Open Recommendations

We recommend that Crow/Northern Cheyenne Hospital, Billings Area Office, and Indian Health Service Headquarters work together to determine which staff members in contact with Indian children currently have a pending background investigation and take immediate action to ensure that there is adequate documented evidence that these staff members meet IHS sight and supervision requirements when children are in their care.

We recommend that Crow/Northern Cheyenne Hospital, Billings Area Office, and Indian Health Service Headquarters work together to update standard operating procedures for provisional staff supervision to address the deficiencies we identified in this report.

We recommend that Crow/Northern Cheyenne Hospital, Billings Area Office, and Indian Health Service Headquarters work together to establish a monitoring system to ensure that the Hospital meets sight and supervision requirements for staff with pending background investigations and documents that they are met.

Examine its domain assessment process - including the Top 100 Initiative and recall inspection activities - and refine its strategies for identifying and tracking risks, deploying resources, and accomplishing goals.

Implement a process to conduct ongoing formal, data-based, comprehensive reviews of inspections results to ensure consistent application of the standards and assist ATF in reaching its inspection program goals of reducing the possibility of firearms being diverted from legal commerce and maintaining the traceability of firearms.

Adopt mechanisms to improve the accuracy of its information-sharing data and the completeness of its information about the outcomes of internal and external referrals and use this information to better assess the value and effectiveness of its information sharing practices, with the goal of providing enhanced oversight of FFLs.

Refine the CGIC performance review process to include sufficient information to allow for an assessment of the outcomes and effectiveness of the CGIC intelligence that is shared with Industry Operations.

Establish a recurring process to assess the risk indicators that contribute to the selection of FFLs for inspection and evaluate the results of the inspections to ensure that field divisions are effectively identifying high-risk FFLs.

The U.S. Mission to the European Union, in coordination with the Bureau of Consular Affairs, should review the need for the Senior Consular Representative position and make adjustments as necessary to meet both U.S. consular policy objectives and Department standards for effective use of resources.

Embassy Beirut, in coordination with the Bureau of Consular Affairs, should implement a plan to mitigate, to the maximum extent practicable, safety risks associated with the area outside the pedestrian gate used by consular customers, in accordance with Department guidelines.

Embassy Beirut, in coordination with the Bureaus of Consular Affairs and Overseas Buildings Operations, should provide protection from the elements for consular applicants, in accordance with Department standards.

Embassy Beirut, in coordination with the Bureau of Overseas Buildings Operations, should bring its fire protection program into compliance with Department standards.

Embassy Beirut, in coordination with the Bureau of Overseas Buildings Operations, should report all unauthorized construction projects and rectify each project in accordance with Department standards.

Embassy Beirut should obtain authorization from the Bureau of Overseas Buildings Operations to use shipping containers for permanent storage or dismantle and remove them in accordance with Department requirements.

Embassy Beirut should bring its contracting officer’s representative program into compliance with Department standards.

Embassy Beirut should enforce driver duty limits for all embassy drivers in accordance with Department guidelines.

Embassy Beirut should require the Beirut Recreation Association Board of Directors to comply with Department standards and its own by-laws regarding its oversight responsibilities.

Embassy Beirut should implement internal controls to ensure government resources are used in accordance with Department standards.

Embassy Beirut should train locally employed information management staff in accordance with Department standards.

Embassy Beirut should perform information systems security officers’ duties in accordance with Department standards.

Embassy Beirut should comply with Department standards for managing its dedicated internet networks.

Embassy Beirut should implement a records management program in accordance with Department standards.

Embassy Beirut, in coordination with the Bureau of Overseas Buildings Operations, should relocate stored items to climate-controlled storage outside the unclassified server room to conform to Department and Occupational Safety and Health Administration standards.

Rec. 1.b: The DoD OIG recommended that the Army Contracting Command-Rock Island Executive Director request a refund from the contractor for any excess payment or arrange for payment to the contractor for any under-billed costs identified by the Defense Contract Audit Agency.

Rec. 1.c: The DoD OIG recommended that the Army Contracting Command-Rock Island Executive Director issue guidance to reinforce the importance of the contracting officer and contracting officer's representative roles and involvement in review of invoices prior to payment.

OIG recommends that the Bureau of Overseas Buildings Operations (OBO), in coordination with the Bureau of Administration, comply with Department of State guidance to address the schedule delay for New Embassy Compound Mexico City, Mexico. Specifically, OBO, in coordination with the Bureau of Administration, must (1) determine the type of delay (excusable, nonexcusable, or compensable), (2) document the delay, (3) develop the government’s position, (4) discuss the government’s position with the contractor, (5) adjust the government’s position based on the discussions with the contractor, and (6) prepare a final decision.

