Open Recommendations

Establish enhanced internal controls to ensure compliance with the law on recruitment, relocation, and retention incentives and take appropriate action when an employee with an active service obligation transfers within the Veterans Health Administration.

Complete the evaluation of the incentives awarded to the employees identified in this report who may not have fulfilled their service obligations, determine whether a debt was incurred, and take any appropriate action.

Establish procedures to monitor compliance with FLRA’s Alternative Work Schedules policy.

Provide training to all employees (which includes supervisors) on all available alternative work schedules. This training should be provided to all new employees during employee orientation and to all employees whenever significant changes to the policy occur.

Modify the FLRA Policy No. 3640.2 Work Schedule Selection Form to the correct flexible schedule options that employees may choose.

We recommend the Vice President, Power Supply and Fuels, determine if impacts from program implementation and adoption challenges have been incorporated in future goals.

Implement a process to thoroughly review the journal entry and supporting documentation used to record and calculate imputed cost, respectively, to ensure that the cost is accurately recorded in the general ledger.

Take appropriate action to award retirement benefits to the 35 claimants identified in our audit.

To prevent future errors, establish controls to ensure employees request and document evidence of lag earnings when claimants allege such earnings.

To prevent future errors, establish controls to ensure employees review prior retirement claims for claimants who may be entitled to additional benefits based on prior claims.

The Marion VA Health Care System Director ensures primary care nursing staff’s adherence to facility fall prevention policy and monitors compliance.

The Marion VA Health Care System Director evaluates the facility fall prevention policy to consider expectations for mental health staff’s role in responding to patient reports of falls at home.

The Marion VA Health Care System Director ensures compliance with the primary care program facility policy concerning specialty consultation staff’s communication with a patient’s primary care provider regarding patient concerns.

The Marion VA Health Care System Director ensures compliance with the facility patient problem list standard operating procedure.

The Marion VA Health Care System Director strengthens processes to ensure compliance with Veterans Health Administration timeliness standards for obtaining and scanning community care records.

The Marion VA Health Care System Director reviews facility care coordination practices between primary care providers and community care providers, identifies barriers to sharing patient treatment information to inform clinical decision-making, and takes action as warranted.

The Marion VA Health Care System Director ensures community care staff adhere to requirements regarding completion of community care-care coordination plan notes and monitors compliance.

The Marion VA Health Care System Director conducts a review of the facility primary care scheduling processes to ensure compliance with Veterans Health Administration and facility policy on care coordination within Patient Aligned Care Teams.

The Marion VA Health Care System Director ensures suicide prevention staff document high-risk flag inactivation within patients’ electronic health records and notify patients when a high-risk flag is activated or inactivated as required by the Veterans Health Administration, and monitors compliance.

The Marion VA Health Care System Director ensures mental health staff adhere to Veterans Health Administration requirements on safety planning during high risk for suicide patient record flag patient contacts.

Develop a plan to timely execute IRDTS use for all programs subject to spot-check and program review, to improve the process of using spot check review results, enhance program accountability and integrity, and reduce payment errors.

Establish a process to regularly use data collected from the spot check reviews for each of its programs that rely on self-certification to identify actions it must take to improve the payment process and reduce payment inaccuracy.

Review the more than $16.4 million in questioned costs identified in one State for ECP payments made from August 2023 through May 2025. As appropriate, recover any costs determined to be unallowable due to violation of agency policy or make additional payments for identified underpayments.

Ensure the applicable State rescinds its guidance that contradicts national guidance.

Ensure that the updated OMB Circular A-136 is utilized when preparing and reviewing the financial statements and footnote disclosures.