Department of Veterans Affairs 

Office of Inspector General 

Office of Healthcare Inspections
 

Report No. 11-01101-196 

Combined Assessment Program
 

Review of the
 

Chalmers P. Wylie
 

VA Ambulatory Care Center
 

Columbus, Ohio
 

June 16, 2011
 

Washington, DC 20420
 
Why We Did This Review 

Combined Assessment Program (CAP) reviews are part of the Office of Inspector 

General's (OIG's) efforts to ensure that high quality health care is provided to our 

Nation's veterans. CAP reviews combine the knowledge and skills of the OIG's Offices 

of Healthcare Inspections and Investigations to provide collaborative assessments of 

VA medical facilities on a cyclical basis. The purposes of CAP reviews are to: 

 Evaluate how well VA facilities are accomplishing their missions of providing veterans 

convenient access to high quality medical services. 

 Provide crime awareness briefings to increase employee understanding of the 

potential for program fraud and the requirement to refer suspected criminal activity to 

the OIG. 

In addition to this typical coverage, CAP reviews may examine issues or allegations 

referred by VA employees, patients, Members of Congress, or others. 

To Report Suspected Wrongdoing in VA Programs and Operations 

Telephone: 1-800-488-8244 

E-Mail: vaoighotline@va.gov 

(Hotline Information: http://www.va.gov/oig/contacts/hotline.asp) 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Glossary
 

AD advanced directive 

BMC Behavioral Management Committee 

C&P credentialing and privileging 

CAP Combined Assessment Program 

facility Chalmers P. Wylie VA Ambulatory Care Center 

FY fiscal year 

H&P history and physical 

OIG Office of Inspector General 

QM quality management 

RN registered nurse 

VHA Veterans Health Administration 

VISN Veterans Integrated Service Network 

VA OIG Office of Healthcare Inspections 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Table of Contents
 

Page 

Executive Summary ................................................................................................... i
 

Objectives and Scope................................................................................................ 1
 

Objectives ............................................................................................................... 1
 

Scope...................................................................................................................... 1
 

Reported Accomplishments...................................................................................... 2
 

Results ........................................................................................................................ 2
 

Review Activities With Recommendations .............................................................. 2
 

Coordination of Care ......................................................................................... 2
 

Management of Workplace Violence................................................................. 3
 

RN Competencies ............................................................................................. 4
 

QM..................................................................................................................... 4
 

Environment of Care.......................................................................................... 5
 

Review Activities Without Recommendations ......................................................... 5
 

Continuity of Care.............................................................................................. 5
 

Medication Management ................................................................................... 5
 

Physician C&P................................................................................................... 6
 

Comments................................................................................................................... 6
 

Appendixes 

A. Facility Profile .................................................................................................... 7
 

B. Follow-Up on Previous Recommendations........................................................ 8
 

C. VHA Satisfaction Surveys ................................................................................. 9
 

D. VISN Director Comments .................................................................................. 10
 

E. Facility Director Comments ............................................................................... 11
 

F. OIG Contact and Staff Acknowledgments ......................................................... 14
 

G. Report Distribution ............................................................................................ 15
 

VA OIG Office of Healthcare Inspections 
Executive Summary: Combined Assessment Program 

Review of the Chalmers P. Wylie 

VA Ambulatory Care Center, Columbus, OH 

Review Purpose: The purpose was 

to evaluate selected activities, focusing 

on patient care administration and 

quality management, and to provide 

crime awareness training. We 

conducted the review the week of 

April 11, 2011. 

Review Results: The review covered 

eight activities. We made no 

recommendations in the following 

activities: 

	 Continuity of Care 

	 Medication Management 

	 Physician Credentialing and 

Privileging 

The facility’s reported accomplishments 

were preventing unnecessary inpatient 

admissions and readmissions and the 

receipt of the Gold Cornerstone Award 

for patient safety. 

Recommendations: We made 

recommendations in the following five 

activities: 

Coordination of Care: Provide patients 

with all components of written advance 

directive notification, document 

notification and screening in the medical 

record, and update local policy to 

include identification of staff responsible 

for providing advance directive 

notification. 

Management of Workplace Violence: 

Ensure all violent incidents involving 

patient or employee victims are 

discussed at the Behavioral 

Management Committee. 

