Audit report, schedule of reimbursable patient day statistics, Appling County Nursing Home, Baxley, Georgia, Medicaid provider no. 00140093A, for the year ended June 30, 1994, Georgia Department of Medical Assistance [June 30, 1994]

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STATE OF GEORGIA DEPARTMENT OF AUDITS
254 WASHINGTON STREET ATLANTA. GEORGIA 30334

AUDIT REPORT SCHEDULE OF REIMBURSABLE COSTS AND
PATIENT DAY STATISTICS APPLING COUNTY NURSING HOME
BAXLEY, GEORGIA MEDICAID PROVIDER NO. 00140093A FOR THE YEAR ENDED JUNE 30, 1994 GEORGIA DEPARTMENT OF MEDICAL ASSISTANCE

APPLING COUNTY NURSING HOME - TABLE OF CONTENTS -
AUDITOR'S REPORT SCOPE OF THE AUDIT SCHEDULE OF REIMBURSABLE COSTS AND PATIENT DAY STATISTICS NOTES TO SCHEDULE EXPLANATION OF FIELD AUDIT ADJUSTMENT

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CLAUDE L. VICKERS
STATE AUDITOR (404) 656-2174

DEPARTMENT OF AUDITS
254 Washington Street, S.W., Suite 214 Atlanta, Georgia 30334-8400
February 3, 1995

Nursing Home Reimbursement Section Georgia Department of Medical Assistance 2 Peachtree Street, NW Room 27-208 Atlanta, Georgia 30303-3159
Ladies and Gentlemen:
We have audited the Nursing Home Cost Report filed with the Georgia Department of Medical Assistance under the Title XIX Medicaid Program by Baxley-Appling County Hospital Authority d/b/a Appling County Nursing Home for the year ended June 30, 1994, and have compiled the accompanying Schedule of Reimbursable Costs and Patient Day Statistics based on our audit. The Nursing Home Cost Report is the responsibility of the management of Baxley-Appling County Hospital Authority d/b/a Appling County Nursing Home. Our responsibility is to determine if the reimbursable costs and patient day statistics reported in the Nursing Home Cost Report are reasonable and allowable, in all material respects, in accordance with the federal and state laws, regulations, policies and procedures governing the Georgia Nursing Home Reimbursement Program. It is also our responsibility to report the results of our audit, including any required adjustments to the cost report data, to the Georgia Department of Medical Assistance.
We conducted our audit in accordance with the Nursing Home Audit Program approved by the Georgia Department of Medical Assistance. Except as described in the following paragraph our audit included examining and evaluating, on a test basis, evidence supporting the amounts and disclosures in the Nursing Home Cost Report. Our audit also included assessing the accounting principles used and significant estimates made by management. We believe our audit provides a reasonable basis for our report.
Our audit did not include tests of the Medicare cost report, form HCFA 2552, filed by Baxley-Appling County Hospital Authority d/b/a Appling General Hospital. This report is audited by the Medicare intermediary. Any adjustments to the costs allocated to Appling County Nursing Home are the responsibility of the Medicare intermediary. The amount of the adjustments, if any, are not known to us and may be material.

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As described in Note 1 of the Notes to Schedule, the accompanying Schedule of Reimbursable Costa and Patient Day Statistics was prepared to present the data necessary for the Georgia Department of Medical Assistance to determine Medicaid reimbursement and is not intended to be a presentation in accordance with generally accepted accounting principles, nor is it intended to be a complete presentation of the assets, liabilities, revenues and expenses of Baxley-Appling County Hospital Authority d/b/a Appling County Nursing Home on the basis described.

In our opinion, except for the effects of the matter discussed in the third paragraph, the "adjusted totals" column in the accompanying Schedule of Reimbursable Costs and Patient Day Statistics - which was compiled by us and reflects any adjustments to the cost report data required as a result of our audit - presents fairly, in all material respects, the reimbursable costs and patient day statistics of Baxley-Appling County Hospital Authority d/b/a Appling County Nursing Home for the year ended June 30, 1994, on the basis of accounting described in Note 1.

This report is intended to be used solely in connection with the

administration of the Georgia Department of Medical Assistance Nursing Home

Reimbursement Program and is not to be used or relied upon for any other

purpose.

