Community Based Outpatient Clinic Reviews: Corpus Christi and New Braunfels, TX; Long Beach (Cabrillo) and Santa Fe Springs (Whittier), CA; San Diego (Mission Valley) and El Centro (Imperial Valley), CA; and Commerce (East Los Angeles) and Oxnard, CA

The VA Office of Inspector General reviewed eight Community Based Outpatient Clinics (CBOCs) the week of April 19–23, 2010. The CBOCs reviewed in Veterans Integrated Service Network (VISN) 17 were Corpus Christi and New Braunfels, TX; and, in VISN 22, Long Beach (Cabrillo) and Santa Fe Springs (Whittier), CA; San Diego (Mission Valley) and El Centro (Imperial Valley), CA; and Commerce (East Los Angeles) and Oxnard, CA. The parent facilities of these CBOCs are South Texas Health Care System (HCS), Long Beach HCS, San Diego HCS, and Greater Los Angeles HCS, 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, suicide safety plans, and CBOC contracts. We noted several opportunities for improvement and made the following recommendations to the VISN and facility management: • Require the Professional Standards Board grant privileges consistent with the services provided. • Utilize VetPro and appropriately document in accordance with Veterans Health Administration (VHA) Handbook 1100.19. • Maintain personally identifiable information in a secure fashion. • Require patient privacy be maintained during the check-in process. • Require the facility Infection Control program include a hand hygiene component. • Require that hand hygiene monitors are collected and reported location specific. • Conduct an environmental safety risk analysis to identify potential safety hazards. • Require the glucometer machine be maintained as required. • Require that egresses are unobstructed and appropriately marked. • Ensure the local safety policy is in compliance with VHA guidance. • Ensure safety plans are developed for all patients at high risk for suicide. • Ensure the Primary Care Management Module Coordinator performs in accordance with VHA Handbook 1101.02 to ensure accuracy of the data reported. • Provide contract oversight and enforcement in accordance with the terms and conditions as stated in the contract. Additionally, the Contracting Officer’s Technical Representative should research the overpayments attributable to dis-enrolled patients or patients not receiving a qualifying visit within the previous 12 months and seek refunds for those overpayments. 1. VetPro is an Internet enabled data bank for the credentialing of VHA health care providers that facilitates completion of a uniform, accurate, and complete credentials file.