Registered Nurse Competencies: 

Complete all competency validation 

documentation. 

Quality Management: Ensure history 

and physical examinations are 

completed and documented in the 

required timeframe prior to procedures 

requiring moderate sedation. 

Environment of Care: Complete N95 

respirator fit testing, and monitor 

compliance. 

Comments 

The Veterans Integrated Service 

Network and Facility Directors agreed 

with the Combined Assessment 

Program review findings and 

recommendations and provided 

acceptable improvement plans. We will 

follow up on the planned actions until 

they are completed. 

JOHN D. DAIGH, JR., M.D.
 

Assistant Inspector General for
 

Healthcare Inspections
 

VA OIG Office of Healthcare Inspections i 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Objectives and Scope
 

Objectives
 

Scope
 

CAP reviews are one element of the OIG’s efforts to ensure 

that our Nation’s veterans receive high quality VA health care 

services. The objectives of the CAP review are to: 

	 Conduct recurring evaluations of selected health care 

facility operations, focusing on patient care administration 

and QM. 

	 Provide crime awareness briefings to increase employee 

understanding of the potential for program fraud and the 

requirement to refer suspected criminal activity to the 

OIG. 

We reviewed selected clinical and administrative activities to 

evaluate the effectiveness of patient care administration and 

QM. Patient care administration is the process of planning 

and delivering patient care. QM is the process of monitoring 

the quality of care to identify and correct harmful and 

potentially harmful practices and conditions. 

In performing the review, we inspected selected areas, 

interviewed managers and employees, and reviewed clinical 

and administrative records. The review covered the 

following eight activities: 

	 Continuity of Care 

	 Coordination of Care 

	 Environment of Care 

	 Management of Workplace Violence 

	 Medication Management 

	 Physician C&P 

	 QM 

	 RN Competencies 

The review covered facility operations for FY 2010 and 

FY 2011 through April 15, 2011, and was done in 

accordance with OIG standard operating procedures for CAP 

reviews. We also followed up on selected recommendations 

from our prior CAP review of the facility (Combined 

Assessment Program Review of the Chalmers P. Wylie 

VA OIG Office of Healthcare Inspections 1 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Independent Outpatient Clinic, Columbus, Ohio, Report 

No. 08-01088-111, April 10, 2008). The facility had 

corrected all findings. (See Appendix B for further details.) 

During this review, we also presented crime awareness 

briefings for 287 employees. These briefings covered 

procedures for reporting suspected criminal activity to the 

OIG and included case-specific examples illustrating 

procurement fraud, conflicts of interest, and bribery. 

In this report, we make recommendations for improvement. 

Recommendations pertain to issues that are significant 

enough to be monitored by the OIG until corrective actions 

are implemented. 

Reported Accomplishments
 Prevention of 

Unnecessary 

Admissions 

Gold Cornerstone 

Award 

The facility implemented a program to prevent unnecessary 

inpatient admissions and readmissions by improving case 

management, providing more services in-house, and 

expanding the hours of the urgent care clinic. During 

FY 2010, the facility prevented 46 readmissions for a cost 

savings of $506,000. 

The facility received the Gold Cornerstone Award from the 

National Center for Patient Safety for their strong root cause 

analyses.1 

Results 

Review Activities With Recommendations 

Coordination of 

Care 

The purpose of this review was to evaluate whether the 

facility managed advance care planning and ADs in 

accordance with applicable requirements. 

We reviewed patients’ medical records for evidence of AD 

notification, AD screening, and documentation of advance 

care planning discussions. We also reviewed the facility’s 

policy to determine whether it was consistent with VHA 

policy. We identified the following areas that needed 

improvement. 

AD Notification and Screening. VHA requires that patients 

receive written notification during the first VHA primary care 

appointment regarding their right to accept or refuse medical 

1 Root cause analysis is a tool or method used to determine why a problem happened and what can be done to 

prevent the problem from happening again. 

VA OIG Office of Healthcare Inspections 2 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Recommendations 

Management of 

Workplace 

Violence 

treatment, to designate a Health Care Agent, and to 

document their treatment preferences in an AD.2 As part of 

notification, patients must be informed that VA does not 

discriminate based on whether or not they have an AD. We 

reviewed the medical records of 20 patients and found that 

none of the records contained evidence of all components of 

written notification. 

