|
REPORT DIGEST
DEPARTMENT OF VETERANS’
AFFAIRS
ILLINOIS VETERANS’ HOME
- MANTENO
COMPLIANCE ATTESTATION EXAMINATION For the Two Years Ended: June 30, 2006 Summary of Findings: Total this audit 4 Total last audit 3 Repeated from last audit 0 Release Date: April 19, 2007
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 Full Report are also available on the worldwide web at http://www.auditor.illinois.gov |
SYNOPSIS · The Home failed to provide the minimum level of direct care nursing hours to its residents as required by Federal regulations. · The Home’s internal controls related to the timely approval of vouchers for payment are inadequate.
(Expenditures
and Activity Measures are summarized on the next page.) |
DEPARTMENT OF VETERANS'
AFFAIRS
ILLINOIS VETERANS’ HOME AT
MANTENO
COMPLIANCE ATTESTATION
EXAMINATION
For
The Two Years Ended June 30, 2006
|
EXPENDITURE STATISTICS |
FY 2006 |
FY 2005 |
FY 2004 |
|
Total Expenditures (All Funds)........... |
$21,235,276 |
$21,946,738 |
$20,943,355 |
|
OPERATIONS
TOTAL.........................
% of Total Expenditures................ |
$21,235,276
100.00% |
$21,946,738
100.00% |
$20,943,355
100.00% |
|
Personal Services...........................
% of
Operations Expenditures.... |
$13,460,581
63.39% |
$12,189,115
55.54% |
$11,952,964
57.07% |
|
Other Payroll Costs (FICA,
Retirement)...................................
% of
Operations Expenditures.... |
$2,155,434
10.15% |
$3,077,944
14.02% |
$2,669,830
12.75% |
|
Contractual Services......................
% of
Operations Expenditures.... |
$3,980,955
18.75% |
$3,537,500
16.12% |
$3,327,069
15.89% |
|
Locally Held Funds - Benefit Fund(1)........
% of
Operations Expenditures.... |
$234,138
1.10% |
$252,592
1.15% |
$245,363
1.17% |
|
All Other Operations Items.................
% of
Operations Expenditures......
NON-APPROPRIATED
FUNDS
Library
Grant Fund (775).........................
% of Total Expenditures....................... |
$1,389,168
6.54%
$15,000
.07% |
$2,877,587
13.11%
$12,000
.05% |
$2,748,129
13.12%
$0
0% |
|
Cost of
Property and Equipment......... |
$45,837,543 |
$45,587,149 |
$44,045,264 |
|
SELECTED ACTIVITY
MEASURES (Not Examined) |
FY 2006 |
FY 2005 |
|
Average Number of Residents – Skilled Care............................... |
277 |
295 |
|
Average Number of Employees................................................... |
293 |
303 |
|
Ratio - Average Number of Employees to Residents..................... |
1.06/1 |
1.03/1 |
|
Annual Cost of Nursing Care Per Resident.................................. |
$74,540 |
$66,963 |
|
HOME ADMINISTRATOR(S) |
|
During Period: Martin J. Downs
Currently: Martin J. Downs |
(1)
Includes all funds except the Member’ Trust
Fund.
|
Direct care nursing
hours provided by the Home fell below the required minimum level 174 out of 321
vouchers tested were not approved in a timely manner |
FINDINGS, CONCLUSIONS, AND
RECOMMENDATIONS NEED TO INCREASE DIRECT CARE HOURS TO COMPLY WITH REGULATIONS The Home failed to provide the minimum level of direct care nursing hours to its residents as required by Federal regulations in order for the Veterans Home to receive Federal per diem reimbursements. The Code of Federal Regulations (38 CFR Part 51.130(d)) requires Veterans Homes that receive Federal per diem for nursing home care of Veterans to provide nursing services to ensure that there is direct care nurse staffing of no less than 2.5 hours per patient per 24 hours, 7 days per week in the portion of any building providing nursing home care. During our examination, we noted the Home fell below the required minimum level for the following months: · In Fiscal year 2005 – July (2.40), August (2.43). · In Fiscal year 2006 – August (2.45). The Home’s management indicated that turnover and attrition rates have superceded hiring practices. Additionally, there is a shortage of licensed nursing personnel in Kankakee County which has compounded the problem. (Finding 1, page 9) We recommended the Home maintain adequate nursing staff to ensure the minimum level of direct care nursing hours is provided to residents as required by Federal regulations. The Home’s management accepted the recommendation and stated they are currently researching new incentives to attract and retain skilled nursing staff. INTERNAL
CONTROLS OVER TIMELY APPROVAL OF VOUCHER ARE INADEQUATE The Home’s internal controls related to the timely approval of vouchers for payment are inadequate. We noted 174 (54%) vouchers out of 321 tested were not approved in a timely manner. We also noted that 111 (35%) of 321 Home Fund vouchers tested were not paid in a timely manner. Several of these late payments required the Home to make an additional interest payment to the vendor. The Home’s management stated that staff shortages, early retirement and delayed filling of vacancies contributed to this situation. The Home is currently recruiting an Executive II, a Public Service Administrator, and an Accountant. (Finding 2, Page 10) We recommended the Home develop procedures to ensure that all vouchers are approved within 30 days of receipt of a proper bill. We further recommended that all vouchers be approved and paid in accordance with the State Prompt Payment Act. The Home’s management responded that vacant positions have been filled with the exception of the Accountant position. The Home has been able to process vouchers in a timely manner and has not incurred any Prompt Payment interest penalties through 12/31/06.
OTHER FINDINGS The remaining findings are reportedly being given attention by the Home. We will review progress toward implementation of our recommendations in our next examination. AUDITORS' OPINION
We conducted a compliance attestation examination of the Home as required by the Illinois State Auditing Act. We also performed certain agreed-upon procedures with respect to the records of the Home to assist in our compliance attestation examination of the entire Department of Veterans’ Affairs. We have not audited any financial statements of the Home for the purpose of expressing an opinion because the Home does not, nor is it required to, prepare financial statements. ____________________________________ WILLIAM G. HOLLAND, Auditor General WGH:JW:pp
SPECIAL ASSISTANT AUDITORS Our special assistant auditors were Nykiel Carlin & Co., LTD. |