5 New VAOIG Reviews

Combined Assessment Program Review of the Samuel S. Stratton VA Medical Center Albany, New York 06/03/09. The purpose of the review was to evaluate selected operations, focusing on patient care administration and quality management (QM). During the review, we provided fraud and integrity awareness training to 199 employees. The review covered eight operational activities. The medical center complied with selected standards in the following two activities (1) contracted/agency registered nurses and (2) survey of healthcare experiences of patients. We identified early suicide risk detection, a new employee orientation initiative, and Schwartz Center rounds as organizational strengths. We made recommendations for improvement in the following six activities: QM program. Emergency/urgent care operations. Coordination of care. Environment of care. Suicide prevention program. Medication management. VAOIG

Combined Assessment Program Review of the VA Illiana Health Care System Danville, Illinois 06/03/09. The purpose of the review was to evaluate selected operations, focusing on patient care administration and quality management (QM). During the review, we provided fraud and integrity awareness training to 403 employees. The review covered seven operational activities. The system complied with selected standards in the following two activities (1) medication management, and (2) survey of healthcare experiences of patients. We identified the system’s recognition by the National Center for Patient Safety as an organizational strength. We made recommendations for improvement in the following five activities: QM program. Environment of care. Coordination of care. Emergency/urgent care operations. Suicide prevention program. VAOIG

Healthcare Inspection Alleged Mismanagement of the Fee Basis Program VA Connecticut Healthcare System, West Haven, Connecticut 06/03/09. The purpose of this inspection was to determine the validity of allegations regarding the mismanagement of the Fee Basis Program at the VA Connecticut Healthcare System (the system). We substantiated that the pre-authorization process for fee-based care was flawed. However, managers initiated new procedures to improve the process prior to the inspection. We did not substantiate that VA physicians self-referred VA patients through the affiliate hospital or benefited financially from fee basis claims paid to the affiliate hospital. We did not substantiate that the system inappropriately utilized the affiliate hospital as a sole source referral center. However, we concluded there was a lack of oversight of the Fee Basis Program and the absence of formal agreements contributed to the appearance of conflict of interest and may have resulted in the overpayments for care to the affiliate hospital. We recommended improved oversight of the program, an assessment of services paid through the program to determine if formal agreements should be considered, regular audits of fee basis claims, and enhanced physician training on VA regulations governing conflict of interest. VAOIG

Combined Assessment Program Review of the Charles George VA Medical Center Asheville, North Carolina 06/02/09. The purpose of the review was to evaluate selected operations, focusing on patient care administration and quality management (QM). During the review, we also provided fraud and integrity awareness briefings to 319 employees. This review focused on eight operational activities. The medical center complied with selected standards in the following four activities: (1) contracted/agency registered nurses, (2) coordination of care, (3) suicide prevention program, and (4) survey of healthcare experiences of patients. We made recommendations for improvements in the following four activities: QM. Environment of care. Emergency/urgent care operations. Medication management. VAOIG

Combined Assessment Program Review of the G. V. (Sonny) Montgomery VA Medical Center Jackson, Mississippi 06/02/09. The purpose of the review was to evaluate selected operations, focusing on patient care administration and quality management (QM). During the review, we provided fraud and integrity awareness training to 252 medical center employees. The review covered eight operational activities. The medical center complied with selected standards in the following four activities: (1) contract/agency registered nurses, (2) coordination of care, (3) emergency/urgent care operations, and (4) patient satisfaction. We identified the patient safety program as an organizational strength. We made recommendations for improvement in the following four activities: Suicide prevention program. Environment of care. QM. Medication management. VAOIG