Recommendations Tracker

CMS should reassess nurse aide training and certification requirements .

CMS should provide effective guidance and assistance to nursing homes on how to comply with updated infection control requirements.

We recommend that MediGold identify, for the high-risk diagnoses included in this report, similar instances of noncompliance that occurred before and after our audit period and refund any resulting overpayments to the Federal Government.

ACF should develop a reference guide to help case managers better evaluate sponsors' identity.

ACF should provide additional guidance for case managers on when to consider recommending discretionary home studies.

ACF should develop an effective monitoring mechanism to identify children who do not receive timely followup calls after their release to sponsors.

Brown & Company recommends that the NIH conduct a system-level risk assessment for the SRA in accordance with NIST SP 800-53 requirements and NIH polices.

We recommend that the Colorado Department of Health Care Policy & Financing work with CMS to develop a risk-based approach to identify nursing homes at which surveys would be conducted more frequently than once every 15 months, such as those with a history of multiple high-risk deficiencies or frequent management turnover.

We recommend that the Choctaw Nation request and review agency contractor background investigations that comply with the ICPFVPA, including documentation that confirms HHS employees met all background investigation requirements of the ICPFVPA, or perform background investigations on these individuals that comply with the ICPFVPA.

We recommend that the Cherokee Nation perform background investigations, as required by the ICPFVPA, on the employees and volunteers we identified as not having complete background investigations who currently have contact with Indian children and determine whether these individuals meet the required minimum character standards.

We recommend that the Cherokee Nation request and review agency contractor background investigations that comply with the ICPFVPA, including documentation that confirms HHS employees met all background investigation requirements of the ICPFVPA, or perform background investigations on these individuals that comply with the ICPFVPA.

We recommend that the Indian Health Service enhance Single Audit Compliance Supplement, part 4: "Agency Program Requirements," for Tribes receiving ISDEAA funds from IHS by: establishing special tests and audit procedures in the annual Single Audit Compliance Supplement for all its ISDEAA programs to ensure that the ICPFVPA's requirements are tested during a review of a Tribal health program as part of the single audit, and reviewing the results of those special tests and audit procedures in the annual single audits for Tribal health programs to help assess whether Tribes are complying with ICPFVPA requirements to conduct background investigations and meet minimum standards of character.

We recommend that the Indian Health Service provide Tribes with documentation that confirms that current HHS employees assigned to Tribal health programs met all background investigation requirements of the ICPFVPA.

CDC should take further steps to ensure the quality of nursing home reporting of COVID-19 data to NHSN.

We recommend that the Oklahoma State Department of Health follow up with the 20 nursing homes reviewed in this audit that demonstrated life safety, emergency preparedness, and infection control deficiencies to ensure that they have taken corrective actions and work with CMS to develop an approach to identify nursing homes where surveys should be conducted more frequently than once every 15 months, such as those with a history of multiple deficiencies or frequent management turnover.

We recommend that Cahaba Safeguard Administrators, LLC, develop quality assurance procedures, to include improved policies and procedures, to ensure that going forward, it calculates Medicare segment pension assets in accordance with Federal requirements.

We recommend that the Ohio Department of Health work with CMS to develop a risk-based approach to identify nursing homes where surveys should be conducted more frequently than once every 15 months, such as those with a history of multiple high-risk deficiencies or frequent management turnover.

We recommend that the Ohio Department of Health work with CMS to develop standardized life safety training for nursing home staff.

We recommend that the California Department of Social Services coordinate with California Department of Health Care Services to modify the existing data sharing agreement to obtain access to Medicaid claim data for all medications prescribed for children under its care and supervision, to the extent allowable under California law.

We recommend that the California Department of Social Services develop and implement procedures for county agency staff to upload the court authorizations for psychotropic medications prescribed for children in foster care into CWS/CMS.

NIH should use risk to prioritize the issuance of MDLs.

NIH should track the effectiveness of single audit processes and single audits' use.

We recommend that the National Institutes of Health issue management decision letters for the two audit reports that indicated a need for increased monitoring.

We recommend that the National Institutes of Health develop policies and procedures to issue timely management decision letters for foreign grant recipient audit reports, with audit findings, within 6 months of the date HHS accepts the audit report package.

HRSA should expedite audits of provider use of PRF payments.