Inspector General Research Articles

B-121 Optimizing Test Ordering: Leveraging Heuristics in Naming Conventions - A PSA Case Study

Abstract Background A common screening test for prostate cancer is the Prostate-Specific Antigen (PSA) test, which may also be referred to as total PSA or total PSA plus free PSA, among other variations. Looking at the test menus of two major reference laboratories, it's apparent that PSA can be ordered under thirteen different test names. From an end-user perspective, the question arises: which of these thirteen tests should be ordered, and why are there so many options? This plethora of choices can lead to confusion and uncertainty for clinicians and patients alike. According to various guidelines, ordering Free PSA is only warranted when PSA values exceed 4 ng/ml. In such cases, the ratio of free PSA to total PSA can aid in further clinical decision-making and patient workup. At Zuckerberg San Francisco General Hospital (ZSFGH), we offer two tests for PSA. The first is named “Prostate Specific Antigen” is total PSA done in house, while the second is labeled “Prostate Spec. Ag. Total and Free.” which is sent out to a reference lab. Upon reviewing our send-out orders, we observed a significant increase (376%) from 2022 to 2023 in the use of the send out order. Methods The ordering data for our providers was collected from February 2022 to January 2024 for both in-house and send-out orders. The data was analyzed using descriptive statistics in Microsoft Excel. Results In our population, we observed an abnormal concentration of send-outs originating from a select group of physicians. Additional we also identified a group of providers who only selected the send out test order. Analysis of in-house assay results for PSA revealed that only 15% (1292 out of 8136) exceeded the cutoff of 4 ng/ml, necessitating further testing to inform clinical decision-making. Yet our send out volume of 4157 test is in discordance with how many PSA would need further evaluation. Based on a cost analysis reducing the send out volume by 80% could result in $53,210 savings. Therefore, to reduce the send out amount and to keep the naming convention similar we decided to implement a new test name that would reflex the PSA to Free PSA if the PSA is above 4 ng/ml. We decided on the name “Prostate Specific Antigen total with reflex to Free Prostate Specific Antigen”. Conclusions Our investigation into the variability in PSA test ordering revealed a significant disparity in the number of send-out orders, particularly originating from a select group of physicians. However, the disproportionately high volume of send-out tests suggested an inefficiency in the current testing approach. To address this issue and align with clinical guidelines, we decided to process a request to our medical executive committee for approval for this reflex test in order to meet reimbursement compliance with the Office of the Inspector General. This change aims to streamline the process, reduce unnecessary send-out tests, and ultimately improve the efficiency and accuracy of prostate cancer screening at our institution.

Evidence of Reputational Priorities of a Sample of U.S. Federal Offices of Inspector General: A Mixed Methods Analysis of Workforce, Budgetary Data, and Statutes

Offices of inspector general (OIGs) have become an important part of the United States government, located in virtually every agency and providing oversight through audits and investigations that examine fraud, waste, abuse, ineffectiveness, and inefficiency. Yet, scholars know little about their activities. Conventional wisdom suggested that investigations would be favored over audits partially because the OIGs would want to bolster their reputation with Congress and the public. This research examines 11 departmental OIGs to explore whether investigations are prioritized over audits, especially in the context of declining budgets. Quantitative workforce data from the U.S. Office of Personnel Management show that contrary to expectation these OIGs largely prioritize auditing through an allocation of more full-time equivalent (FTE) employees. Budget data, adjusted for inflation, show that funding since the 2010s was flat followed by marked increases for some OIGs during the Trump Administration, which doesn’t help explain these priorities; however, a qualitative analysis of statutes shows Congress assigns auditing tasks more often than investigative tasks. Overall, this mixed methods research provides preliminary evidence that OIGs’ desire to maintain or improve their reputation and be responsive to Congress leads them to focus on improving agency performance and helping their agencies fulfill their missions.

The Publication and Historical Significance of Modern Chinese Medical Reports.

