VAOIG Inspections of Community Based Outpatient Clinics From Lockport and Olean, NY Monaca and Washington, PA Berwick and Sayre, PA Somerset, KY

Healthcare Inspection Community Based Outpatient Clinic Reviews Lockport and Olean, NY Monaca and Washington, PA Berwick and Sayre, PA Somerset, KY 09/23/09. The VA Office of Inspector General reviewed seven Community Based Outpatient Clinics (CBOCs) the week of July 13–17, 2009. The CBOCs reviewed in VISN 2 were Lockport and Olean, NY; in VISN 4, Monaca and Washington, PA; and Berwick and Sayre, PA; and, in VISN 9, Somerset KY. The parent facilities of these CBOCs are VA Western NY Healthcare System (HCS), VA Pittsburgh HCS, Wilkes-Barre VA Medical Center (VAMC), and Lexington VAMC, respectively. The purpose of the review was to assess whether CBOCs are operated in a manner that provides veterans with consistent, safe, high-quality health care. The review covered five areas: quality of care measures, credentialing and privileging, environment of care and emergency management, patient satisfaction, and CBOC contracts. We noted several opportunities for improvement and made the following recommendations to VISN and facility management: Require that contract providers are privileged according to VHA policy. Accomplish providers’ background checks according to VHA policy. Require physician assistants are consistently monitored and evaluated by the collaborative physician and that results of the evaluations are used during the re-credentialing process. Ensure clinical competencies are monitored by the appropriate discipline. Ensure staff are trained and evaluated, and that their competencies are documented. Conduct a security risk assessment and evaluate the assessment to determine appropriate measures. Implement appropriate measures as described in the vulnerability review. Maintain patients’ auditory privacy during their check-in process. Take appropriate actions to secure and protect health records. Provide proper CBOC access to disabled patients. Adhere to manufacturer’s equipment maintenance requirements. Ensure pharmaceuticals are dispensed according to VHA policy. Properly reprocess reusable medical equipment. Develop and maintain an emergency management plan that includes emergency response to all mental health emergencies and reflects current practices. Recover overcharges from the contractor and ensure that future invoices are verified for compliance with contract provisions. Ensure information is accurate and complete on contractor billings. Formalize the contractual agreement with the contractor regarding the “Point of Care” addendum. VAOIG