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FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS
INSUFFICIENT RESOURCES ALLOCATED TO PATIENT
ACCOUNTS
The Center did not take appropriate action in creating
financial case records; processing Notices of Determination and referring
account receivables to Central office in accordance with Department policies.
Our testing of 24 patient files revealed the following:
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For seventeen of 24 patient files tested (71%) the Center
did not obtain information about the patient’s assets and other resources to
complete the financial case record.
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One patient out of 24 (4%) was not billed even though the
patient received social security benefits and was Medicare eligible.
The Center did
not send the “Notice of Determination” to the patient within 60 days as
required.
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For two of twenty-four (8%) accounts receivable tested
totaling $1,763, the “Notice of Determination” were completed 20 and 58 days
after the 60 day grace period.
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One out of twenty-four (4%) accounts receivable tested
totaling $3,037 did not have a “Notice of Determination” on file.
The Center did not notify the
Department of Human Services Central Office of a collection problem with
certain patient’s accounts receivable.
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Eighteen out of twenty-four (75%) accounts receivable tested
were over 180 days old and the Center did not report the collection problems
to Central Office. These accounts receivable totaled $84,915 and ranged from
$458 to $29,797.
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Six out of twenty-four (25%) accounts receivable tested were
over 180 days old and the Center did not report timely the collection problems
to Central Office. These accounts receivable totaled $35,687 and ranged from
$2,406 to $7,916. Delays in reporting accounts to Central Office ranged from
1 to 29 months.
The Center lost Medicare billing
opportunities.
We tested 24 patient files which
included 11 that were Medicare eligible. Our testing revealed that the Center
placed six of the 11 (55%) Medicare eligible patients in one of the Center’s
non-certified Medicare units, thus rendering the Medicare reimbursement
non-applicable. (Finding 1, pages 10-12)
The Department agreed with our
recommendation to allocate sufficient resources to the Recipient Resource
Unit. The Center will assign an
Account Clerk II at least (4) hours a day and the Office Associate two (2) days
after each payroll close out to alleviate the current backlog.
FAILURE TO COMPLETE EMPLOYEE PERFORMANCE EVALUATIONS IN A TIMELY MANNER
The Center did not conduct employee performance evaluations
in accordance with administrative and Center policies.
Twenty-four personnel files out of fifty (48%) files tested
did not included annual performance evaluations based on the employee’s
creditable service date. Our procedures revealed that thirteen employee
performance evaluations were presented between one and seven months late,
eight were past due as of the end of our fieldwork and three had no record of
a performance evaluation on file. (Finding 2, page 13) This finding has
been repeated since 2001.
The Department agreed with our recommendation to implement
necessary controls to ensure that annual performance evaluations are
conducted as required by the Department of Human Services Administrative
Directives. The Center as of November
1, 2005 has implemented a resource database which will give all supervisors
six (6) weeks notice prior to the evaluation due date. Supervisors have been provided training
and the Hospital Administrator will monitor compliance. (For previous Agency
response, see Digest Footnote #1.)
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 entire
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– FAILURE TO COMPLETE EMPLOYEE PERFORMANCE
EVALUATIONS IN A TIMELY MANNER – Previous Agency Response
2003: Recommendation accepted. The Center will
continue its efforts to ensure that
all annual performance
evaluations are conducted as required and completed on
time.
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