Unlike Western medical journals such as The Lancet which focused on Western-centric medical cases, Medical Reports analyzed medical and sanitary issues in East Asia, including China, Korea, and Japan and sought solutions to these problems. Medical Reports, a medical project initiated by the Chinese Maritime Customs Service (CMCS) in 1871, aimed to compile reference materials on the health conditions and diseases in ports. It was launched by the British Inspector General Robert Hart, who appointed the British Shanghai Customs Surgeon R. Alexander Jameson as the editor. Beginning in the 1860s, the British-led CMCS began expanding its reach from major cities to border areas, western regions, Taiwan Island, and Hainan Island, as well as territories beyond Qing Dynasty, such as Seoul, Busan, Incheon, Hong Kong, and Macau. This expansion required multinational cooperation, leading to the participation of Customs Surgeons, medical missionaries, and military doctors from ten countries, including the UK, the United States, France, China, Germany, Canada, Portugal, Norway, the Netherlands, and Australia, in the Medical Reports project. The Medical Reports were directly tied to the medical and sanitary initiatives in that community. They were authored by Customs Surgeons from a country with substantial regional influence. An analysis of the authors' nationalities, primary research focuses, and the relationship between the customs regions they covered revealed a statistically significant correlation. Even after Robert Koch discovered bacteria in the late nineteenth century, the miasma theory remained dominant, and most British doctors in India did not acknowledge the possibility that diseases could be caused by parasites. Despite this conservative historical context, the Medical Reports featured progressive research, including studies on leprosy based on germ theory and studies that actively embraced the emerging theory that parasites could be the cause of certain illnesses. In this process, the relatively unknown young physician named Patrick Manson, while working at the CMCS for 13 years, significantly advanced his medical knowledge by publishing numerous studies on filaria in the Medical Reports. His work led to the groundbreaking discovery that mosquitoes transmit infectious diseases. These research achievements pioneered the field of tropical medicine, a discipline that had not been established even in the extensive colonial holdings of France and Britain in tropical regions. Manson's work for the Medical Reports significantly advanced human efforts to prevent and respond to infectious diseases.

Civil Monetary Penalties for EMTALA Violations Involving Minors, 2002-2023.

The Emergency Medical Treatment and Labor Act (EMTALA) is intended to prevent inadequate, delayed, or denied treatment of emergent conditions by emergency departments (EDs). EMTALA requirements pertain to patients of all ages presenting to dedicated EDs regardless of whether facilities have dedicated pediatric specialty services. This study aims to describe EMTALA-related civil monetary penalty (CMP) settlements involving minors. Descriptions of all EMTALA-related CMPs occurring between 2002 and 2023 were obtained from the Office of the Inspector General web site and reviewed for involvement of minors (<18 years of age) using keywords in settlement summaries. Characteristics of settlements involving minors were described and compared with settlements not involving minors. Of 260 EMTALA-related CMPs, 38 (14.6%) involved minors. Most involved failure to provide a medical screening exam (MSE) (86.8%) and/or stabilizing treatment (52.6%). Seven (18.4%) involved pregnant minors. Eleven (28.9%) involved ED staff directing a patient (or guardian) to another facility, typically by private vehicle, and another involved 2 patients referred to on-campus outpatient clinics without an MSE. One in 7 CMPs related to EMTALA violations involved minors, and 1 in 5 of these minors was pregnant. One-third of CMPs involving minors included ED staff directing patients to proceed to another facility or on-campus clinic without MSE or stabilization. Findings suggest a need for providers to understand EMTALA-specific requirements for appropriate MSE, stabilization, and transfer, and for EDs at hospitals with limited pediatric services to implement policies for the evaluation of minors and protocols for transfer when indicated.

