Open Recommendations

ACL should establish guidance for analysis and reporting of data collected by State Ombudsman programs from facility-initiated discharge notices.

ACL and CMS should coordinate to strengthen safeguards to protect nursing home residents from inappropriate facility-initiated discharges.

ACL and CMS should ensure that all State Ombudsmen, State agencies, and CMS ROs have an ongoing venue to share information about facility-initiated discharges and potentially other systemic problems in nursing homes.

Develop a departmentwide human capital plan or evaluate and revise existing plans to guide the recruitment, retention, and skill development of staff involved in IT acquisitions. The plan should include related metrics to measure plan implementation and effectiveness.

Evaluate IT acquisition process workflows and identify ways to simplify the processes, facilitate more effective stakeholder coordination across offices, and create efficiencies when possible. Status

Establish a centralized acquisition tracking system that allows for input and monitoring by all offices involved with the IT acquisition process by: a. Developing a plan with detailed implementation milestones; b. Obtaining appropriate approvals and funding; and c. Implementing a centralized acquisition tracking system, based on the implementation plan and approvals from 4a and 4b.

Determine and document the conditions or parameters under which the use of remote video to conduct off-site partial compliance evaluations is feasible from a legal, technical, and programmatic perspective.

Finalize the Remote Video Partial Compliance Evaluation workgroup’s standard operating procedures.

Determine whether and how remote video can be used in conjunction with a document review to qualify as a full-compliance evaluation for purposes of the Clean Air Act Stationary Source Compliance Monitoring Strategy and provide instruction to state and local agencies.

We recommend that DHS (Drawbacks) continue to communicate the appropriate retention period to claimants and brokers;

We recommend that DHS (Seized and forfeited property) enhance existing controls, including communicating quality information and training individuals for key roles, to prevent and detect material errors in the seized property footnote.

We recommend that DHS enforce policies and procedures to use reliable data in accrual calculations.

We recommend that DHS implement controls to ensure all necessary journal entries are completely recorded each period.

Implement a postpayment edit process to detect claims submitted by suppliers processed before a beneficiary's notice of election of hospice care is processed in the CWF, and instruct the DME Medicare contractors to deny DMEPOS claims identified by the edit process if they do no have the GW modifier.

Study the feasibility of including palliative items and services not related to a beneficiary's terminal illness and related conditions within the hospice per diem. Such a requirement would eliminate the need for Medicare to make additional payments for these services consistent with CMS's longstanding position that payments for services unrelated to a beneficiary's terminal illness and related conditions should be exceptional, unusual, and rare given the comprehensive nature of the services covered under the Medicare hospice benefit. In analyzing the feasibility of such a change, CMS could consider: (1) beneficiary access to care, (2) administrative costs, (3) appropriate adjustments to…

Rec. 1.a: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness ensure the Defense Civilian Human Resources Management System, when fully implemented, provides human resources officials within the Department the capability to match individual civilian personnel to specific authorized and budgeted positions across all DoD Components in order to assist in identification and closing of skill gaps.

Rec. 1.b.1: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness, in coordination with the Military Departments and DoD Components, identify relevant performance metrics related to hiring a sufficient and well-qualified DoD overseas civilian workforce (such as vacancy/hire/fill rates) that account for unique overseas conditions.

Rec. 1.b.2: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness, in coordination with the Military Departments and DoD Components, incorporate the metrics in relevant human capital planning documents or systems.

Rec. 1.b.3: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness, in coordination with the Military Departments and DoD Components, use the metrics to monitor improvement in the hiring of the overseas civilian workforce.

Rec. 1.c.1: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness, in coordination with the civilian human resources agencies of the Military Departments and DoD Components, capture and disseminate overseas civilian hiring guidance that identifies best practices to allow workforce owners to collect and report data on vacant positions, also known as skills gaps, in a standardized format to support DoD-wide analysis.

Rec. 1.c.2: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness, in coordination with the civilian human resources agencies of the Military Departments and DoD Components, capture and disseminate overseas civilian hiring guidance that identifies best practices to allow workforce owners to supplement the Office of Personnel Management 80-day, end-to-end hiring initiative to account for the additional hiring actions, including the permanent change of station process, needed to onboard employees at overseas locations.

Rec. 1.c.3: The DoD OIG recommended that the Under Secretary of Defense for Personnel and Readiness, in coordination with the civilian human resources agencies of the Military Departments and DoD Components, capture and disseminate overseas civilian hiring guidance that identifies best practices to allow workforce owners to assist human resources officials at overseas locations in developing practical local hiring timelines to minimize the quantity and duration of vacancies among overseas positions and to aid in the transition of duties.

Develop and implement a quality review process at the local Regional Office level that includes review of the data at key points during the case life cycle

Develop and implement a standard methodology for documenting data in the NxGen case file

Enforce the existing policies and procedures, which includes forwarding accounts receivable source documents to the Cincinnati Finance Center, in accordance with the time frame provided in the applicable resource management directives.