In addition, VHA requires that staff screen patients during the 

first VHA primary care appointment to determine whether 

they have an AD and document the screening in the medical 

record.3 Facility staff did not document this screening for 

10 of the 20 patients whose medical records we reviewed. 

Facility Policy. VHA requires that the facility identify the staff 

responsible for providing AD notification.4 The facility’s 

policy did not designate the staff responsible for providing 

notification. 

1. We recommended that processes be strengthened to 

ensure that all components of written AD notification are 

provided to patients and that AD notification and screening 

are documented in the medical record. 

2. We recommended that facility policy be updated to 

include identification of the staff responsible for providing AD 

notification. 

The purpose of this review was to determine whether VHA 

facilities issued and complied with comprehensive policy 

regarding violent incidents and provided required training. 

We reviewed the facility’s policy and training plan. We 

selected two assaults that occurred at the facility within the 

past 2 years, discussed them with managers, and reviewed 

applicable documents. We identified the following area that 

needed improvement. 

Management of Incidents. Facility policy requires that all 

violent incidents involving patient or employee victims be 

discussed at the BMC. We reviewed BMC meeting minutes 

and did not find discussion of the two assault incidents. 

2 VHA Handbook 1004.02, Advance Care Planning and Management of Advance Directives, July 2, 2009.
 3 VHA Handbook 1004.02.
 4 VHA Handbook 1004.02.
 

VA OIG Office of Healthcare Inspections 3 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Recommendation	 3. We recommended that processes be strengthened to 

ensure that all violent incidents involving patient or employee 

victims are discussed at the BMC. 

RN Competencies	 The purpose of this review was to determine whether the 

facility had an adequate RN competency assessment and 

validation process. 

We reviewed facility policies, interviewed nurse managers, 

and reviewed initial and ongoing competency assessment 

and validation documents for 12 RNs. We identified the 

following area that needed improvement. 

Competency Validation Documentation. VHA requires that 

nursing personnel are competent to function in their 

assignments.5 Core competencies, such as medication 

administration, are skills required for all RNs. Unit/position 

competencies are specific to a particular area of patient care, 

such as surgery. Eight of the 12 RN competency folders had 

incomplete or missing validation documentation. 

Recommendation	 4. We recommended that processes be strengthened to 

ensure that competency validation documentation is 

complete. 

QM	 The purpose of this review was to evaluate whether the 

facility had a comprehensive QM program in accordance with 

applicable requirements and whether senior managers 

actively supported the program’s activities. 

We interviewed senior managers and QM personnel, and we 

evaluated policies, meeting minutes, and other relevant 

documents. We identified the following area that needed 

improvement. 

Moderate Sedation. VHA requires that providers document a 

complete H&P examination within 30 days prior to a 

procedure where moderate sedation will be used.6 We 

reviewed the medical records of 10 patients who had 

selected procedures where moderate sedation was used and 

found that 2 patients did not have an H&P examination 

completed in the required timeframe. 

Recommendation	 5. We recommended that processes be strengthened to 

ensure that H&P examinations are completed and 

5 VHA Manual M-2, Clinical Affairs, Part V, Nursing Service, Chapter 2, “Clinical Nursing Practice,” July 13, 1989. 6 VHA Directive 2006-023, Moderate Sedation by Non-Anesthesia Providers, May 1, 2006. 

VA OIG Office of Healthcare Inspections 4 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

documented in the required timeframe prior to procedures 

requiring moderate sedation. 

Environment of	 The purpose of this review was to determine whether the 

Care facility maintained a safe and clean health care environment 

in accordance with applicable requirements. 

We inspected the same day surgery/post-anesthesia care 

unit and the urgent care, mental health, spinal cord injury, 

physical medicine, primary care, and specialty care clinics. 

The facility maintained a generally clean and safe 

environment. However, we identified the following area that 

needed improvement. 

Infection Control. If facilities use N95 respirators, the 

Occupational Safety and Health Administration requires that 

designated employees are fit tested annually. We reviewed 

20 employee training records and determined that four 

designated employees did not have the required annual fit 

testing. 

Recommendation	 6. We recommended that N95 respirator fit testing be 

completed and that compliance be monitored. 

