Long-Term Care Facilities FY21

Examinations – Fiscal Year Ended June 30, 2021

June 10, 2025

Report Summary

Background

An examination of fourteen Long-Term Care Facility fiscal records of the Delaware Department of Health and Social Services, Division of Medicaid and Medical Assistance, Medicaid Long-Term Care Facilities’ Statement of Reimbursement Costs for Skilled and Intermediate Care Nursing Facilities – Title XIX and Nursing Wage Survey (cost report and nursing wage survey, respectively) for fiscal year ended June 30, 2021. Under the Delaware’s Medicaid State Plan, the state is required to examine a sample of facilities located with the state to ensure the facilities’ cost reports and nursing wage surveys are compliant with federal and state requirements.

These engagements were conducted in accordance with federal requirements (42 CFR 447.253 and 483 Subpart B) and state requirements (Title XIX Delaware Medicaid State Plan, Attachment 4.19D) (criteria), as applicable to the Long-Term Care Facility fiscal records. The criteria were used to prepare the Schedule of Adjustments to the Trial Balance, Patient Days, and Nursing Wage Survey for fiscal year ended June 30, 2021, found in the reports.

The State Auditor is authorized under 29 Del. C., §2906 to conduct audits of all financial transactions of all state agencies.

Key Information and Findings

All of the fourteen (14) long-term care facilities examined received unmodified opinions and complied, in all material respects, with the criteria mentioned.

All facilities audited had adjustments or findings in the reports. Under Governmental Auditing Standards, the adjustments and findings do not have a material impact on the examination. However, they are included to alert the readers of the reports with the comments made during the examination.

The most common findings and adjustments included:

Improper calculation of patient days on the cost report
Improper calculation of depreciation
Nursing wage survey’s improperly reported
Supporting documentation missing
Grouping expenses to improper cost centers
Variances between Medicaid, Medicare, and Other payer types
Self-insurance funds not setup through an independent fiduciary
Inclusion of non-allowable expenses with reimbursable costs

Full PDF Reports:

Category: 3. Other Entities, Audit Reports, Fiscal Year 2021, Long Term Care Facilities

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