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Reports Issued for Fiscal Year 2008:

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9/15/2008 Combined Assessment Program Review of the Hampton VA Medical Center Hampton, Virginia [08-00916-204] pdf 327 KB
9/11/2008 Combined Assessment Program Review of the VA Northern California Health Care System Sacramento, California  [08-01745-201] pdf 295 KB
9/11/2008 Audit of Veterans Health Administration’s Government Purchase Card Practices [07-02796-203] pdf 417 KB
9/10/2008 Combined Assessment Program Review of the Miami VA Healthcare System Miami, Florida [08-00777-200] pdf 175 KB
9/10/2008 Healthcare Inspection Quality of Care Issues Huntington VA Medical Center Huntington, West Virginia  [07-02599-199] pdf 312 KB
9/9/2008 Healthcare Inspection Alleged Physician Privileging Issues Sioux Falls VA Medical Center Sioux Falls, South Dakota [08-01989-196] 
9/5/2008 Audit of the Impact of the Veterans Benefits Administration's Special Hiring Initiative [08-01559-193] pdf 537 KB
8/28/2008 Healthcare Inspection Human Subjects Protections in One Research Protocol VA Medical Center, Washington, DC [08-02346-191] pdf 356 KB
8/26/2008 Healthcare Inspection Post-Traumatic Stress Disorder Program Issues VA San Diego Healthcare System San Diego, California  [08-01297-187] pdf 215 KB
8/26/2008 Combined Assessment Program Review of the St. Louis VA Medical Center St. Louis, Missouri [08-00400-190] pdf 251 KB
8/14/2008 Healthcare Inspection Quality of Care of Two Deceased West Virginia Veterans [08-01377-185] pdf 222 KB
8/13/2008 Combined Assessment Program Review of the VA Connecticut Healthcare System, West Haven, Connecticut [07-03174-184] pdf 325 KB
8/13/2008 Combined Assessment Program Review of the VA Southern Oregon Rehabilitation Center and Clinics White City, Oregon [08-00988-181] pdf 347 KB
8/12/2008 Healthcare Inspection Oversight of the Community Nursing Home Program VA North Texas Health Care System Dallas, Texas  [07-01922-180] pdf 271 KB
8/6/2008 Healthcare Inspection Human Subjects Protections Violations at the Central Arkansas Veterans Healthcare System Little Rock, Arkansas  [07-03042-182] pdf 393 KB
8/1/2008 Combined Assessment Program Review of the Oklahoma City VA Medical Center, Oklahoma City, Oklahoma [08-01266-176] pdf 213 KB
7/31/2008 Combined Assessment Program Review of the Alaska VA Healthcare System Anchorage, Alaska [08-01459-174] pdf 204 KB
7/31/2008 Healthcare Inspection - Alleged Inpatient Care Issues, Tennessee Valley Healthcare System, Alvin C. York Campus, Murfreesboro, Tennessee [08-01993-177] pdf 251 KB
7/29/2008 Healthcare Inspection - Alleged Research Funding Irregularities at the Central Texas Veterans Health Care System Temple, Texas [08-01105-171] pdf 369 KB
7/29/2008 Healthcare Inspection Out-of-Operating Room Airway Management in Veterans Health Administration Medical Centers [08-01130-173] pdf 317 KB
7/25/2008 Healthcare Inspection Quality of Care Issues, VA Gulf Coast Health Care System, Biloxi, Mississippi [08-01369-172] pdf 320 KB
7/17/2008 Audit of Veterans Benefits Administration Transition Assistance for Operations Enduring and Iraqi Freedom Service Members and Veterans [06-03552-169] pdf 219 KB
7/14/2008 Healthcare Inspection Credentialing and Privileging Issues VA Medical Center Fayetteville, North Carolina [08-01484-168] pdf 245 KB
7/11/2008 Healthcare Inspection Quality of Care, Courtesy, and Communication Issues VA Medical Center St. Louis, Missouri [08-01359-165] pdf 104 KB
