Open Recommendations

We recommend that the Ohio Department of Health work with CMS to develop a risk-based approach to identify nursing homes where surveys should be conducted more frequently than once every 15 months, such as those with a history of multiple high-risk deficiencies or frequent management turnover.

We recommend that the Ohio Department of Health develop a plan with CMS to address the foundational issues preventing more frequent surveys at nursing homes with a history of multiple high-risk deficiencies.

We recommend that the Ohio Department of Health follow up with the 18 nursing homes in this audit that demonstrated life safety, emergency preparedness, and infection control deficiencies to verify that corrective actions have been taken regarding the deficiencies identified in this report.

Conduct a formal assessment of the Regional Service Provider examination program to establish program-level goals, metrics, and indicators and determine whether additional resources and controls are needed to improve the effectiveness of the program, as identified in this memorandum.

Develop and implement a course approvals plan to address the existing backlog and to avoid future approval delays.

Establish and implement quality control measures for course approvals to include peer review or other mechanisms to ensure course approvals meet requirements.

Develop and implement goals and requirements for the course oversight auditing program, including the number and type of audits to be conducted by each auditor in a given time period.

Establish and implement controls to ensure audit results are used to improve operations and apply enforcement actions to MTPs, such as suspension or withdrawal of course approvals, after serious nonconformities are identified.

Develop and implement policy and procedures for routinely conducting in person-audits of mariner training sites to ensure sites are operating in accordance with the site approval.

Develop and implement a policy for routinely conducting audits of thirdparty course approvers to ensure they have processes for reviewing, approving, and monitoring training that are equal to the Coast Guard’s course approval and oversight processes.

Develop and implement a plan to modernize NMC’s examination processes, with a milestone timeline endorsed by the Coast Guard offices whose support and assistance is needed.

Office of the Chief Information Officer implement adequate data logging in compliance with applicable NIST guidance.

Office of Chief Information Officer implements and updates the agency’s cybersecurity incident response plan to align with Manual Section 899 to include the Office of Inspector General and other required offices in breach notifications.

Office of Chief Information Officer ensures that the Peace Corps network is continuously monitored to mitigate the risk of cyberthreats.

In addition to using available ITIN Policy Section resources, coordinate with the other IRS business operating divisions to identify additional resources to assist with ensuring that on-site compliance reviews of all high-risk CAAs are completed.

Complete a study to determine the feasibility of developing a tool for ITIN applicants, similar to Where’s My Refund?, to check the status of their application.

Review the 5,534 tax returns we identified for which the IRS incorrectly paid retroactive credit claims and take the steps needed to recover the erroneously issued funds.

Review the 2,519 tax returns we identified for which the IRS incorrectly denied retroactive credit claims and take the steps needed to ensure that these taxpayers receive the benefits to which they are entitled.

Review over 150,000 returned billing statements, and resolve any involving identity theft, then refer fraudulent loans to OIG.

We recommend that the California Department of Social Services establish procedures for county agency staff to utilize Medicaid data match reports to verify that court authorizations for psychotropic medications prescribed for children in foster care are documented and maintained.

We recommend that the California Department of Social Services establish procedures for county agency staff to document all medications (including opioid medications) prescribed for children in foster care in CWS/CMS, to the extent allowable under California law.

We recommend that the California Department of Social Services develop and implement procedures for county agency staff to upload the court authorizations for psychotropic medications prescribed for children in foster care into CWS/CMS.

We recommend that the California Department of Social Services coordinate with California Department of Health Care Services to modify the existing data sharing agreement to obtain access to Medicaid claim data for all medications prescribed for children under its care and supervision, to the extent allowable under California law.

Ensure that designated members of a Breach Response Team participate in a tabletop exercise, at least annually.

Require those with specific security and privacy roles to take privacy role-based training.