Generation Projects and Fleet Services take steps to reinforce the (1) need for adequate support before approving project change requests and (2) requirement for project change requests to document project estimate revisions.

We recommend that the Senior Vice President, Generation Projects and Fleet Services, in conjunction with the Office of the General Counsel, educate the appropriate individuals on the importance of not sharing confidential contractor information.

The VA Fayetteville Coastal Healthcare System Director reviews the endocrine consult management process and takes actions as needed to ensure compliance with current Veterans Health Administration directives and guidance.

The VA Fayetteville Coastal Healthcare System Director implements a strategy to review patients affected by delayed endocrine consults to evaluate whether harm occurred and the appropriateness of institutional disclosures.

The VA Fayetteville Coastal Healthcare System Director ensures a sustainable and effective service line agreement between endocrine and primary care services is developed and agreed upon by both services, and monitors implementation.

The VA Fayetteville Coastal Healthcare System Director confirms effective utilization of endocrine clinic appointments to ensure timely access to care.

The VA Fayetteville Coastal Healthcare System Director ensures a process is in place for monitoring and tracking clinic profile modification requests.

The VA Mid-Atlantic Health Care Network Director reviews the leadership performance of the chief of medicine related to communication and collaboration and takes action as necessary.

The VA Fayetteville Coastal Healthcare System Director evaluates communication gaps identified in this report between leaders of primary care and the Medicine Service and takes action to ensure consistency with Veterans Health Administration High Reliability Organization goals.

The VA Mid-Atlantic Health Care Network Director reviews the leadership performance of the chief of medicine related to communication and collaboration and takes action as necessary.

The VA Fayetteville Coastal Healthcare System Director implements a strategy to review patients affected by delayed endocrine consults to evaluate whether harm occurred and the appropriateness of institutional disclosures.

The VA Fayetteville Coastal Healthcare System Director evaluates communication gaps identified in this report between leaders of primary care and the Medicine Service and takes action to ensure consistency with Veterans Health Administration High Reliability Organization goals.

The VA Fayetteville Coastal Healthcare System Director ensures a process is in place for monitoring and tracking clinic profile modification requests.

Along with the Vice President, Delivery Operations; Vice President, Processing Operations; and Vice President, Logistics, develop and provide training to staff on the correct processes for the disposal of day-old poultry.

Revise Publication 52 to require the mailer to include a "deliver by" date, which is 72-hours after hatching, on all packages of day-old poultry.

Develop electronic methods to uniquely track shipments of day-old poultry, including shipments that have perished.

Develop a written plan for Superfund program continuity that includes procedures for recurring tasks and clearly assigns responsibilities to the Office of Financial Management personnel who will likely inherit the cost reconciliation duties.

Update its guidance to sufficiently detail its reconciliation process, including: (a) identifying and reconciling cost reports, (b) extracting data for Superfund and non-Superfund costs, (c) applying direct labor and indirect cost rates, and (d) accounting for other direct costs. Additionally, this guidance should be maintained as a living document and regularly reviewed and updated, at least annually, to ensure accurate, consistent, and efficient financial reporting.

Revise the indirect cost reconciliation calculation report and Schedule 4 to include descriptive terms that more accurately reflect the fields Superfund Indirect Percentage, Superfund Indirect Rate, and
Total Indirect Rate.

Work with OSP to reevaluate the grant goals and clarify grant expectations and goals for the 15PBJA-23-GG-00975-COVE grant.

Require OSP to develop and formalize performance reporting procedures and documentation to help ensure program results are accurately reported and supported, as required.

Ensure that OSP develops and implements adequate federal financial reporting procedures to help ensure that it submits accurate FFRs.

We recommend MSAC document its procedures for completing award Federal Financial Reports, including how to calculate indirect costs.