OIG recommends that the Bureau of Overseas Buildings Operations, working collaboratively with Caddell Construction Co, LLC, develop and implement an action plan to ensure the Project Execution Schedule meets all the purposes outlined in Contract Specification 013205, paragraph 1.4 for Contract SAQMMA17C0287, NEC Mexico City, Mexico.

OIG recommends that the Bureau of Overseas Buildings Operations (OBO), in coordination with the Bureau of Administration, evaluate and respond to the Time Impact Analysis (TIA) prepared by the contractor to determine whether a schedule extension was justified for the unilateral modification P00066 to the New Embassy Compound Mexico City, Mexico. In accordance with the Federal Acquisition Regulation and Department of State policy, OBO, in collaboration with the Bureau of Administration, must (1) prepare a prenegotiation memorandum and a findings of fact that include a TIA, (2) issue a decision on the prenegotiation memorandum, (3) proceed with negotiations, including discussion…

OIG recommends that the Bureau of Overseas Buildings Operations (OBO), in coordination with the Bureau of Administration, assess time as part of their independent government cost estimate process and evaluate and respond to the Time Impact Analysis (TIA) prepared by the contractor for all outstanding requests for proposals to the New Embassy Compound Mexico City, Mexico, project when preparing an independent government cost estimate. In accordance with the Federal Acquisition Regulation and Department of State policy, OBO, in collaboration with the Bureau of Administration, must (1) prepare a prenegotiation memorandum and a findings of fact that include TIAs, (2) issue…

Revise Security and Hazardous Materials Safety Order 1600.20 guidance to avoid overlap or contradiction with similar procedures contained in FAA Order 1600.38.

We recommend that the Centers for Medicare & Medicaid Services correct the inaccurately reported deficiencies that we identified for the sampled nursing homes.

We recommend that the Centers for Medicare & Medicaid Services correct existing programming in ASPEN that prevented the 56 emergency preparedness deficiencies from being reported on Care Compare.

We recommend that the Centers for Medicare & Medicaid Services strengthen its processes for reviewing inspection results reported on Care Compare by requiring State survey agencies to verify that deficiencies shown in ASPEN are also shown in CASPER when they are preparing to conduct an inspection.

We recommend that the Centers for Medicare & Medicaid Services strengthen its processes for reviewing inspection results reported on Care Compare by providing technical assistance and additional training to State survey agencies that are not following procedures in the State Operations Manual and ASPEN Central Office Procedures Guide for reporting deficiencies in ASPEN.

We recommend that the Centers for Medicare & Medicaid Services strengthen its processes for reviewing inspection results reported on Care Compare by including in its manual quality assurance check a verification that nursing home inspection results are accurately reported.

We recommend that HumanaChoice refund to the Federal Government the $480,295 of net overpayments.

We recommend that HumanaChoice identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred before or after our audit period and refund any resulting overpayments to the Federal Government.

We recommend that HumanaChoice examine its existing compliance procedures to identify areas where improvements can be made to ensure that diagnosis codes that are at high risk for being miscoded comply with Federal requirements and take the necessary steps to enhance those procedures.

Ensure all cloud-based systems are appropriately authorized by Federal officials,including selection and assessment of all relevant security controls;

Ensure all cloud-based systems are appropriately reported for inclusion in the Department’s cloud inventory.

Submit agency authorizations to the FedRAMP Project Management Office for cloud-based systems that are FedRAMP-authorized

Modify continuous monitoring plans, policies, and procedures to include monitoring results from FedRAMP, where applicable.

Ensure all cloud-based systems are appropriately authorized by Federal officials, including selection and assessment of all relevant security controls;

Ensure all cloud-based systems are appropriately reported for inclusion in the Department’s cloud inventory.

Submit agency authorizations to the FedRAMP Project Management Office for cloud-based systems that are FedRAMP-authorized.

Modify continuous monitoring plans, policies, and procedures to include monitoring results from FedRAMP, where applicable.

AmeriCorps enhance its process of performing enterprise risk management assessments to determine the respective risk posture of its systems to include the entity-wide performance metrics for measuring the effectiveness of its:• Data exfiltration and enhanced network defenses;• Incidence detection and analysis process; and• Incidence handling process. (New)

The Office of Chief Financial Officer develops an automated process to calculate evacuation allowance payments.

Develop an oversight mechanism to retain receipts and monthly reconciliations to ensure record retention. (Finding 1)

Develop an oversight mechanism to hold cardholders and Approving Officials accountable for timely completion and approval of monthly statement reconciliation and consider disciplinary actions for repeat offenders. (Finding 1)