7/10/2008 Healthcare Inspection - Emergency Care, Patient Discharges, and Staffing Issues Central Alabama Veterans Health Care System, Tuskegee, Alabama [08-01383-161] pdf 244 KB
7/10/2008 Healthcare Inspection Alleged Medication Overdose and Poor Communication VA Boston Healthcare System Boston, Massachusetts [08-01777-163] pdf 322 KB
7/10/2008 Administrative Investigation Failure to Satisfy Financial Obligations, Battle Creek VAMC  [07-02623-164] 
7/9/2008 Fiscal Year 2007 Federal Information Security Management Act Assessment [07-00608-162] 
7/7/2008 Healthcare Inspection – Staffing, Quality of Care, and Access Issues, Central Alabama Veterans Health Care System, Tuskegee, Alabama [07-03359-156] pdf 315 KB
6/27/2008 Healthcare Inspection Alleged Patient Neglect During a Magnetic Resonance Imaging Exam Michael E. DeBakey VA Medical Center Houston, TX [08-01380-154] pdf 319 KB
6/19/2008 Administrative Investigation - Alleged Conflict of Interest Veterans Benefits Administration, VA Central Office Washington, DC [07-00649-150] 
6/12/2008 Combined Assessment Program Review of the Providence VA Medical Center, Providence, Rhode Island [07-03173-145] pdf 204 KB
6/12/2008 DoD/VA Care Transition Process for Service Members Injured in OIF/OEF [06-02857-127] pdf 1,784 KB
6/11/2008 Healthcare Inspection Clinic Appointment Scheduling Issues VA San Diego Healthcare System San Diego, California [08-01299-144] pdf 88 KB
6/10/2008 Combined Assessment Program Review of the VA Salt Lake City Health Care System Salt Lake City, Utah [08-00819-143] pdf 295 KB
6/4/2008 Review of Enterprise-Wide PC Lease Awarded to Dell Marketing, L.P. [08-02213-138] pdf 370 KB
6/4/2008 Combined Assessment Program Review of the Coatesville VA Medical Center Coatesville, Pennsylvania [08-01089-137] pdf 384 KB
6/3/2008 Healthcare Inspection Colonoscopy Management El Paso VA Health Care System El Paso, Texas [08-00437-135] pdf 210 KB
5/30/2008 Semiannual Report for October 1, 2007 to March 31, 2008 [] pdf 602 KB
5/29/2008 Combined Assessment Program Review of the Battle Creek VA Medical Center Battle Creek, Michigan  [08-00399-131] pdf 309 KB
5/29/2008 Combined Assessment Program Review of the Richard L. Roudebush VA Medical Center Indianapolis, Indiana [08-00401-133] pdf 457 KB
5/29/2008 Combined Assessment Program Review of the Kansas City VA Medical Center Kansas City, Missouri [08-00001-134] pdf 321 KB
5/19/2008 Audit of Alleged Manipulation of Waiting Times in Veterans Integrated Service Network 3 [07-03505-129] pdf 482 KB
5/14/2008 Healthcare Inspection Evaluation of Quality Management in Veterans Health Administration Facilities Fiscal Year 2007 [07-00060-126] pdf 276 KB
5/7/2008 Healthcare Inspection Scopes of Practice for Unlicensed Physicians Engaged in Veterans Health Administration Research [07-01202-124] pdf 237 KB
5/5/2008 Audit of Veterans Health Administration's Oversight of Nonprofit Research and Education Corporations [07-00564-121] pdf 401 KB
5/1/2008 Follow-Up Healthcare Inspection VA's Role in Ensuring Services for Operation Enduring Freedom/Operation Iraqi Freedom Veterans after Traumatic Brain Injury Rehabilitation  [08-01023-119] pdf 584 KB
4/23/2008 Combined Assessment Program Review of the VA Palo Alto Health Care System, Palo Alto, California [08-00786-116] pdf 301 KB
4/22/2008 Healthcare Inspection Veterans Integrated Service Network Oversight of Peer Review Processes  [08-00338-115] pdf 132 KB
4/21/2008 Combined Assessment Program Review of the VA Boston Healthcare System Boston, Massachusetts [07-03172-114] pdf 164 KB
