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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
|
2.54/1
|
2.36/1
|
|
Cost Per Year Per Resident.................................
|
* |
$273,243 |
$258,096 |
|
*The Department had not calculated this cost at the
close of audit fieldwork. |
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FACILITY ADMINISTRATOR |
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|
During Examination Period: Elaine Novak
Currently: Elaine Novak |
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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. |