VA Health Care:

Problems in Implementing Locality Pay for Nurses Not Fully Addressed

HRD-93-54: Published: May 21, 1993. Publicly Released: Jun 1, 1993.

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Pursuant to a congressional request, GAO reviewed the Department of Veterans Affairs' (VA) implementation of a locality pay system (LPS) for nurses, focusing on the adequacy of VA medical centers' surveys in setting nurse salary rates.

GAO found that: (1) VA did not follow Bureau of Labor Statistics standards in developing and conducting its surveys of nurse salaries; (2) VA did not pretest its questionnaire, provide sufficient training to its staff on survey techniques, verify salary rates of competing medical facilities, effectively match or validate job descriptions with salaries at competing medical facilities, prohibit nurses from independently gathering salary data, or review all medical centers' surveys for compliance; (3) VA did not correct its survey deficiencies before conducting a second round of surveys; and (4) VA planned to review all medical center surveys on a continuous basis to identify salary inconsistencies.

Recommendations for Executive Action

  1. Status: Closed - Not Implemented

    Comments: On the basis of the results of VA's Office of Human Resources Management's risk assessment and VHA input, a decision was made not to report the nurse LPS administration as a material weakness. VA implementation of planned improvements to LPS will be monitored by the Senior Management Review Council.

    Recommendation: The Secretary of Veterans Affairs should report VA administration of the locality pay system to the Office of Management and Budget as a material internal control weakness under the Federal Managers' Financial Integrity Act.

    Agency Affected: Department of Veterans Affairs

  2. Status: Closed - Implemented

    Comments: VHA is taking steps to implement a plan to improve the effectiveness and validity of the nurse LPS. Funding for training data collectors and training to VHA's four regions was approved and training provided in May 1995.

    Recommendation: The Secretary of Veterans Affairs should develop a plan and a timetable for correcting the internal control weaknesses in the system.

    Agency Affected: Department of Veterans Affairs


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