Review Activities Without Recommendations
 

Continuity of Care	 The purpose of this review was to evaluate whether 

adequate continuity of care was provided for clinic patients 

hospitalized in the community. 

To evaluate the adequacy of communication between facility 

primary care providers and community hospitals, we 

reviewed the medical records of 10 patients who were 

hospitalized in the community at VA expense. We 

determined that pertinent community hospital information 

was consistently conveyed to VA primary care providers. 

We made no recommendations. 

Medication	 The purpose of this review was to determine whether the 

Management facility employed safe practices in the preparation, transport, 

and administration of hazardous medications, specifically 

chemotherapy, in accordance with applicable requirements. 

We observed the compounding and transportation of 

chemotherapy medications and the administration of those 

medications in the oncology clinic, and we interviewed 

employees. We determined that the facility safely prepared, 

VA OIG Office of Healthcare Inspections 5 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

transported, and administered the medications. We made no 

recommendations. 

Physician C&P	 The purpose of this review was to determine whether the 

facility had consistent processes for physician C&P that 

complied with applicable requirements. 

We reviewed C&P files and profiles and meeting minutes 

during which discussions about the physicians took place. 

We determined that the facility had implemented a consistent 

C&P process that met current requirements. We made no 

recommendations. 

Comments
 The VISN and Facility Directors agreed with the CAP review findings and 

recommendations and provided acceptable improvement plans. (See Appendixes D 

and E, pages 10–13 for full text of the Directors’ comments.) We will follow up on the 

planned actions until they are completed. 

VA OIG Office of Healthcare Inspections 6 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Appendix A 

Facility Profile7 

Type of Organization Ambulatory care medical center 

Complexity Level 3 

VISN 10 

Community Based Outpatient Clinics Grove City, OH 

Marion, OH 

Newark, OH 

Zanesville, OH 

Veteran Population in Catchment Area 135,164 

Type and Number of Total Operating Beds: 

 Hospital, including Psychosocial 

Residential Rehabilitation Treatment 

Program 

N/A 

 CLC/Nursing Home Care Unit N/A 

 Other N/A 

Medical School Affiliation(s) The Ohio State University 

 Number of Residents 12.5 

Resources (in millions): 

 Total Medical Care Budget 

Current FY (through 

January 2011) 

$171 

Prior FY (2010) 

$166 

 Medical Care Expenditures $46 $166 

Total Medical Care Full-Time Employee 

Equivalents 

Workload: 

 Number of Station Level Unique 

Patients 

 Inpatient Days of Care: 

o Acute Care 

850.2 

26,200 

N/A 

774 

34,132 

N/A 

o CLC/Nursing Home Care Unit N/A N/A 

Hospital Discharges N/A N/A 

Total Average Daily Census (including all bed 

types) 

N/A N/A 

Cumulative Occupancy Rate (in percent) N/A N/A 

Outpatient Visits 138,733 403,767 

7 All data provided by facility management. 

VA OIG Office of Healthcare Inspections 7 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Appendix B 

Follow-Up on Previous Recommendations 

Recommendations Current Status of Corrective Actions 

Taken 

In Compliance 

Y/N 

Repeat 

Recommendation? 

Y/N 

QM 

1. Document Peer Review Committee 

discussions of recommendations for 

improvement in clinical practice, follow-up of 

provider responses to Level 2 or 3 peer 

reviews, and written feedback from 

supervisors. 

The Peer Review Committee 

implemented a standardized format for 

minutes, agenda items, discussions 

with recommendations for 

improvement in clinical practice, and 

actions and/or follow-up items. This 

includes provider responses to Level 2 

or 3 peer reviews, designation of the 

responsible party, and due dates for 

action items. 

Y N 

2. Ensure that providers are only privileged to 

perform procedures that are within the 

capability of the clinic. 

Core privileges have been revised to 

reflect the capability of the facility. 

Annual reviews are performed. 

Y N 

3. Implement a process to monitor 

moderate sedation. 

A process for monitoring compliance 

with defined protocols for moderate 

sedation and the use of reversal 

agents has been instituted. This data 

is on the Performance Improvement 

Committee agenda. 

Y N 

Pharmacy Operations 

4. Conduct and document annual training for 

controlled substance inspectors. 

