Open Recommendations

We recommend that the Deputy Secretary develop an appropriate system for documenting all reasonable accommodation requests in a manner where the documentation is complete, organized, and readily available for examination.

We recommend that the Deputy Secretary assess whether OEEOS has allocated sufficient resources and assistance to the reasonable accommodation program and make changes as appropriate.

We recommend that the Deputy Secretary direct the Program Manager to develop and implement a tracking system that includes appropriate data validation checks and captures all of the information the Department is legally required to track and report.

We recommend that the Deputy Secretary ensure the Program Manager is populating the tracking system with dates that comply with definitions established in policy (e.g., request dates; provision dates).

We recommend that the Deputy Secretary develop and implement the use of a form that supervisors are required to complete and submit to the Program Manager within a specified timeframe after a reasonable accommodation request is received to assist with ensuring the Program Manager is notified of all requests and captures needed data for tracking and reporting purposes.

We recommend that the Deputy Secretary coordinate with the Office of the Chief Information Officer to determine whether a process can be established that would allow reasonable accommodation requests for assistive technology submitted through the ServiceNow portal to be designated as such and notifications of such requests to be automatically sent to the Program Manager for tracking and reporting purposes.

We recommend that the Deputy Secretary ensure the Department’s Program Manager coordinates with the FSA Program Manager to obtain needed data for compiling the annual MD-715 report.

CMS should provide surveyors with instructions for how to assess the contents of nursing home emergency preparedness documentation as a part of the survey process.

CMS should Issue guidance that encourages SAs to collaborate and share information.

CMS should provide surveyors with instructions for how to assess the contents of nursing home emergency preparedness documentation as a part of the survey process.

CMS should issue guidance that encourages SAs to collaborate and share information.

Take corrective actions on the case errors we identified in the sample that were still unresolved as of November 2024.

Provide refresher training to Processing Center 8 staff on Social Security Administration policies and the screening guide related to the issues identified in this report.

Determine whether the $13,517 are allowable costs and, if not, request a refund.

We recommend that the Texas Department of Health and Human Services ensure that providers correct the 253 instances of provider noncompliance identified in this report.

We recommend that the Texas Department of Health and Human Services improve oversight and monitoring of providers.

We recommend that the Texas Department of Health and Human Services work with providers to improve their facilities, staffing, and training.

We recommend that the Grantee develop and implement written policies and procedures surrounding the management of federal awards, in accordance with the Uniform Guidance.

We recommend that the Grantee work with ARC to resolve the $3,321 in questioned, matching costs.

The OIG recommends facility leaders define and assign roles and responsibilities to toxic
exposure screening navigators and ensure program oversight.

The OIG recommends the Director ensures staff keep patient care areas safe and clean.

The OIG recommends the Director ensures biohazard storage areas display proper signage, have appropriate hand-washing supplies and equipment available, and do not contain housekeeping supplies.

The OIG recommends the Associate Director ensures staff identify one or more facility environment of care trends and establish a performance improvement plan, including outcome measures, to address them.

The OIG recommends that facility leaders continue to develop and implement administrative processes to ensure ordering providers promptly communicate and document test results.

The OIG recommends that facility leaders ensure staff maintain and reference current VHA requirements and update facility-level policies and standard operating procedures to comply with them.