Audit of Nursing Homes and Denial of Payment Remedies - State of Ohio - October 1, 1999 Through September 30, 2001 - Ohio Department of Job and Family Services

EXECUTIVE SUMMARY:

The objectives of this audit were to ensure that the mandatory denial of payment remedy for substandard quality of care was applied to nursing homes that were not in substantial compliance with the prescribed Medicaid participation requirements and to evaluate whether State controls were adequate to prevent improper Medicaid payments to nursing homes under the denial of payment remedy.  Our audit included denial of payment sanctions, which were in effect from October 1, 1999 to September 30, 2001.   We found that the State permitted improper Medicaid payments for new admissions totaling $30,223 ($17,796 Federal share) to sanctioned nursing homes.  We recommended a financial adjustment and implementation of additional procedures, to ensure payments to providers are suspended timely.  The dollar amount of overpayments was adjusted in response to auditee comments on the draft report.  The State agrees with the amount recommended for adjustment and concurred with our recommendation for implementation of additional procedures.