Open Recommendations

(U) Rec. 1: The DoD OIG recommended that the Secretary of Defense establish policy and procedures for implementing basing actions of a unified combatant command. The policy should include potential internal controls to ensure that basing action decisions are transparent and based on verified data. The policy should direct that a candidate location's ability to achieve "Full Operational Capability" within a specific timeframe or other appropriate measurement be incorporated for all future basing actions.

CMS should ensure that participating States submit accurate quarterly reports.

Update the AHTF Program application guide with the revised performance measures and implement processes to assess the outcome of its AHTF Program performance measures.

Establish procedures to enhance the review process of progress reports to analyze the completeness, accuracy, and success of the AHTF Program.

Rec. 2.b: The DoD OIG recommended that the Director of the Federal Electronic Health Record Modernization Program Office, in coordination with the Director of the Defense Health Agency; Program Executive Director for Electronic Health Record Modernization Integration; and Program Manager for DoD Healthcare Management System Modernization develop and implement a plan for migrating legacy patient health care information needed for a patient's complete electronic health record once the Federal Electronic Health Record Modernization Program Office determines the health care data domains of patient health care information that constitutes a complete patient electronic health record.

Rec. 2.c: The DoD OIG recommended that the Director of the Federal Electronic Health Record Modernization Program Office, in coordination with the Director of the Defense Health Agency; Program Executive Director for Electronic Health Record Modernization Integration; and Program Manager for DoD Healthcare Management System Modernization develop and implement a plan for creating interfaces that would allow medical devices to connect and transfer patient health care information to Cerner Millennium.

Rec. 2.d: The DoD OIG recommended that the Director of the Federal Electronic Health Record Modernization Program Office, in coordination with the Director of the Defense Health Agency; Program Executive Director for Electronic Health Record Modernization Integration; and Program Manager for DoD Healthcare Management System Modernization develop and implement a plan to modify Cerner Millennium user roles to ensure users are granted access to only the patient health care information necessary to perform their job responsibilities.

CMS should update and broaden its lists of hospital-acquired conditions to capture common, preventable, and high-cost harm events.

CMS should explore expanding the use of patient safety metrics in pilots and demonstrations for health care payment and service delivery, as appropriate.

CMS should develop and release interpretive guidance to surveyors for assessing hospital compliance with requirements to track and monitor patient harm events.

AHRQ should, with support from HHS leadership, coordinate agency efforts to update agency-specific Quality Strategic Plans.

AHRQ should optimize use of the Quality and Safety Review System (QSRS), including assessing the feasibility of automating data capture for national measurement and to facilitate local use.

AHRQ should develop an effective model to disseminate information on national clinical practice guidelines or best practices to improve patient safety.

AHRQ should continue efforts to identify and develop new strategies to prevent common patient harm events in hospitals.

Record death information on the Numident, as appropriate, for the 40 deceased beneficiaries in our sample.

Take action, as appropriate, to record death information in the Numident for the 15,714 beneficiaries identified by our current audit.

Take appropriate action to record death information to the Numident for the 595,514 beneficiaries identified by our prior audits.

Working with the Office of the Secretary and “group of four” oversight entities as appropriate, identify and implement changes to thereview and dissemination process for I&A’s election-related intelligence products to ensure they are in accordance with applicable policies andguidelines.

We recommend that the FWS work with the Department to require the electronic system for volunteer work to limit the number of hours that can be claimed on a specific day to ensure hours are reported daily.

We recommend that the FWS work with the Department to update policies and procedures to include guidance for daily entry of hours.

We recommend that the FWS work with the Department to develop and implement training for supervisors and volunteers to ensure proper documentation and approval of volunteer time.

(U) Rec. 1: The DoD OIG recommended that the Under Secretary of Defense for Research and Engineering update the Joint Federated Assurance Center Charter and the Joint Federated Assurance Center Concept of Operations and develop a process to prioritize the quantifiable assurance method efforts of the supporting DoD laboratories.

We recommend CBP and CWMD key stakeholders develop an agreed to support plan to monitor and sustain RPM systems that includes: • An assessment of RPM panel condition; and • Operational Analysis to assess RPM system performance and operations to identify evolving requirements and future capability needs, and changes to sustainment approach.

Use a system-approach that complies with Public Law 116-92, EEO MD-715, and 29 CFR 1614.

Review and evaluate current processes, procedures, and practices, make revisions, and implement guidance to improve efficiencies associated with obtaining contract award for conducting investigations and drafting final agency decisions.

Develop and implement processes and procedures to ensure the contractors adhere to the Statement of Work for Equal Employment Opportunity services, to include, but not limited to (1) completing investigations timely, (2) submitting authorizations for extensions, if necessary, and (3) submitting weekly status reports; and where applicable enforce any associated penalties for delays.

Define and formalize the roles and responsibilities of the Office of General Counsel in the processing of discrimination complaints. Specifically, implement policies and procedures to demonstrate the agency has a fair and impartial Equal Employment Opportunity process, to include but not limited to, ensuring: a clear separation between the agency’s Equal Employment Opportunity complaint program and its defensive function, and the agency representative does not intrude or have the appearance of intruding upon Equal Employment Opportunity counseling, investigations, and final agency decisions.

