Department of Health and Human Services

Office of Inspector General -- AUDIT

"Results of Our Audit of Albuquerque Manor's Medicaid Nursing Facility Cost Report for the Fiscal Year Ended December 31, 2000," (A-06-03-00015)

January 21, 2004


Complete Text of Report is available in PDF format (523 KB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

Albuquerque Manor, a New Mexico nursing home, claimed costs on its Medicaid cost report for the year ended December 31, 2000 that were not:  (1) related to patient care or supported, (2) reduced to costs for related party transactions, and (3) allocable to the Manor.  New Mexicoís Medicaid program requires costs to be related to patient care and cost information to be accurate, current, and in sufficient detail to support payments for services rendered.  It also requires that purchases from related organizations not exceed the cost to the related organization and that costs must be based on an approved cost finding method.  The conditions occurred because the Manor did not have policies, procedures, and controls to ensure compliance with the Stateís Medicaid program requirements.  As a result, the Manorís Medicaid cost report was overstated by $518,492.  We recommended that the Manor: (1) establish and implement policies and procedures to ensure program requirements are met, and (2) submit a revised cost report that reduces costs by the amounts questioned, which will be used by the State Medicaid program to re-compute and adjust Medicaid reimbursement payments.  The Manor did not fully agree with the recommended adjustment and was not responsive to the conditions in our report.