4/14/2008 Combined Assessment Program Review of the Ralph H. Johnson VA Medical Center Charleston, South Carolina [08-00529-112] pdf 270 KB
4/10/2008 Combined Assessment Program Review of the Chalmers P. Wylie Independent Outpatient Clinic Columbus, Ohio [08-01088-111] pdf 284 KB
4/8/2008 Healthcare Inspection Radiology Issues at a VA Medical Center  [07-02063-109] pdf 296 KB
4/4/2008 Healthcare Inspection Resident Credentialing and Supervision Central Arkansas Veterans Healthcare System Little Rock, Arkansas [07-03379-110] pdf 132 KB
4/3/2008 Healthcare Inspection Medical Device Recall Process in Veterans Health Administration Medical Centers  [07-02369-107] pdf 242 KB
3/31/2008 Independent Review of Department of Veterans Affairs Fiscal Year 2007 Special Disabilities Capacity Report [08-00972-105] 
3/31/2008 Healthcare Inspection Surgical Care Improvement Project [07-00773-106] pdf 232 KB
3/27/2008 Audit of QTC Medical Services, Inc.'s Settlement Offer for Overcharges under Contract V101(93)P-2099  [07-02280-104] pdf 338 KB
3/26/2008 Independent Review of VA's Fiscal Year 2007 Performance Summary Report To the Office of National Drug Control Policy  [08-00782-100] 
3/26/2008 Healthcare Inspection Additional Quality of Care Issues Marion VA Medical Center Marion, Illinois  [08-00869-102] pdf 436 KB
3/25/2008 Healthcare Inspection Alleged End of Life Care Issues VA Palo Alto Health Care System Palo Alto, California [08-00509-103] pdf 337 KB
3/20/2008 Healthcare Inspection Alleged Quality of Care Issues James A. Haley Veterans Hospital Tampa, Florida and Bay Pines VA Health Care System Bay Pines, Florida  [08-00183-94] pdf 363 KB
3/20/2008 Combined Assessment Program Review of the VA Long Beach Healthcare System Long Beach, California  [08-00373-99] pdf 289 KB
3/17/2008 Combined Assessment Program Review of the Wilkes-Barre VA Medical Center, Wilkes-Barre, Pennsylvania [07-03445-97] pdf 276 KB
3/17/2008 Independent Review of VA's Fiscal Year 2007 Detailed Accounting Submission To the Office of National Drug Control Policy  [08-00782-93] 
2/27/2008 Combined Assessment Program Review of the Alexandria VA Medical Center Pineville, Louisiana [08-00054-84] pdf 289 KB
2/26/2008 Combined Assessment Program Review of the John J. Pershing VA Medical Center Poplar Bluff, Missouri [07-02837-83] pdf 163 KB
2/25/2008 Combined Assessment Program Review of the VA Northern Indiana Health Care System Fort Wayne and Marion, Indiana [07-03185-82] pdf 410 KB
2/21/2008 Combined Assessment Program Review of the VA Caribbean Healthcare System San Juan, Puerto Rico  [07-02948-81] pdf 344 KB
2/20/2008 Healthcare Inspection Supply, Processing, and Distribution Issues and Quality of Care Concerns William Jennings Bryan Dorn VA Medical Center Columbia, South Carolina [07-02902-78] pdf 145 KB
2/20/2008 Healthcare Inspection Diagnostic Radiopharmaceutical Management VA North Texas Health Care System Dallas, Texas  [07-01876-80] pdf 238 KB
2/19/2008 Combined Assessment Program Review of the John D. Dingell VA Medical Center Detroit, Michigan [07-03184-77] pdf 376 KB
2/14/2008 Healthcare Inspection Questionable Medical Treatment and Suspicious Deaths VA Medical Center Alexandria, Louisiana  [07-03382-76] pdf 138 KB
2/14/2008 Healthcare Inspection Alleged Quality of Care Issues Martinsburg VA Medical Center Martinsburg West Virginia  [07-03087-75] pdf 395 KB
2/12/2008 Combined Assessment Program Review of the El Paso VA Health Care System El Paso, Texas [08-00137-74] pdf 152 KB
