Department of Veterans Affairs OIG
The VA Office of Inspector General (OIG) reviewed the measures taken by the Veterans Health Administration’s (VHA) Homeless Program Office, medical facilities, and community service providers to mitigate COVID-19 risks in transitional housing programs for veterans experiencing homelessness. The OIG found that while transitional housing service providers successfully implemented four of six specific Centers for Disease Control and Prevention (CDC) COVID-19 risk mitigation measures, the providers could have strengthened implementation of two others. VHA and service provider staff said the Homeless Program Office allowed them the flexibility to isolate vulnerable veterans, facilitate telehealth exams, and coordinate the provision of medical care in the community. Some service providers and VA medical facilities also developed their own best practices for reducing COVID-19 risks. As the pandemic continues, VHA and its service providers will need to sustain their efforts and strengthen measures to minimize COVID-19 exposure among veterans experiencing or at risk for homelessness. Staff at all 14 facilities assessed by the OIG review team made substantial progress on four measures: cleaning frequently with disinfectant, screening veterans for symptoms, creating isolation site plans, and maintaining adequate cleansing and sanitation supplies and personal protective equipment. The OIG found improved communications from the Homeless Program Office to medical facilities helped these efforts. However, several facilities appeared to struggle with the remaining two measures: identifying high-risk veterans and communicating suggested precautions and social distancing. Interviewees expressed concerns about service providers’ ability to maintain enough personal protective equipment for veterans during the prolonged pandemic. Medical facility staff will need to coordinate with service providers to help them develop contingency plans. The OIG made four recommendations to the under secretary for health regarding additional measures VHA could take to strengthen the implementation of CDC guidelines at the service providers’ facilities.
Department of Health & Human Services OIG
We did this review to determine the number and results of onsite State surveys of nursing homes during the COVID-19 pandemic. Nursing home residents are particularly vulnerable to infectious diseases such as COVID-19, and infection control has been a persistent problem for most nursing homes. As of November 8, 2020, more than 67,000 nursing home residents had died of COVID-19-related illnesses, which represented almost 30 percent of all COVID 19 deaths in the United States at that time. Onsite State surveys assess the quality of services in nursing homes, a critical function for protecting residents. CMS changed survey practices in response to the pandemic. These changes—together with nursing home residents' high-risk status and the importance of the State surveys—warrant close examination to assess the sufficiency of this oversight.
Department of Veterans Affairs OIG
Review of Veterans Health Administration’s Emergency Department and Urgent Care Center Operations During the COVID-19 Pandemic
The VA Office of Inspector General (OIG) conducted a review of the Veterans Health Administration’s response to anticipated demand and use of emergency department and urgent care center services when faced with the possibility of an influx of patients needing evaluation during the COVID-19 pandemic. A survey was deployed and 63 emergency department and urgent care center directors were interviewed. The OIG learned there was a decreased number of patient visits to the emergency departments (19.8 percent decline) and to the urgent care centers (28.6 percent decline) for January–June 2020 when compared with the same time frame in 2019. Other issues described by interviewees included a small number of rooms with negative pressure and small waiting rooms that made it difficult to isolate or separate patients with known or suspected COVID-19. Twenty-three emergency department and urgent care center directors reported a loss of staff due to providers testing positive for the virus, transfers, resignations, or retirements. COVID-19 testing was generally available at the selected facilities. Some directors reported a lack of or need to ration certain items of personal protective equipment. Regular communications with leaders that addressed the most recent COVID-19 topics were informative and helpful. Data related to supplies, clinical treatment, COVID-19 epidemiology, and hospital utilization were deemed critical and helpful for decision making. Virtually all respondents stated that they closely monitored staff for signs of fatigue and burnout. Lessons learned included patient and provider COVID-19 education, rethinking how emergency or urgent care can be delivered in a pandemic, and redesigning the day-to-day operations of the work place. The directors also noted the need to preserve the capability to provide emergency or urgent care for non-COVID-19 patients while attending to the special care needs of patients with COVID-19.
Department of the Interior OIG
Department of the Treasury's Office of Inspector General
Department of Education OIG
The objective of our inspection was to assess the U.S. Department of Education’s (Department) plans and procedures for returning employees to the federal office in the wake of the coronavirus pandemic, including what existing guidance the Department considered when developing its plans and procedures. We found that the Department generally incorporated available guidance, which was intended to provide for a safe and gradual return to federal offices, in its Workplace Reconstitution Transition Plan (Reconstitution Plan). However, we noted that the Department’s Reconstitution Plan does not address anti-retaliation as recommended in OSHA guidance. In addition, we found that the Department did not periodically reassess and update self-screening questions as necessary in its Reconstitution Plan as suggested by OMB.
Department of Housing and Urban Development OIG
Interim Audit Memorandum – The HUD Single Family Insurance Operations Division Should Take Additional Action To Inform Homeowners of Changes to Its FHA Refund Process Resulting From the COVID-19 Pandemic
We audited the U.S. Department of Housing and Urban Development’s (HUD) response to COVID-19 to determine if it appropriately, effectively, and efficiently tracked, monitored, and issued Federal Housing Administration (FHA) refunds owed to homeowners with terminated loans. During our field work, the Coronavirus 2019 (COVID-19) pandemic began and as a result, we developed a second, more urgent audit objective to determine how COVID-19 has affected policies, procedures, and distribution of FHA refunds and whether HUD’s response was appropriate. We determined that COVID-19 generally did not affect the Single Family Insurance Operations Division’s (SFIOD) FHA refund policies and procedures; however, SFIOD did not fully notify homeowners of operational changes to its physical mail procedures, which potentially impacted its distribution of refunds. We issued this interim report to ensure HUD was made aware of the issues identified during our review and could act in a timely manner to address them. The audit prompted HUD to take immediate corrective action for all three recommendations, one of which will be closed concurrently with the issuance of this memorandum and two that will be completed during audit resolution.
Small Business Administration OIG