Measuring Transparency of State and Local Offices of Inspector General

Inspectors general are the independent government watchdogs tasked with combating fraud, waste, abuse, and corruption, and promoting efficiency and effectiveness of the agencies, programs, and jurisdictions they oversee. Unlike federal inspectors general, state and local inspectors general are not required to adhere to the reporting requirements of the federal Inspector General Act of 1978, which raises questions on their activities. To date, there is limited research on state and local inspectors general given their substantial differences in reporting requirements, content, and publication. The author brings attributes from Stohl’s Information Visibility Scale and the Department of Homeland Security Office of Inspector General Transparency Act to develop a 5-point scale to measure transparency of state and local offices of inspector general. This analysis finds 53% out of 116 state and local offices are very or extremely transparent while the remaining 47% are moderately to not transparent at all. The author recommends amendments to state and local inspector general statutes and their reporting methods to improve transparency within the inspection and oversight profession.

Identifying Dominant Actors of Ferdy Sambo's Case Network on Social Media X/Twitter Using Social Network Analysis for Public Relations Strategy

The Indonesian National Police (Polri) has experienced ups and downs in building a positive image in interacting with the public. This decline in trust is caused by the emergence of various issues that show the low performance of the police. In the Ferdy Sambo case study, the performance and integrity of the police is at stake and the sensitivity of the police to meet public expectations. One solution to im-prove the image is through an effective public relations strategy. However, to develop it, a deep un-derstanding of the characteristics and interaction patterns between social media through social net-work analysis is required. This research aims to identify influential X/Twitter actors in the case study of Inspector General Ferdy Sambo by applying the centrality method in Social Network User Analysis. The results of centrality analysis on the network show a wide variety of centrality levels. The @Zaindamai account dominates with the highest Degree Centrality value of 0.426829, indicating the number of connections in the network. The main role in disseminating information is held by @Zaindamai with the highest Betweenness Centrality value of 0.325748, indicating its role in connect-ing various networks. @Rizkynu46127931 stands out in Closeness Centrality with a high value of 0.497791, signifying quick and efficient access to all parts of the social network. In addition, @Rizkynu46127931 has significant influence in the network based on the highest Eigenvector Cen-trality of 0.245625. This centrality value forms the basis for formulating a more focused public relations strategy, improving the efficiency of communication with stakeholders, and designing a more concrete public relations plan.

The impact of risk management implementation on the effectiveness of SAI’s internal audit function

Internal audits play an important role in monitoring the achievement of organizational objectives. However, research on the factors influencing the success of internal audits remains limited. This study aims to investigate the effectiveness of BPK’s Itama (The Inspectorate General of the Audit Board of the Republic of Indonesia) functions, hypothesized to be influenced by risk management policy implementation. This study employs quantitative methods; data were collected via surveys and analyzed using structural equation modeling (SEM) to test theory-based hypotheses. Results reveal a significant positive correlation between risk management policy implementation and the effective functioning of Itama. Additionally, the study identifies key factors determining the success of risk management policy implementation: economic, social, and political conditions. Therefore, internal auditors of supreme audit institutions must consider these external factors when implementing risk management policies. This study contributes to understanding internal audit effectiveness by highlighting the impact of external economic, social, and political conditions.

Evaluasi Penyelesaian Temuan Pemeriksaan yang Tidak Dapat Ditindaklanjuti (TPTD) Hasil Pemeriksaan Inspektorat Jenderal