2/11/2008 Combined Assessment Program Review of the VA Puget Sound Health Care System Seattle, Washington  [07-03341-73] pdf 335 KB
2/8/2008 Audit of Veterans Health Administration Blood Bank Modernization Project [06-03424-70] pdf 368 KB
2/8/2008 Healthcare Inspection Quality of Care Issues W. G. (Bill) Hefner VA Medical Center Salisbury, North Carolina [07-01912-72] pdf 138 KB
2/7/2008 Audit of Veterans Benefits Administration Non-Rating Claims Processing [06-03537-69] pdf 201 KB
2/4/2008 Combined Assessment Program Review of the Harry S. Truman Memorial Veterans' Hospital Columbia, Missouri [07-02836-66] pdf 269 KB
1/31/2008 Healthcare Inspection Alleged Mismanagement and Patient Care Issues Martinsburg VA Medical Center Martinsburg, West Virginia  [07-02388-68] pdf 376 KB
1/31/2008 Healthcare Inspection Alleged Certification Irregularities of Licensed Clinical Social Workers VA Western New York Healthcare System Buffalo, New York [07-02335-67] pdf 473 KB
1/28/2008 Healthcare Inspection Quality of Care Issues VA Medical Center, Marion, Illinois [07-03386-65] pdf 1,505 KB
1/24/2008 Healthcare Inspection Alleged Premature Discharge of a Veteran VA Pittsburgh Healthcare System Pittsburgh, Pennsylvania  [07-01622-62] 
1/23/2008 Combined Assessment Program Review of the Manchester VA Medical Center Manchester, New Hampshire  [07-03100-63] pdf 248 KB
1/16/2008 Healthcare Inspection Alleged Quality of Care Issues VA Loma Linda Healthcare System Loma Linda, California  [07-03292-60] pdf 234 KB
1/10/2008 Healthcare Inspection Surgery Quality of Care Issues VA Eastern Kansas Health Care System Leavenworth, Kansas  [07-02655-56] pdf 304 KB
1/9/2008 Combined Assessment Program Review of the VA Greater Los Angeles Healthcare System Los Angeles, California [07-02946-55] pdf 317 KB
1/8/2008 Combined Assessment Program Review of the Erie VA Medical Center Erie, Pennsylvania  [07-03081-54] pdf 317 KB
1/7/2008 Healthcare Inspection Alleged Administrative Review Issues VA Nebraska Western Iowa Health Care System Omaha, Nebraska  [07-03010-53] pdf 113 KB
1/4/2008 Healthcare Inspection Vascular Laboratory Quality of Care Issues at the Hunter Holmes McGuire Va Medical Center Richmond, Virginia [07-02405-51] 
1/4/2008 Combined Assessment Program Review of the Philadelphia VA Medical Center Philadelphia, Pennsylvania  [07-02498-52] pdf 370 KB
1/3/2008 Combined Assessment Program Review of the Southern Arizona VA Health Care System Tucson, Arizona  [07-02557-50] pdf 304 KB
1/2/2008 Combined Assessment Program Review of the Sioux Falls VA Medical Center Sioux Falls, South Dakota  [07-02705-49] pdf 274 KB
12/20/2007 Healthcare Inspection Infusion Clinic Closure and Patient Notification VA Southern Nevada Healthcare System Las Vegas, Nevada  [07-03298-48] pdf 246 KB
12/19/2007 Healthcare Inspection Pain Management Concerns Primary Care Clinic Richard L. Roudebush VA Medical Center Indianapolis, Indiana  [07-02296-44] pdf 236 KB
12/19/2007 Audit of the Effectiveness of Veterans Benefits Administration Compensation Writeouts  [06-01791-45] pdf 335 KB
12/19/2007 Combined Assessment Program Review of the VA Medical Center Durham, North Carolina  [07-03443-46] pdf 328 KB
12/18/2007 Healthcare Inspection Alleged Quality of Care Issues VA Nebraska-Western Iowa Health Care System Omaha, Nebraska [07-03037-43] pdf 165 KB
12/17/2007 Healthcare Inspection Quality of Care in the Surgical Intensive Care Unit South Texas Veterans Health Care System San Antonio, Texas  [06-02509-40] pdf 357 KB
