REPORT DIGEST

 

 

CHICAGO READ

 MENTAL HEALTH CENTER

 

LIMITED SCOPE

COMPLIANCE EXAMINATION

For the Two Years Ended:

June 30, 2007

 

Summary of Findings:

 

Total this audit                   2

Total last audit                   2

Repeated from last audit    1

 

Release Date:

June 12, 2008

 

 

 

State of Illinois

Office of the Auditor General

WILLIAM G. HOLLAND

AUDITOR GENERAL

 

To obtain a copy of the Report contact:

Office of the Auditor General

Iles Park Plaza

740 E. Ash Street

Springfield, IL 62703

(217) 782-6046 or TTY (888) 261-2887

 

This Report Digest and the Full Report is also available on the worldwide web at

www.auditor.illinois.gov

 

 

 

 

 

 

 

 

SYNOPSIS

 

 

¨      The Center had inadequate controls over identifying a patient’s ability to pay and following up on accounts receivable.

 

¨      The Center did not complete patient communication restriction forms.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

{Expenditures and Activity Measures are summarized on the reverse page.}


                                       CHICAGO READ MENTAL HEALTH CENTER

                                    LIMITED SCOPE COMPLIANCE EXAMINATION

                                               For The Two Years Ended June 30, 2007

 

EXPENDITURE STATISTICS

FY 2007

FY 2006

FY 2005

 

     Total Expenditures (All Appropriated Funds)...........

 

 

$28,725,510

 

$27,630,814

 

$32,827,435

     OPERATIONS TOTAL..................................

         % of Total Expenditures........................

        

         Personal Services...................................

$28,328,836

98.6%

 

$21,330,093

$27,249,783

98.6%

 

$20,850,302

$32,457,235

98.9%

 

$23,741,208

                % of Operations Expenditures...........

                Average No. of Employees............

                Average Salary Per Employee.......

 

75.3%

311

$68,586

76.5%

320

$65,157

73.2%

359

$66,131

         Other Payroll Costs (FICA, Retirement)..

                % of Operations Expenditures.......

$3,949,812

13.9%

$3,273,393

12.0%

$5,367,282

16.5%

         Contractual Services...............................

                % of Operations Expenditures.......

$2,223,336

7.9%

$2,277,097

8.4%

$2,447,549

7.5%

         Commodities...................................................

                % of Operations Expenditures...................

$481,774

1.7%

$548,663

2.0%

$561,873

1.7%

         All Other Items......................................

                % of Operations Expenditures........

 

$343,821

1.2%

$300,328

1.1%

$339,323

1.1%

     GRANTS TOTAL..........................................

         % of Total Expenditures.........................

 

$396,674

1.4%

$381,031

1.4%

$370,200

1.1%

Cost of Property and Equipment.................

$26,936,743

$26,778,003

$24,968,799

SELECTED ACTIVITY MEASURES (Not Examined)

FY 2007

FY 2006

FY 2005

     Average Number of Residents..............................

121

126

152

Ratio of Employees to Residents...........................

Paid Overtime Hours & Earned Compensatory Hours.................................................................

Value of Paid Overtime Hours & Earned Compensatory Hours...........................................

2.57/1


87,987


$3,217,389

2.54/1


83,487


$2,803,470

2.36/1


89,592


$2,928,294

     Cost Per Year Per Resident.................................

*

$273,243

$258,096

*The Department had not calculated this cost at the close of audit fieldwork.

FACILITY ADMINISTRATOR

     During Examination Period:  Elaine Novak

     Currently:  Elaine Novak

 

 


 

 

 

 

 

 

 

 

 

 

Failure to maintain complete patient financial case records

 

 

 

 

 

 

Failure to send Notice of Determination within 60 days           

 

 

 

 

 

Failure to follow-up on accounts receivable

 

 

 

 

 

 

 

 

Agency agrees with auditors

 

 

 

FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS

 

INADEQUATE CONTROLS OVER ACCOUNTS RECEIVABLE       

 

      The Center had inadequate controls over identifying a patient’s ability to pay and following up on accounts receivable.                                                                                 

 

      The Center did not maintain complete patient financial case records to support the initial setup of the patient’s receivable in the billing system.

 

¨      16 of 25 (64%) accounts receivable tested did not have a completed “Certification and Signature by Patient” form included in the file.                   

 

The Center did not send the “Notice of Determination” within 60 days of admittance or did not complete it timely.

 

¨      2 of 25 (8%) accounts receivable tested did not reflect timely completion of the Notice of Determination.  These notices were completed 11 days to 5 years after the 60 day period from date of admittance.

 

The Center did not follow-up on accounts receivable or report them as a collection problem to Central Office.

 

¨    1 of 25 (4%) accounts receivable tested was outstanding over 180 days and not reported as a problem account to the Department’s Central Office. (Finding 1, pages 10-11) This finding, or variations thereof, was first reported in 2003.

 

Department officials agreed with our recommendation that the Center comply with existing policies and procedures to process, bill and collect amounts owed. They stated that the certification and signature by patient form are now part of the admission packet and being completed at the time of admission.  Patient Resource Unit is now under the Health Information Department.  Staff will provide assistance to Reimbursement Officer in completing notice of determination.  Also, assistance will be provided in filing the report to the Central Office concerning collection problems.  (For previous agency response, see Digest footnote #1)

 

 

 

 

 

 

 

 

The Center did not complete patient communication restriction forms

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Agency agrees with auditors

 

 

 

 

 

STATUTORY MANDATE FOR PATIENT COMMUNICATION NOT FOLLOWED

 

      The Center did not complete patient communication restriction forms.

 

      Two of 15 (13%) patient files tested did not have documentation as to patient communication restrictions.  Those two patients were from a unit for which patient communication was restricted by the Center.   (Finding 2, page 12)

 

      The Mental Health & Developmental Disabilities Code (405 ILCS 5/2-103 (c)) states that communication by mail, telephone, and visitation may be reasonably restricted by the facility director only in order to protect the recipient or others from harm, harassment or intimidation, provided that notice of such restriction shall be given to all recipients upon admission.  When communications are restricted, the facility shall advise the recipient that he has the right to require the facility to notify the affected parties of the restriction, and to notify such affected party when the restrictions are no longer in effect.

 

Department officials agreed with our recommendation that the Center implement procedures to comply with State mandates.  They stated that the Center will ensure nursing staff and physicians are retrained on how to properly complete the Restriction of Rights Forms and emergency procedures.  Health

Information Services will conduct an audit of Restriction of Right compliance.

 

AUDITORS’ OPINION

 

      We conducted a compliance examination of the Center as required by the Illinois State Auditing Act.  This was a limited

scope compliance examination.  The Center’s accounting records will be covered by the audit of the entire Department of Human Services.  Financial statement for the Department will be

presented in that report.

 

____________________________________

WILLIAM G. HOLLAND, Auditor General

WGH:KMC:drh

 

SPECIAL ASSISTANT AUDITORS

 

      Our special assistant auditors were Prado & Renteria.

 

 

DIGEST FOOTNOTES

 

#1–  INADEQUATE CONTROLS OVER ACCOUNTS RECEIVABLE -       Previous Agency Response

 

2005:  Agreed.  The Center will assign an Account Clerk II at least four (4) hours a day and the Office Associate two (2) days after each payroll close out to alleviate the current backlog in the Patient Resource Unit.  This arrangement will start March 6, 2006.