This study aims to evaluate the implementation of the TPTD settlement process from the Inspectorate General examination results compared to the applicable TPTD guidelines. The study was conducted at the Inspectorate General of the Ministry of Health. This research uses a case study research strategy with a qualitative descriptive data analysis method. The data sources used were obtained from interviews and documentation. The results showed that the implementation of the settlement has followed the applicable TPTD guidelines but it is necessary to update the follow-up guidelines and make technical follow-up instructions for the results of supervision or TPTD special guidelines that explain the operational definition of TPTD criteria regarding benchmarks and document limits from authorized agencies that must be met as TPTD requirements, work steps regarding the TPTD proposal mechanism from the work unit, discussion and determination of TPTD by the Inspectorate General, as well as the format of submitting TPTD proposals along with supporting data that must be completed. Recommendations of audit results that become TPTD due to improper provision of recommendations The Inspectorate General can carry out the development of APIP competence of the Inspectorate General on an ongoing basis. The findings decided by TPTD but seen from the follow-up carried out are not timely or protracted, it is necessary to monitor the follow-up carried out by the Inspectorate General every month and be actively involved in maintaining the time commitment. Keywords: Findings, follow-up Inspectorate General, TPTD, recommendations

“Oh, You, That in Sorrow You Grunble Against God in Vain, Man!..” Functions of the Lomonosov Quote in N. V. Gogol’s Comedy “The Inspector General”

The attention of researchers has already been drawn to a quotation from “Ode Selected from Job” by M. V. Lomonosov, included in the replica of Khlestakov, flirting with Marya Antonovna. Yu. V. Mann identified its following functions: comedy due to the discrepancy between the topic of conversation and the content of the given poetic lines, as well as due to the situation that Khlestakov faced, as in a gymnasium exam; thought about the vicissitudes of human fate. Comparison of the content of this lyrical work, which was textbook-famous for the reader of the 19th century, with the Silent Scene, as well as with the later “Dénouement of the Inspector General”, also a Gogol text, allows us to take a fresh look at the role of the mentioned quotation. Synthesis of arts, allusiveness, rich symbolism of the Silent Scene, rich allegorical imagery of “Dénouement of the Inspector General” through associative connections with the spiritual ode of M. V. Lomonosov strengthen the eschatological and apocalyptic semantic plans of “The Inspector General”, emphasize the spiritual and moral issues, formulate their phased formulation and deepening. “Inspector General” in this aspect can be perceived not only as a satirical and socially accusatory work, but also — in the context of the later “Reflections on the Divine Liturgy” and “Selected Passages from Correspondence with Friends” — as a call to repentance and Christian renewal of life.

Pandemic profiteering at a time of crisis: Using python to detect fraud in covid-19 testing and treatment payments

During the pandemic, the Centre for Medicare and Medicaid Services (CMS) introduced blanket waivers and rule flexibilities to address rising COVID-19 cases. This included expanding telehealth services to urban areas and waiving certain reporting requirements, along with various testing options such as surveillance testing, school and workplace testing, self-tests, and testing in more inpatient settings such as nursing homes. The federal and state governments also covered COVID-19 testing, vaccination and treatment for the uninsured population, creating opportunities for fraud and unnecessary testing, double billing, kickbacks, and deceased billing, mainly for monetary gain, by unscrupulous healthcare providers. Using Python programming, the study adopted an unsupervised learning approach by employing Isolation Forest to detect healthcare providers who were anomalies in the payment for COVID-19, treatment and vaccination by the Health Resources and Services Administration (HRSA). Additionally, using official search enquiry into official U.S. government websites such as the FBI, USDOJ, and HHS-OIG, this study identified eight (8) fraud, waste and abuse schemes related to laboratory testing and treatment. The isolation forest algorithm, set at a 5% contamination level, identified 1,890 healthcare providers (7.64% of total claims) as being anomalies. These results support the recommendations given to the HRSA by the Office of Inspector General of the Department of Health and Human Services (HHS-OIG), emphasizing the need for identifying and addressing improper payments. Protecting public health resources requires preventing fraud in the healthcare industry. Strong education programs for healthcare workers are crucial, as are vigilant oversight and collaboration between federal and state agencies. Additionally, this study emphasizes how crucial it is to use official government resources—such as the FBI, HHS-OIG, USDOJ, and CDC—to efficiently detect and prevent fraudulent activities. In the wake of information asymmetry, calls for private‒public partnerships are needed to address fraud, waste and abuse in the healthcare industry.