Redlly submitte

CLV/lb/by

Claude L. Vickers State Auditor

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APPLING COUNTY NURSING HOME SCOPE OF THE AUDIT
FOR THE YEAR ENDED JUNE 30, 1994
This audit was performed in order to determine if the reimbursable costs and patient day statistics reported in the Nursing Home Cost Report are reasonable and allowable, in all material respects, in accordance with the federal and state laws, regulations, policies and procedures governing the Georgia Medicaid Program, and to report to the Georgia Department of Medical Assistance (OMA) any adjustments to the cost report data required as a result of our audit.
In order to accomplish these objectives, we examined, on a test basis, evidence supporting the amounts and disclosures in the Nursing Home Cost Report, and assessed the accounting principles used and significant estimates made by management. Tested transactions and accounts were evaluated for compliance with OMA Policies and Procedures for Nursing Home Services and for compliance with federal laws and regulations applicable to the Title XIX Medicaid Program. Any adjustments to the cost report data required as a result of our audit are included in this report.
Information contained in the cost report Schedule B-2, Supporting Schedule of Operating Expenses, is based upon both direct costs of the nursing facility and indirect costs allocated to it from Appling General Hospital. These indirect cost allocations result from the step-down of general service costs from the hospital as shown on the Medicare cost report, Worksheet B, Parts I and II. Our audit did not include tests of either these indirect costs or the reclassifications and adjustments made to determine net expenses for cost allocation on the Medicare cost report worksheets. These costs are subject to audit by the Medicare intermediary. Any audit adjustments by the Medicare intermediary made to indirect costs which impact the nursing facility will be reflected in the Medicaid cost report in the year the Medicare cost report is final-settled.
Our audit included a limited consideration of the organization's internal control structure sufficient to plan the audit. Our consideration for this limited purpose would not necessarily disclose all reportable conditions in the internal control structure. Accordingly, we do not express an opinion on the internal control structure.
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APPLING COUNTY NURSING HOME SCHEDULE OF REIMBURSABLE COSTS
AND PATIENT DAY STATISTICS FOR THE YEAR ENDED JUNE 30, 1994

REIMBURSABLE COSTS

PER COST REPORT
AS FILED

Routine Services

$ 425,434

Special Services

118,681

Dietary

176,098

Laundry and Housekeeping

125,202

Operation and Maintenance of Plant

115,141

Administrative and General

80,492

Property and Related Expenses

38,401

OFFICE

FIELD

AUDIT

AUDIT

ADJUSTMENTS ADJUSTMENTS

ADJUSTED TOTALS

$ 425,434

118,681

176,098

125,202

$

2,995

115,141 83,487

(2,995)

35,406

Total Reimbursable Costs $1,079,449

$

0 $1,079,449

PATIENT DAY STATISTICS

11,024

11,024

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APPLING COUNTY NURSING HOME NOTES TO SCHEDULE
FOR THE YEAR ENDED JUNE 30, 1994
NOTE ls SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES ENTITY INFORMATION
Appling County Nursing Home is a 31-bed long-term health care facility located in Baxley, Georgia. The facility provides both skilled and intermediate care services to resident patients. The facility is owned and operated by Baxley-Appling County Hospital Authority, which operated both Appling General Hospital and Appling County Nursing Home in the same physical facility during the year under review.
The provider was in compliance with the Department of Medical ssistance's requirements for classification as a hospital-based nursing home as specified in OMA Policies and Procedures for Nursing Home Services, paragraph 1002.1.g.
BASIS OF ACCOUNTING The Nursing Home Cost Report and the associated Schedule of Reimbursable
Costs and Patient Day Statistics, hereinafter referred to as the Schedule, were prepared in conformity with the Principles of Reimbursement for Provider Cost published by the Secretary of Health.and Human Services as modified by the provisions of Policies and Procedures for Nursing Home Services published by the Georgia Department of Medical Assistance. This basis of accounting required by the Medicaid Program differs from generally accepted accounting principles. Consequently, the information presented in this report reflects only the allowable reimbursable costs and patient day statistics required for OMA to determine the healthcare provider's Medicaid reimbursement rate. This report does not reflect the provider's financial position or the results of its operations; it is intended to be used solely in connection with the administration of the Georgia Department of Medical Assistance Nursing Home Reimbursement Program and is not to be used or relied upon for any other purpose.
NOTE 2: OFFICE AUDIT ADJUSTMENTS The Office Audit Adjustments column on the Schedule is provided to show
the net effect of adjustments made during the office audit process. No office audit was performed prior to the cost report field audit and, therefore, no adjustments are shown.
NOTE 3: FIELD AUDIT ADJUSTMENTS The Field Audit Adjustments column on the Schedule is provided to show
the net effect of adjustments made during the cost report field audit process. The audit adjustment made as a result of this audit is explained in the Explanation of Field Audit Adjustment.
NOTE 4: PROPERTY COST REIMBURSEMENT Effective July 1, 1994, in accordance with Section 1002.2 of OMA Policies
and Procedures for Nursing Home Services, the provider is reimbursed for property and related expenses under the Dodge Index system rather than historical costs.
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ADJUSTMENT NUMBER
1

APPLING COUNTY NURSING HOME EXPLANATION OF FIELD AUDIT ADJUSTMENT
FOR THE YEAR ENDED JUNE 30, 1994

EXPLANATION

INCORRECT EXPENSE CLASSIFICATIONS

Documentation examined during the audit showed that liability insurance expense was not classified in accordance with the Uniform Chart of Accounts prescribed by the Department of Medical Assistance for providers participating in the Medicaid Nursing Home Reimbursement Program. This adjustment is made to reclassify costs to the appropriate cost centers. (DMA Policies and Procedures, Appendix D)

COST CENTER Administrative and General Property and Related Expenses

$ 2,995 (2,995)

Net Adjustment to Reimbursable Costs

$

0

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