All training is completed annually. Y N 

VA OIG Office of Healthcare Inspections 8 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Appendix C 

VHA Satisfaction Surveys
 VHA has identified patient and employee satisfaction scores as significant indicators of 

facility performance. Patients are surveyed monthly. Table 1 below shows facility, 

VISN, and VHA overall inpatient and outpatient satisfaction scores and targets for 

FY 2010. 

Table 1 

FY 2010 

(inpatient target = 64, outpatient target = 56) 

Inpatient 

Score 

Quarter 1 

Inpatient 

Score 

Quarter 2 

Inpatient 

Score 

Quarter 3 

Inpatient 

Score 

Quarter 4 

Outpatient 

Score 

Quarter 1 

Outpatient 

Score 

Quarter 2 

Outpatient 

Score 

Quarter 3 

Outpatient 

Score 

Quarter 4 

Facility * * * * 52.8 54.5 57.0 56.3 

VISN 62.4 64.9 60.5 61.1 57.1 58.2 57.0 58.1 

VHA 63.3 63.9 64.5 63.8 54.7 55.2 54.8 54.4 

* This is an outpatient clinic, so there were no inpatient scores to report. 

Employees are surveyed annually. Figure 1 below shows the facility’s overall employee 

scores for 2008, 2009, and 2010. Since no target scores have been designated for 

employee satisfaction, VISN and national scores are included for comparison. 

VA OIG Office of Healthcare Inspections 9 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Appendix D 

VISN Director Comments 

Department of 

Veterans Affairs	 Memorandum 

Date:	 May 25, 2011 

From:	 Director, VA Healthcare System of Ohio (10N10) 

Subject:	 CAP Review of the Chalmers P. Wylie VA Ambulatory 

Care Center, Columbus, OH 

To:	 Director, Kansas City Office of Healthcare Inspections 

(54KC) 

Director, Management Review Service (VHA 10A4A4 

Management Review) 

1.	 I have reviewed the recommendations and concur with responses and 

action plans submitted by the Chalmers P. Wylie VA Ambulatory Care 

Center, Columbus, Ohio. 

2.	 If you have questions or require additional information, please contact 

Jane Johnson, VISN 10 Deputy Quality Management Officer at 

(513) 247-4631. 

(original signed by:) 

Jack G. Hetrick, FACHE 

Director, VA Healthcare System of Ohio (10N10) 

VA OIG Office of Healthcare Inspections 10 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Appendix E 

Facility Director Comments 

Department of 

Veterans Affairs	 Memorandum 

Date:	 May 20, 2011 

From:	 Director, Chalmers P. Wylie VA Ambulatory Care Center 

(757/00) 

Subject:	 CAP Review of the Chalmers P. Wylie VA Ambulatory 

Care Center, Columbus, OH 

To:	 Director, VA Healthcare System of Ohio (10N10) 

1.	 Attached please find my comments and implementation plans in 

response to the recommendations identified in the OIG CAP Review 

conducted April 11–14, 2011, of the Chalmers P. Wylie VA Ambulatory 

Care Center, Columbus, OH. I concur with the findings and 

recommendations. 

2.	 I appreciate the opportunity for this review as a continuing process to 

improve care to Veterans. 

3.	 Should you have questions or require further information, please 

contact me at (614) 257-5450. 

(original signed by:) 

Lilian T. Thome, M.D. 

VA OIG Office of Healthcare Inspections 11 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Comments to Office of Inspector General’s Report
 

The following Director’s comments are submitted in response to the recommendations 

in the Office of Inspector General report: 

OIG Recommendations 

Recommendation 1. We recommended that processes be strengthened to ensure that 

all components of written AD notification are provided to patients and that AD 

notification and screening are documented in the medical record. 

Concur 

Target date for completion: 05/27/2011 

The Computerized Patient Records System AD reminders were revised to provide 

documentation of AD actions and written information provided in the medical record. 

Clinical Reminder reactivation timelines have been adjusted to align with the AD policy 

for ongoing monitoring of AD status or changes requested. 

Recommendation 2. We recommended that facility policy be updated to include 

identification of the staff responsible for providing AD notification. 

