Report Summary

Title: Financial Efficiency Review of the VA Boston Healthcare System in Massachusetts
Report Number: 21-03853-174 Download
Issue Date: 7/7/2022
VA Office: Veterans Health Administration (VHA)
Report Author: Office of Audits and Evaluations
Report Type: Financial Inspection
Release Type: Unrestricted

The VA Office of Inspector General (OIG) assessed the VA Boston Healthcare System’s stewardship and oversight of funds in fiscal year (FY) 2021 and identified potential cost efficiencies in carrying out medical center functions. The review team looked at open obligation oversight, purchase card use, inventory and supply management, and pharmacy operations.

From the healthcare system’s 421 open obligations, the team selected 20 totaling $20.6 million and found half were at least 90 days past their end date, most without being reviewed to see if they were still valid and necessary, and two had residual funds totaling approximately $4,439 that should have been released from obligation and used elsewhere to support veterans.

Of 36 purchase card transactions totaling $441,000, the team found 28 lacked evidence to show they were properly approved and that payments were accurate, and 25 were processed by cardholders and approving officials whose duties were not segregated as required. The team also identified 10 purchases that should have been procured through contracting but were intentionally split into multiple transactions to stay below the cardholder’s single purchase limit.

The team found inaccurate entries in the inventory system that caused it to show insufficient amounts of stock on hand in more than 70 percent of tested cases. The inaccuracies result in inefficient purchasing and receiving and could adversely affect patient care.

The healthcare system had a low pharmacy turnover rate, an efficiency measure. In FY 2021, the healthcare system reported a rate of 8.2 compared to the recommended 12. Low inventory turnover rates could indicate an inability to properly forecast needed drug inventories, which could adversely affect patient care.

The OIG made eight recommendations to improve the stewardship of VA resources and address issues that could adversely affect patient care.

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