Auditors ding The Bridge at South Pittsburg

A nursing home in South Pittsburg, Tennessee, was dinged in a state audit for almost $50,000 in unallowable expenses, inaccurate reporting of resident days and for not refunding more than $32,000 in credit balances on the accounts of 68 former residents.

The Tennessee Comptroller of the Treasury Division of State Audit reviewed the books at The Bridge at South Pittsburg covering the facility’s Medicaid cost report for the period Jan. 1, 2014, through Dec. 31, 2014; resident days for the period Jan. 1, 2014, through June 30, 2015; and resident accounts for the period Oct. 1, 2014, through Sept. 30, 2015, the audit states.

Management at The Bridge at South Pittsburg responded to all the findings with formal comments on what actions or remedies have been taken to address them, according to audit documents.

In the first finding, auditors said the facility billed Medicaid for $48,399 in unallowable expenses.

“As a result of these adjustments, as well as the adjustments to resident days and gross charges, overpayments made to the facility are estimated at $42,899.22 in overpayments made to the facility by the Medicaid Program, computed from July 1, 2015, through June 30, 2016,” the audit states.

Management at The Bridge at South Pittsburg said facility officials “have reviewed and modified our preparation process and educated our staff to ensure we correctly offset applicable marketing personnel,” the audit states.

In the second finding, the Bridge at South Pittsburg overreported 259 Level 1 patient care days, while underreporting 258 days at a higher level of care, according to the audit.

The facility overstated its Level 1 gross charges by $47,397. The facility also understated gross charges for Level 2 by $15,189 and other Level 1 care by $32,025, the audit states.

Management at the facility said officials have reviewed and modified the facility’s cost report preparation process and trained staff “to ensure that we correctly place the [Level 1 care] days on the appropriate line in the cost report,” the audit states.

Under the third finding that the facility improperly managed credit balances for deceased or discharged patients, auditors said the facility’s “accounts receivable unrefunded credit balances totaling $32,090.29 remain on the accounts of 68 former residents.”

Of that amount, $32,204.59 is owed to Medicaid and $885.70 is due to two former Medicaid residents or their legal representatives, the auditor states.

According to management’s comment in the audit, when the facility works with insurance companies it attempts to get the insurance to recoup the funds overpaid.

“If the insurance company does not recoup, South Pittsburg issues a refund to the resident,” management states. “All of the credit balances that were reviewed as part of this audit have been refunded to the appropriate payer[s].”

Auditors said they will follow up on the disposition of that finding within six months of the report’s release on June 7.