Concur 

Target date for completion: 06/15/2011 

The AD policy has been revised to identify staff responsible for conducting AD 

notifications; the policy is currently being routed for approval. Additional plans to 

improve AD education include: regularly scheduled AD classes for Veterans; overhead 

announcements about classes; AD info blitz, info on the marquee, and quick-view 

monitors and AD day on 06/08/11. 

Recommendation 3. We recommended that processes be strengthened to ensure that 

all violent incidents involving patient or employee victims are discussed at the BMC. 

Concur 

Target date for completion: 04/22/2011 

The recommendation was addressed with the BMC and all cases of disruptive behavior 

will be reviewed by the committee and reported through the Environment of Care 

Committee monthly. 

VA OIG Office of Healthcare Inspections 12 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Recommendation 4. We recommended that processes be strengthened to ensure that 

competency validation documentation is complete. 

Concur 

Target date for completion: 06/01/2011 

Completed an audit of current RN/ Licensed Practical Nurse competency records. All 

current records are up to date with competency validation documentation. A 

standardized competency tool was developed for use with all RN and Licensed Practical 

Nurse competency validation. Monthly cross audits will be implemented and results 

reported to the Nurse Executive up to the Continuous Readiness Committee and the 

Performance Improvement Committee. 

Recommendation 5. We recommended that processes be strengthened to ensure that 

H&P examinations are completed and documented in the required timeframe prior to 

procedures requiring moderate sedation. 

Concur 

Target date for completion: 05/20/2011 

Facility implemented a new process prior to the arrival of the OIG visit. The process 

included completing a new H&P at the time of the procedures requiring moderate 

sedation, if the H&P was greater than 30 days. Revision to the Pre-Moderate Sedation 

Template to include H&P, History of Present Illness, reason for the procedure and 

American Society of Anesthesiologists Score was completed and is scheduled for 

review and approval by the facility forms committee prior to implementation. Facility will 

conduct monthly random review of medical record audits to monitor new processes and 

sustain improvements. The analysis of the audit will be reported through the 

Performance Improvement Committee. 

Recommendation 6. We recommended that N95 respirator fit testing be completed 

and that compliance be monitored. 

Concur 

Target date for completion: 06/01/2011 

The Respiratory Protection Program was evaluated fully to ensure compliance with all 

requirements as defined in the Occupational Safety and Health Administration 1910.134 

standard. The Fit Test process for the N95 respirators has been improved to ensure 

annual Fit Testing is completed for designated personnel. The Environment of Care 

Committee will track compliance of N95 Fit Test for designated employees on a 

quarterly frequency. 

VA OIG Office of Healthcare Inspections 13 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Appendix F 

OIG Contact and Staff Acknowledgments 

Contact For more information about this report, please contact the 

Office of Inspector General at 202-461-4720. 

Contributors Dorothy Duncan, RN, Project Leader 

Jennifer Kubiak, RN, Team Leader 

James Seitz, RN 

Laura Tovar, LCSW 

Jennifer Whitehead, Program Support Assistant 

Gavin McClaren, Office of Investigations 

VA OIG Office of Healthcare Inspections 14 
CAP Review of the Chalmers P. Wylie VA Ambulatory Care Center, Columbus, OH 

Appendix G 

Report Distribution 

VA Distribution 

Office of the Secretary 

Veterans Health Administration 

Assistant Secretaries 

General Counsel 

Director, VA Healthcare System of Ohio (10N10) 

Director, Chalmers P. Wylie VA Ambulatory Care Center (757/00) 

Non-VA Distribution 

House Committee on Veterans’ Affairs 

House Appropriations Subcommittee on Military Construction, Veterans Affairs, and 

Related Agencies 

House Committee on Oversight and Government Reform 

Senate Committee on Veterans’ Affairs 

Senate Appropriations Subcommittee on Military Construction, Veterans Affairs, and 

Related Agencies 

Senate Committee on Homeland Security and Governmental Affairs 

National Veterans Service Organizations 

Government Accountability Office 

Office of Management and Budget 

U.S. Senate: Sherrod Brown, Rob Portman 

U.S. House of Representatives: Steve Stivers, Pat Tiberi 

This report is available at http://www.va.gov/oig/publications/reports-list.asp. 

VA OIG Office of Healthcare Inspections 15