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FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS
INADEQUATE CONTROLS OVER ACCOUNTS
RECEIVABLE
The Center had inadequate controls over identifying a
patient’s ability to pay, following up on accounts receivable and processing
Medicare claims.
The Center did not complete the
“Notice of Determination”
within 60 days of admittance or did not complete it timely.
-
Eight out of 24 (29%) accounts receivable tested totaling
$247,081 did not reflect timely completion of the “Notice of Determination.”
These notices were completed 65 to 459 days after admittance;
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One out of 24 (4%) accounts receivable tested did not have a
“Notice of Determination” on file.
The Center did not follow-up on
accounts receivable up to 180 days old or report them as a collection problem
to Central Office.
-
Eighteen out of 24 (75%) accounts receivable tested were
over 180 days old and not reported as problem accounts to DHS Central Office.
These accounts receivable totaled $706,342 and ranged from $3,402 to
$281,788.
The Center did not process Medicare
claims timely.
-
One of 20 (5%) qualified Medicare claims tested totaling
$14,786 was uncollectible due to lack of timely billing by the Center. The
patient was discharged in October 2003 and had not been billed at the
conclusion of our fieldwork in October 2005;
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Claims for 11 of 20 (55%) discharged patients potentially
eligible for Medicare billing had not been filed with Medicare. Estimated
patient fees for these patients total $359,898. Dates of patient discharge
ranged from May 2004 to June 2005.
The Center did not maintain complete
and accurate records of Medicare accounts receivable.
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Two of 20 (10%) Medicare patient billings totaling $13,815
billed in April 2005 were not reflected on the Central Office’s aging report
of accounts receivable as of June 30, 2005. The Center was unable to explain
why these balances were excluded from the aging report.
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The Center does not record Medicare billings in the Center
Office’s system. (Finding 1, pages 9-11)
The Department agreed
with our recommendation to allocate
sufficient resources to the Recipient Resource Unit to process, bill and
collect amount owed. The Center has
hired a Business Manager with special emphasis on Medicare and Medicaid
billing and collections.
FAILURE TO COMPLETE EMPLOYEE
PERFORMANCE EVALUATIONS IN A TIMELY MANNER
The Center did not
complete employee performance evaluations in a timely manner.
Twelve
personnel files out of 50 (24%) files tested did not include annual
performance evaluations based on the employee’s creditable service date.
Performance evaluations ranged from three to eleven months late.
The Center
did not follow the employee creditable service date to determine the annual
performance evaluation period. (Finding 2, page 12)
The Department agreed with our
recommendation to implement necessary controls to ensure annual performance
evaluations are conducted as required by the Department of Human Services
Administrative Directives.
SPECIAL REVENUE FUNDS NOT
REMITTED ON TIME
The Center did not
remit excess special revenue funds timely.
Excess Special Revenue Rehabilitation Fund funds totaling $9,200 were
remitted nine months after the required remittance day.
According to Center officials, the $9,200 excess funds were
inadvertently left out. The error was detected during the close-out for
fiscal year 2005 and the funds were remitted late. (Finding 5, page 15)
The Department agreed with our recommendation to establish
procedures to ensure that these errors are timely detected.
OTHER FINDINGS
The remaining
findings dealt with the perpetual inventory system not updated timely and
excess inventory levels. We will
review progress toward implementation of all recommendations during the next
examination.
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. We also
performed certain agreed upon procedures with respect to the accounting
records of the Center to assist with the financial audit of the entire
Department of Human Services.
Financial statements 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.
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