Open Recommendations

We recommend that the Iowa Department of Human Services, Iowa Medicaid Enterprise work with CMS to develop standardized life safety training for nursing home staff, conduct more frequent surveys at nursing homes that have a history of multiple high-risk deficiencies, (212-909-10-02) and require nursing homes and inspection contractors to (1) tag systems that are critical to the health and safety of nursing home residents when they have found that these systems may not work as required when needed and (2) notify the State agency. (074-348-10-02)

We recommend that the Iowa Department of Human Services, Iowa Medicaid Enterprise conduct more frequent surveys at nursing homes that have a history of multiple high-risk deficiencies,

We recommend that the Iowa Department of Human Services, Iowa Medicaid Enterprise require nursing homes and inspection contractors to (1) tag systems that are critical to the health and safety of nursing home residents when they have found that these systems may not work as required when needed and (2) notify the State agency.

The Under Secretary for Health ensures a review of policies related to the role and training requirements of chaperones for sensitive examinations and takes action as appropriate.

Determine the allowability of the questioned transactions and recover $5,130,999, if applicable.

Establish a formal process to capture and track data related to wildland fire activities to ensure completion of all preparedness activities and mitigation efforts.

Ensure oversight activities related to wildland fire management such as review and approval of the contractor's Wildland Fire and Health Plan, performance of formal assessments, and verification of mitigation efforts through operational awareness

We recommend the U.S. Border Patrol Chief and Office of Field Operations Executive Assistant Commissioner ensure the Canine Program has enough certified canine instructors and adequate training aids to provide proficiency training for canines after they are deployed. This should include:• implementing a process to ensure sufficient staff are available to provideall training needs to U.S. Border Patrol and the Office of Field Operationscanine teams; and• creating a systemic schedule and plan for pseudo and actual narcoticreplacement for every U.S. Border Patrol sector and Office of FieldOperations field office within the time recommended by the Laboratoriesand Scientific Services Directorate. (See…

We recommend the Executive Director of the Laboratories and Scientific Services Directorate conduct a study to determine the appropriate time for replacement of pseudo and actual narcotics to limit the constant expiration of these training aids. Pseudo and actual narcotic replacement cycles should be updated according to the results of the Laboratories and Scientific Services Directorate study.

We recommend the U.S. Border Patrol Associate Chief of Law Enforcement Operations and Office of Field Operations Director of Tactical Operations update the Canine Program policies to provide adequate oversight to ensure program needs are being met. The policies should include:• record retention timelines for all training documents to beconsistent with the CBP Records General Schedule or provideadequate documentation on retention policies after consultationwith record retention personnel to determine the appropriateapproach;• a systematic schedule and plan for pseudo and actual narcotictraining aids (see Recommendation 2.); and• development of standard operating policies, procedures, andquality assurance measures for use of the Canine…

We recommend the DHS Chief Procurement Officer improve its written procedures to ensure only those contracts awarded through other than full and open competition are included in the required report.

We recommend the DHS Chief Financial Officer, with advice from the Office of General Counsel, develop written procedures for generating the required report to sufficiently identify, review, and validate noncompetitive grant award information

OIG recommends that the Bureau of Diplomatic Security, in coordination with the Bureau of Administration, (a) update any bureau-specific motor vehicle procedures in place to comply with the Foreign Affairs Manual and Bureau of Administration guidance within 90 days of final report issuance; and (b) establish a process to review and update these procedures, as appropriate, at least annually thereafter.

We recommend the DHS Chief Information Officer coordinate with CBP and USCIS to establish a process for reliable interchange of information between data systems used to process and track aliens in the PACR and HARP programs.

We recommend that the Louisiana Department of Health promptly provide notice and cancel the eligibility of beneficiaries identified with income over the allowable limit.

We recommend that the California Department of Health Care Services ensure that the selected provider complies with Federal and State requirements for providing and claiming reimbursement for OTP services.

We recommend that the California Department of Health Care Services verify that the selected provider implements corrective action plans that were approved by the State agency.

We recommend that the California Department of Health Care Services work with the selected provider to improve the quality of care provided to beneficiaries by correcting deficiencies.

Develop, implement, and formally communicate a process to ensure review of all proposed Information Sharing Access Agreements involving personally identifiable information.

We recommend that the Choctaw Nation of Oklahoma strengthen policies and procedures by clarifying responsibilities between and within Tribal departments for the review and approval of costs submitted on contractor invoices.

Resolve the $412,363 in questioned subaward costs and direct UF to repay or otherwise remove the sustained questioned costs from its NSF awards.

