YELLOW SHEET Office of the State Auditor of Missouri |
Report No. 2000-112
October 25, 2000
The
Department of Mental Health built the wrong size rooms in the new Southwest
Missouri Psychiatric Rehabilitation Center, leaving the facility unable to seek
Medicaid reimbursement for some clients. The department also paid an extra
approximately $137,000 to construct the new center.
We
noted these concerns in our audit of the rehabilitation center. Our findings
focused on eight areas:� the new center
in El Dorado Springs, expenditures, supported Community Placement Programs,
fixed assets, vehicle usage, receipt controls, and employee meals.� The following highlights our findings.
New facility cost more, missed out on Medicaid
reimbursement
Inadequate
planning of the new rehabilitation center in El Dorado Springs resulted in
additional construction costs of $101,000 and additional rental costs of
$36,222.� In addition, the rooms built
at the new facility do not meet the size requirements of the Medicaid
reimbursement program, thus clients staying in the new center that could have
qualified for such funds cannot.� We
could not determine how much the state lost in reimbursement revenue. (See page
7)
Center paid another hospital�s costs
The Department of Mental Health directed the
rehabilitation center to pay more than $161,000 of Fulton State Hospital�s
operating costs, but represented these costs as rehabilitation center
expenditures.� This practice overstates
the center�s total costs and circumvents the state budget process. (See page 8)
The facility also bought more than $25,000 in furniture,
televisions, stereos and video recorders for the proposed expansion of the new
center in June 1999, even though the state did not approve the project until
October 1999.� The items remain idle in
storage and several were stolen in January 2000. Buying items before they are
needed is an unnecessary use of state funds. (See page 8)
Community Placement Program mixed client and
operating funds
Our audit reviewed six Community Placement Programs,
which provide residential care for several rehabilitation center clients, and
found these concerns: (See Page 10)
�
Some placement facilities maintained the client
personal funds in the facility�s operating account, increasing the likelihood
that client monies are not accounted for properly.
�
Some facilities did not keep invoices or vouchers to
show disbursements of client funds or�
acquire appropriate approval for client purchases in excess of $100.
�
Some facilities allowed clients to keep a negative
balance, which forced other clients to cover their expenses.
Some staff primarily use state cars for commuting
to work
Two of the center�s top staff members use state cars
mainly to drive to work.� Between these
two employees, their commutes total 150 miles daily.� Mileage records showed that these commutes accounted for 63
percent of Executive Director�s total miles in his state car and 90 percent of
the Unit Manager�s total miles. (See Page 13)