Open Recommendations

We recommend that the Centers for Medicare & Medicaid Services provide guidance to reeducate Medicare Administrative Contractors on the need to review, grant, and document requests from skilled nursing facilities for exceptions to cost reporting requirements in compliance with 42 CFR § 413.17(d).

We recommend that the Centers for Medicare & Medicaid services require the MACs to include, as part of the normal desk review or audit process, a review of reporting and disclosure of related-party costs.

We recommend that the Centers for Medicare & Medicaid Services develop and implement guidance for skilled nursing facilities on the appropriate methods for providers to determine their allowable related-party costs.

We recommend that the Centers for Medicare & Medicaid Services provide guidance to reeducate Medicare Administrative Contractors on the need to review, grant, and document requests from skilled nursing facilities for exceptions to cost reporting requirements in compliance with 42 CFR § 413.17(d).

Enhance procedures to ensure COR designation letters are appropriately created and signed by all parties upon award of the contract or modification to change the COR.

Update procedures to ensure the signed COR designation letters are maintained in the required locations to evidence the acceptance of COR appointments.

PBGC should provide guidance and training to workflow developers and business testers to ensure that workflows supporting internal control over financial systems are configured to automatically reject rather than approve workflow items when all required elements are not met.

Management should review existing OEM jobs and ensure that each job logs, detects, and alerts on job failures where there is potential impact to system processing routines. Further, a job monitoring process with escalation parameters and resolution paths should be developed and followed to ensure consistency of control execution.

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

We recommend that the Grantee take appropriate internal control measure to ensure adequate segregation of duties in its invoice preparation process.

We recommend that the Grantee work with ARC, to resolve the $33,614 of questioned costs.

Castro recommends that Treasury Office of Inspector General (OIG) follow-up with New Hampshire's management to confirm if the $14,027,288 noted as unsupported expenditures within the Direct Payments greater than or equal to $50,000 payment type can be supported. If support is not provided, Treasury OIG should recoup the funds or request New Hampshire management to provide support for replacement expenses, not previously charged, that were eligible during the CRF period of performance. ' In addition, Castro recommends that Treasury OIG request New Hampshire management to provide support for replacement expenses, not previously charged, that were eligible during the CRF period…

Treasury Office of Inspector General (OIG) should follow up with Oklahoma County's management to confirm if the $91,218 noted as unsupported expenditures within the Transfers greater than or equal to $50,000, Aggregate Reporting less than $50,000, and Aggregate Payments to Individuals payment types can be supported. If support is not provided, Treasury OIG should recoup the funds or request Oklahoma County management to provide support for replacement expenses, not previously charged, that were eligible during the CRF period of performance. In addition, Treasury OIG should request Oklahoma County management to provide support for replacement expenses, not previously charged, that were…

Treasury OIG should follow-up with Oklahoma's management to confirm if the $35,499,181 noted as unsupported expenditures within the Grants greater than or equal to $50,000, Transfers greater than or equal to $50,000, Direct Payments greater than or equal to $50,000, Aggregate Reporting less than $50,000, and Aggregate Payments to Individuals payment types can be supported. If support is not provided, Treasury OIG should recoup the funds or request Oklahoma management to provide support for replacement expenses, not previously charged to CRF, that were incurred during the period of performance. In addition, Treasury OIG should request Oklahoma management to provide support…

Develop data quality controls for the WTTS, create/update detailed guidance for implementing these controls, and train staff to perform these controls properly, especially with regard to the dates and information expected in key WTTS data fields.

Update the format of WTTS reports to ensure they clearly capture the information required for internal reviews and external reporting.

Update guidance and ensure that all OCHCO staff take appropriate training regarding the hiring process. This training should include refresher training.

Develop procedures and adjust the functions/tasks between the HR specialists and hiring managers to better balance the workload among the staff.

Develop plans to expand the use of the NRC’s excepted service authority.

The Chairman and FDIC Board of Directors set a tone at the top where all FDIC executives model the FDIC’s core values and principles through their behaviors and attitudes. This should be assessed and measured regularly by climate surveys with appropriate actions taken.

The Chairman expedite the process to establish an agreement with a third-party entity to conduct investigations of harassment and related misconduct complaints against senior FDIC officials.

Update the travel policy and continue efforts to ensure that all written policies and
procedures are reviewed and revised in a timely manner.

Note: We did not make a formal recommendation for this report. However, we are claiming cost savings. The following is the language we used in the Tracking Sheet we submitted to the agency. We request SSA review the cases of the beneficiaries in payment status that are listed as deceased in the New York City death data and terminate benefits for the beneficiaries it confirms are deceased, as they appear to be based on the New York City death data. Because payments should not be made after beneficiaries’ deaths, SSA should initiate overpayment collections for any such payments. We referred…

The Ralph H. Johnson VA Health Care System Director ensures that mental health Hinesville VA Clinic staff are using accurate current procedural terminology codes to document services provided to patients in the electronic medical record.

The Ralph H. Johnson VA Health Care System Director confirms evaluation of administrative processes to include consult management and patient scheduling within the mental health service at the Hinesville VA Clinic and takes action as necessary to optimize patient access and experience.