Report Materials
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 Mexico's 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 State's Medicaid program requirements. As a result, the Manor's 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.
Notice
This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.