12/17/2007 Audit of Vocational Rehabilitation and Employment Program Operations [06-00493-42] pdf 645 KB
12/13/2007 Healthcare Inspection Alleged Quality of Care Issues VA Medical Center Birmingham, Alabama [07-02106-38] pdf 146 KB
12/13/2007 Healthcare Inspection Evaluation of the Veterans Health Administration's Contract Community Nursing Home Program [05-00266-39] pdf 254 KB
12/12/2007 Healthcare Inspection Atypical Antipsychotic Medications and Diabetes Screening and Management [05-00680-37] pdf 1,779 KB
12/11/2007 Healthcare Inspection Quality of Care Issues Tennessee Valley Healthcare System Nashville and Murfreesboro, Tennessee  [07-01181-36] pdf 134 KB
12/7/2007 Combined Assessment Program Review of the Edward Hines, Jr. VA Hospital Hines, Illinois [07-00767-34] pdf 378 KB
11/30/2007 Healthcare Inspection Importation of Blood Products for Research Purposes New Mexico VA Health Care System Albuquerque, New Mexico [07-03025-32] pdf 347 KB
11/30/2007 Semiannual Report for April 1, 2007 to September 30, 2007 [] pdf 607 KB
11/28/2007 Audit of the Veterans Health Administration's Home Respiratory Care Program  [06-00801-30] pdf 233 KB
11/27/2007 Combined Assessment Program Review of the Central Texas Veterans Health Care System Temple, Texas  [07-01731-28] pdf 340 KB
11/27/2007 Combined Assessment Program Review of the New Mexico VA Health Care System Albuquerque, New Mexico  [07-02349-29] pdf 293 KB
11/19/2007 Audit of VA Purchases Made on Behalf of the Department of Defense [06-03540-24] pdf 795 KB
11/15/2007 Report of the Audit of the Department of Veterans Affairs Consolidated Financial Statements for Fiscal Years 2007 and 2006  [07-01016-21] pdf 4,602 KB
11/13/2007 Combined Assessment Program Review of the VA Nebraska Western Iowa Health Care System Omaha, Nebraska [07-00167-22] pdf 392 KB
11/7/2007 Healthcare Inspection Quality of Care Issues VA Ann Arbor Healthcare System Ann Arbor, Michigan [06-03145-23] pdf 116 KB
11/6/2007 Combined Assessment Program Review of the VA Medical Center Louisville, Kentucky [07-02271-20] pdf 291 KB
10/30/2007 Combined Assessment Program Review of the Portland VA Medical Center Portland, Oregon [07-02081-17] pdf 333 KB
10/29/2007 Combined Assessment Program Review of the VA Montana Health Care System Fort Harrison, Montana  [07-00171-15] pdf 356 KB
10/29/2007 Healthcare Inspection Quality of Care and Management Issues in Surgical Service John D. Dingell VA Medical Center Detroit, Michigan  [07-01400-16] pdf 273 KB
10/25/2007 Healthcare Inspection Alleged Mismanagement and Safety Issues Battle Creek VA Medical Center Battle Creek, Michigan  [06-02868-14] pdf 331 KB
10/24/2007 Combined Assessment Program Review of the Bay Pines VA Healthcare System Bay Pines, Florida  [07-01248-13] pdf 294 KB
10/23/2007 Combined Assessment Program Review of the VA New York Harbor Healthcare System New York, New York  [07-00766-11] pdf 478 KB
10/18/2007 Combined Assessment Program Review of the Jesse Brown VA Medical Center Chicago, Illinois  [07-00543-08] pdf 335 KB
10/18/2007 Administrative Investigation Misuse of Time, Resources, & Title, And Improper Remote Access VA Central Office  [07-02423-10] 
10/16/2007 Combined Assessment Program Review of the Hunter Holmes McGuire VA Medical Center Richmond, Virginia [07-01753-07] pdf 177 KB
10/15/2007 Final Report Special Review of Federal Supply Schedule Medical Equipment and Supply Contracts Awarded to Resellers [05-01670-04] pdf 445 KB
10/9/2007 Administrative Investigation Misuse of Government Travel Card VA Central Office  [06-02434-03] 
7/22/08