Strengthening Internal Supervision in Improving APIP Capability Achievement at the TNI Inspectorate General

Evaluating APIP capability impacts improving performance and maintaining transparency and accountability standards. Increasing the value of the APIP Capability Model provides a comprehensive framework for analyzing and improving APIP capabilities on an ongoing basis. This study aims to analyze the factors that influence the Government's Internal Supervisory Apparatus (APIP) capability. Analyzing the role of management in achieving the APIP capability level, analyzing the impact of APIP's role in implementing the TNI Government Internal Control System (SPIP), analyzing the importance of APIP capacity building within the TNI, analyzing the relationship between APIP capability and TNI financial management performance, analyzing the impact of the effectiveness of implementing the Internal Audit Capability Model (IACM) in improving APIP capability in the TNI. The steps suggested are a practical analysis of the influence of APIP capability, including management commitment, SPIP improvement, competency improvement, focus on improving financial performance, and implementation of IACM throughout the TNI.

Disclaimer of Political Rights As An Effort to Eradicate Corruption

Corruption is an extraordinary crime, so extraordinary methods are also needed to prevent and eradicate this crime. The imposition of serious crimes is one of the ways needed to eradicate them, then new punitive breakthroughs are also needed in order to provide a sense of deterrence and fear to both the perpetrators and the community. Several cases that have been decided during the trial of corruption at the first level, among others, are on behalf of the accused, Inspector General. Djoko Susilo in the corruption case of the procurement of a driving license (SIM) simulator tool, the KPK Public Prosecutor demanded additional crimes of revoking the right to vote and vote in general elections and public office (political rights), and the panel of judges granted the demands at the appeal level. This additional punishment is regulated in article 35 of the Criminal Code in conjunction with article 18 paragraph (1) of Law Number 31 of 1999 in conjunction with Law Number 20 of 2001 concerning Corruption. This research uses normative legal research methods, supported by primary, secondary and tertiary legal sources. With descriptive qualitative analysis.The problem with this additional punishment for depriving political rights is how to apply this additional punishment for depriving political rights in the prevention and eradication of corruption, because of course the KPK has strong reasons why this additional punishment is included as a punishment for perpetrators of corruption.

Federal report reveals lack of BH providers in Medicare, Medicaid programs

Few behavioral health providers in selected counties are actively serving Medicare and Medicaid enrollees, causing enrollees who experience difficulty accessing providers delays in care and the potential to forgo treatment altogether, according to a new report released by the U.S. Department of Health and Human Services' Office of Inspector General (OIG).

Exploring the Effects of Corruption on Administration of Justice in Uganda

Corruption in Ugandan courts is still a widespread problem that must be aggressively combated before the rule of law could be upheld. It is sad to see the thriving nature of corruption in the Ugandan judiciary despite the provisions of the Anti-Corruption Act. This article explore the effects of corruption on the administration of justice in Uganda. Data for the article were secondarily sourced from journal articles, technological blogs, policy briefs, statutory provisions, case laws, newspaper publications and textbooks. At the end, the article recommends for the Inspector General of Government’s office to create an independent spy network that can discover corruption in courts. More so, the provisions of the Anti-Corruption Act should be enforced without favouritism, and the Ministry of Justice should support whistleblowers policy, who should always be on ground to reveal corruption incidences. Furthermore, CCTV cameras should be effectively and efficiently deployed in various judicial offices. Finally, justice dispensation processes should be sped up in Uganda. Keywords: Administration of justice, Anti-Corruption Act, Corruption, Court, Whistleblower.

