Open Recommendations

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.

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

We recommend MSAC establish controls to ensure its Federal financial reporting procedures are followed.

We recommend MSAC document and implement payroll reconciliation procedures that verify recorded payroll costs are accurate and supported (2 CFR 200.430(g)(1)(i)).

We recommend MSAC establish controls to ensure its payroll reconciliation procedures are followed.

We recommend MSAC establish document retention controls that ensure its policy is followed.

We recommend MSAC establish and implement Federal financial reporting controls that ensure honorifics are excluded from
all costs included in award financial reports (General Terms 13).

We recommend MSAC document and implement procedures that ensure prompt and accurate compliance with
Federal Financial Accountability and Transparency Act requirements (2 CFR 170, Appendix A).

We recommend MSAC establish controls that ensure its Federal Financial Accountability and Transparency Act procedures are followed.

We recommend MSAC establish and implement controls that ensure Federal and Arts Endowment subawarding notification (2 CFR 200.332(b), General Terms 1 & 22), cost allowability (General Terms 13 & 2 CFR 200 Subpart E), and acknowledgment requirements (General Terms 3) are included in its grant contract documents.

We recommend MSAC strengthen its controls over subaward closeout to ensure all subawards are closed
before submitting the Federal financial report (General Terms 23).

We recommend MSAC establish procedures to evaluate and monitor its compliance with Federal and Arts
Endowment award requirements (2 CFR 200.303(c)).

We recommend MSAC establish controls that ensure compliance evaluations are conducted and gaps are
addressed (2 CFR 200.303(a)).

We recommend the NEA disallow $674,750 in unsupported Federal financial report costs from the 2019 Award.

We recommend the NEA disallow $16,761 of unsupported payroll costs - $4,507 from the 2020 Award; $7,281 from the 2021 Award; and $4,973 from the 2022 Award.

We recommend the NEA disallow $105,000 in honorifics from reported costs- $10,000 from the 2019 Award, $20,000 from the 2020 Award, $15,000 from the 2021 Award, and $60,000 from the 2022 Award.

We recommend the NEA disallow $194,315 in questioned or unallowable subrecipient costs - $41,211 from the 2019 Award FFR; $42,348 from the 2020 Award FFR; $76,387 from the 2021 Award FFR; and $34,369 from the 2022 Award FFR.

We recommend the NEA disallow the $50,000 unallowable ARP cost from the 2020 Award.

We recommend the NEA determine whether a refund is due for costs questioned in recommendation NEA 5.