Resolve the $47,226 in questioned participant support, travel, and publication expenses for which UF has not agreed to reimburse NSF and direct UF to repay or otherwise remove the sustained questioned costs from its NSF awards.

Direct UF to provide documentation that it has repaid or otherwise credited the $66,590 of questioned participant support, travel, other direct, and indirect costs for which it has agreed to reimburse NSF.

Resolve the $83,227 in questioned supplies, software, severance and publication costs for which UF has not agreed to reimburse NSF and direct UF to repay or otherwise remove the sustained questioned costs from its NSF awards.

Direct UF to provide documentation that it has repaid or otherwise credited the $29,600 in questioned lab supplies, materials, travel costs, and tuition fees for which it has agreed to reimburse NSF.

Direct UF to provide documentation that it has repaid or otherwise credited the $1,717 of questioned graduate student stipend costs for which it has agreed to reimburse NSF.

We recommend that the Centers for Medicare & Medicaid Services review the list of 100 error-prone providers identified in this audit and take specific action as appropriate, such as prior authorization, prepayment reviews, and postpayment review.

We recommend that the Centers for Medicare & Medicaid Services use annual CERT data to identify individual providers that have an increased risk of receiving improper payments and apply additional program integrity tools to these providers.

Update the I-9 Guide to include minimum elements ICE officials must document in case files to justify fine reductions.

Conduct an assessment of the IMAGE program to determine whether implementation of other approaches would aid in achieving its outreach goal and be cost effective, or if funds should be put to better use.

Establish guidance and procedures for U.S. Marshals Service staff to follow in working with the Department of Health and Human Services' Office of Refugee Resettlement case workers to facilitate communication between family unit adults separated from associated family unit minors, especially parents in U.S. Marshals Service custody and their children in Office of Refugee Resettlement custody.

Work with the Department of Health and Human Services' Office of Refugee Resettlement and the Department of Homeland Security to develop a formal interagency agreement (such as a memorandum of understanding) regarding the facilitation of communication between separated children in Office of Refugee Resettlement custody and their parents in U.S. Marshals Service custody.

Work with the Department of Health and Human Services' Office of Refugee Resettlement and the Department of Homeland Security to develop a formal interagency agreement (such as a memorandum of understanding) regarding the facilitation of communication between separated children in Office of Refugee Resettlement custody and their parents in U.S. Marshals Service custody.

Recommendation is not publicly available.

Recommendation is not publicly available.

Recommendation is not publicly available.

Review the loans identified as potentially ineligible to determine if the businesses met eligibility requirements. If not, take appropriate action related to loan guaranty and forgiveness.

USAID's Chief Information Officer should collaborate with the Office of Human Capital and Talent Management to document and implement a process to verify that separated employees' accounts are disabled in a timely manner in accordance with Agency policy.

USAID's Chief Human Capital Officer should implement a process to maintain records electronically for onboarding and off boarding staff.

Provide documentation to support that program activities within NHSLA's interfund were for eligible NSP2 activities or repay the program $3,425,679 from non-Federal funds.

Return the outstanding balance of $529,745 owed to NSP2. In addition, cease the practice of depositing NSP2 funds in non-NSP2 accounts and making them available to be used or borrowed for non-NSP2 activities.

Provide documentation to support that $658,261 in loan proceeds was used for an eligible NSP2 activity or property or repay the program from non-Federal funds.

Provide documentation to support that $500,000 in NSP funds transferred to the revolving loan fund was used for an eligible NSP2 activity or property or repay the program from non-Federal funds.

Amend the NSP2 action plan to include its revolving loan fund.

Adjust program income calculation methodology to ensure it is in accordance with HUD requirements.

Submit overdue NSP2 quarterly reports to DRGR and update prior reports that did not accurately report program income activity.

Provide adequate documentation to support its administrative and project delivery cost expenditures or repay the program $1,388,545 from non-Federal funds.

Provide supporting documentation to show whether the outstanding liability of $324,478 is correctly classified as an NSP2 liability. If not, HUD should ensure that NHSLA corrects its NSP2 cost reimbursement summary for the 12 months ending June 30, 2018, to reclassify the expenses to a non-NSP2 program. Such funds would be considered funds to be put to better use.

Obtain training to ensure that it understands NSP2 regulations and requirements related to payroll allocation for its administrative and project delivery costs and program income calculation methodology to ensure it properly computes the amount it is allowed to charge for administrative costs.

Support the reasonableness of the South Gate contract or repay NSP2 $856,692 from non-Federal funds.