Evaluasi Penerapan Sistem Manajemen Anti Penyuapan (SMAP) pada Inspektorat Jenderal Kementerian A

To implement Presidential Instruction No. 10 of 2016 concerning Actions to Prevent and Eradicate Corruption, the National Standardization Body adopted ISO 37001:2016 concerning the Anti-Bribery Management System (Sistem Manajemen Anti Penyuapan/SMAP) to become SNI ISO 37001:2016. Currently, SMAP has been implemented by government institutions and companies in Indonesia. One of the agencies implementing SMAP is the Inspectorate General of Ministry A. The urgency of implementing SMAP is that the Inspectorate General as the Government Internal Supervisory Apparatus has a risk when conducting an audit that has the potential for negotiations to cover up a problem, so that the audit process made to be vulnerable to bribery. The purpose of this research to evaluate the implementation of the SMAP that has been carried out by the Inspectorate General of Ministry A. This research is case study research with evaluation scenarios using the gap analysis method on 7 requirements clauses based on SNI ISO 37001: 2016 namely Organizational Context, Leadership, Planning, Operations, Support, Performance Evaluation, and Improvement. Gap analysis is used to find out the weaknesses between the current application Conditions and how important the Conditions must be achieved. The results of the study show that the implementation of the Support, Performance Evaluation, and Improvement clauses in terms of implementation still needs to be improved.

Insider Threats to the Military Health System: A Systematic Background Check of TRICARE West Providers.

To address the pandemic, the Defense Health Agency (DHA) expanded its TRICARE civilian provider network by 30.1%. In 2022, the DHA Annual Report stated that TRICARE's provider directories were only 80% accurate. Unlike Medicare, the DHA does not publicly reveal National Provider Identification (NPI) numbers. As a result, TRICARE's 9.6 million beneficiaries lack the means to verify their doctor's credentials. Since 2013, the Department of Health and Human Services' (HHS) Office of Inspector General (OIG) has excluded 17,706 physicians and other providers from federal health programs due to billing fraud, neglect, drug-related convictions, and other offenses. These providers and their NPIs are included on the OIG's List of Excluded Individuals and Entities (LEIE). Patients who receive care from excluded providers face higher risks of hospitalization and mortality. We sought to assess the extent to which TRICARE screens health care provider names on their referral website against criminal databases. Between January 1-31, 2023, we used TRICARE West's provider directory to search for all providers within a 5-mile radius of 798 zip codes (38 per state, ≥10,000 residents each, randomly entered). We then copied and pasted all directory results' first and last names, business names, addresses, phone numbers, fax numbers, degree types, practice specialties, and active or closed statuses into a CSV file. We cross-referenced the search results against US and state databases for medical and criminal misconduct, including the OIG-LEIE and General Services Administration's (GSA) SAM.gov exclusion lists, the HHS Office of Civil Rights Health Insurance Portability and Accountability Act (HIPAA) breach reports, 15 available state Medicaid exclusion lists (state), the International Trade Administration's Consolidated Screening List (CSL), 3 Food and Drug Administration (FDA) debarment lists, the Federal Bureau of Investigation's (FBI) list of January 6 federal defendants, and the OIG-HHS list of fugitives (FUG). Our provider search yielded 111,619 raw results; 54 zip codes contained no data. After removing 72,156 (64.65%) duplicate entries, closed offices, and non-TRICARE West locations, we identified 39,463 active provider names. Within this baseline sample group, there were 2398 (6.08%) total matches against all exclusion and sanction databases, including 2197 on the OIG-LEIE, 2311 on the GSA-SAM.gov list, 2 on the HIPAA list, 54 on the state Medicaid exclusion lists, 69 on the CSL, 3 on the FDA lists, 53 on the FBI list, and 10 on the FUG. TRICARE's civilian provider roster merits further scrutiny by law enforcement. Following the National Institute of Standards and Technology 800, the DHA can mitigate privacy, safety, and security clearance threats by implementing an insider threat management model, robust enforcement of the False Claims Act, and mandatory security risk assessments. These are the views of the author, not the Department of Defense or the US government.