Establish and implement procedures to ensure agency responses submitted to Equal Employment Opportunity Commission in its EEO MD-715 submissions are accurate, complete, and supported by documentation.

Develop and implement controls to ensure standard operating procedures are kept up to date to reflect subsequent organizational, policy, or procedural changes that can affect processing of discrimination complaints.

Ensure the continuity of operations plan is tested annually, as required by Federal Continuity Directive 1.

(U) Rec. 1.a: The DoD OIG recommended that the Under Secretary of Defense (Acquisition and Sustainment) review and identify DoD issuances related to forecasting logistics demand for campaign planning.

(U) Rec. 1.b.i: The DoD OIG recommended that the Under Secretary of Defense (Acquisition and Sustainment), by no later than the next periodic review process, identify and recommend updates to the DoD issuances identified in Recommendation 1.a. or the creation of new issuances to assign roles and responsibilities across the Joint Logistics Enterprise. At a minimum, the recommended updates should establish a DoD wide executive agent or management action group to track and monitor ongoing development and implementation of interoperable systems and tools (as defined in DoD Instruction 8330.01) for forecasting logistics demand across the Joint Logistics Enterprise, with the…

(U) Rec. 1.b.ii: The DoD OIG recommended that the Under Secretary of Defense (Acquisition and Sustainment), by no later than the next periodic review process, identify and recommend updates to the DoD issuances identified in Recommendation 1.a. or the creation of new issuances to assign roles and responsibilities across the Joint Logistics Enterprise. At a minimum, the recommended updates should task existing logistics executive agents and offices of primary responsibility with coordinating and standardizing Joint Logistics Enterprise data, planning factors, tools, and logistics support area processes within their areas of responsibility.

(U) Rec. 1.b.iii: The DoD OIG recommended that the Under Secretary of Defense (Acquisition and Sustainment), by no later than the next periodic review process, identify and recommend updates to the DoD issuances identified in Recommendation 1.a. or the creation of new issuances to assign roles and responsibilities across the Joint Logistics Enterprise. At a minimum, the recommended updates should assign new executive agents and offices of primary responsibility to coordinate and standardize data, planning factors, tools, and logistics support area processes for areas within the Joint Logistics Enterprise that do not currently have an executive agent or office of…

CMS should Issue new guidance on the appropriate use of MAO clinical criteria in medical necessity reviews.

CMS should Update its audit protocols to address the issues identified in this report, such as MAO use of clinical criteria, and/or examine particular service types.

CMS should direct MAOs to take additional steps to identify and address vulnerabilities that can lead to manual review errors and system errors.

Establish a grievance tracking system to ensure timely responses to all detainee grievances filed at South Texas, with a completegrievance log.

Ensure compliance with segregation standards, including the use of restraints, access to recreation, legal calls, laundry services forbedding and clothing, mail, legal materials, and the law library.

The executive director of the Electronic Health Record Modernization Program Management Office complies with internal guidance and ensures the development of an integrated master schedule for the Electronic Health Record Modernization program that complies with standards adopted from GAO for scheduling.

The executive director of the Electronic Health Record Modernization Program Management Office takes action to improve stakeholder coordination in the development of the program schedules to ensure activities from all relevant VA entities are included.

The executive director of the Electronic Health Record Modernization Program Management Office develops procedures for when and how staff should perform an initial schedule risk analysis for the program and conduct periodic updates as needed.

The executive director of the Electronic Health Record Modernization Program Management Office ensures consistency between contract language and program office plans or other guidance identifying the entity or individuals responsible for developing and maintaining the program’s work breakdown structure and integrated master schedule.

Update NARA 1572, Preventing Theft and Vandalism of NARA Holdings in NARA Facilities, and its Supplement(s) to include documented procedures that include simplified reporting of internal incidents of loss, theft, or damage of NARA holdings.

We recommend that the Massachusetts Executive Office of Health and Human Services, Office of Medicaid continue to coordinate with DDS and DPPC to ensure that all reasonable suspicions of abuse and neglect are properly identified, reported, and investigated as needed.

We recommend that the Massachusetts Executive Office of Health and Human Services, Office of Medicaid require periodic training for DDS and group home staff on reporting reasonable suspicions of abuse and neglect.

HHS OCIO work with all OpDivs to ensure that: All systems on the network have a valid ATO. OpDivs should ensure that security authorization policies and procedures are fully developed and disseminated to the appropriate personnel to ensure that all OpDiv personnel understand the requirements for completing the ATO process.

HHS OCIO work with all OpDivs to ensure that: ISCM strategy and procedures should clearly define critical reporting metrics for reports utilized by internal and external stakeholders. Additionally, OpDivs should coordinate reporting efforts with the OCIO to ensure the definitions and reporting requirements are consistently implemented.

Continue implementation of an automated CDM solution that provides a centralized, enterprise-wide view of risks across all of HHS.

Update the ISCM strategy to include a more specific roadmap; including target dates, for ISCM deployment across the HHS enterprise.