Does whistleblowing always compromise bureaucratic reputation? Exploring the role of accountability institutions through bureaucratic reputation theory

ABSTRACT Organizational reputation is subject to losses when whistleblowing occurs. Based on ethics management and bureaucratic reputation theories, we examined whether the loss could vary depending on whistleblowing channels, such as official channels of accountability institutions (U.S. Office of Special Counsel and Office of Inspector General), and unofficial channels (media) and the existence of whistleblowing management from official channels. From survey experiments with U.S. citizens, we found reputational loss may occur after whistleblowing, but it could be mitigated when managed properly through accountability institutions. Our findings suggest the importance of governments showing efforts to resolve moral issues from citizens’ views.

Analisis Framing Pemberitaan Pembunuhan Brigadir J di Media Online CNNIndonesia.com

This research aims to find out how the framing was carried out by CNNIndonesia.com in reporting on the murder case of Brigadier J, July 11-12 2022 edition. This research uses a qualitative description approach with Robert N Entman's framing analysis method, where Entman's framing analysis includes four stages: Define problem , Diagnose cause, Make moral Judgment, and Treatment recommendation. The results of the research show that, Define problem, disclosure of the murder case of Brigadier J. Diagnose cause is that the police believe that Brigadier J's death was motivated by sexual harassment towards the wife of the Head of the National Police Propam Division, Inspector General Ferdy Sambo. Make a moral judgment where the police emphasize Brigadier J's immoral behavior and temperament which has sexually harassed Ferdy Sambo's wife. Treatment recommendation, CNNIndonesia.com emphasizes two solutions, namely: first, the Police through the South Jakarta Metro Police and the Police Propam Division to continue to investigate the case of Brigadier J's death. Second, encourage the formation of a joint fact-finding team (TGPF) to uncover the case of his death. Brigadier J..

DoD OIG: White House gave out drugs including fentanyl, Provigil, and Ambien

Billing the Department of Defense for prescriptions for people who were ineligible for those benefits — 6 to 20 per week — and giving out too many controlled substances in extremely large amounts without any controls are just two of the results reported in a blistering evaluation by the Department of Defense Office of Inspector General (DoD OIG) last week. The report is dated Jan. 8 but was not released until almost four weeks later.

Abstract TP118: Development and Integration of a Dedicated Neurorehabilitation Space Within a Hospital-Based Stroke Unit

Background: It is well documented that rehabilitation post-stroke is associated with better functional outcomes, however, in the United States access to post-acute care rehabilitation is becoming increasingly limited. The Office of the Inspector General recently reported that 13% of Medicare beneficiaries were denied access by some Medicare Advantage Organizations to medically necessary care, including admission to inpatient rehabilitation facilities (IRF). Further, the Centers for Medicare and Medicaid Services have initiated the Review Choice Demonstration (RCD) for IRF Services in several states which is anticipated to further reduce access to post-acute care rehabilitation. In response, when our institution began planning for a new neuroscience unit, the decision was made to build a dedicated neurorehabilitation space. The purpose of this project was to design a space that would increase patient access to high quality, intensive neurorehabilitation in the hospital setting. Methods: To maximize utilization and effectiveness of the space, the neurorehabilitation staff were involved in the design of the layout and the selection of appropriate equipment, and participated in several training sessions. One year after opening, the neurorehabilitation staff were surveyed about their access to necessary equipment, and their perception of the effects different features of the space had on the quality of their treatment sessions. Results: Of the 20 surveys completed, the percentage of staff who reported they had the necessary equipment increased from 35% to 100%, and 90% of the space’s features had a favorable effect on the quality of the treatment sessions. Additionally, 95% of staff reported that the overall time spent with each patient increased and overall job satisfaction improved from 60% to 85%. Conclusion: A dedicated rehabilitation space was developed to better meet the needs of the neurorehabilitation staff, and to improve patient access to neurorehabilitation in the hospital setting. Survey results suggested that job satisfaction and staff’s perception of therapy quality improved after opening the new space.