Finding Text
Nash County, North Carolina
Schedule of Findings and Questioned Costs
For the Year Ended June 30, 2024
Dollar threshold used to determine a State major program: $ 5 00,000
Auditee qualified as State low-risk auditee? X yes no
Finding: 2024-001 Budget Violation
SIGNIFICANT DEFICIENCY /NONCOMPLIANCE
Criteria:
Condition:
Effect:
Cause:
Recommendation:
Views of responsible officials
and planned corrective
i
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medicaid Assistance Program (Medicaid; Title XIX)
AL# 93.778
Finding 2024-002 Inaccurate Information Entry
SIGNIFICANT DEFICIENCY
Eligibility
Criteria:
Condition:
Questioned Cost:
Context:
There was no affect to eligibility and there were no questioned costs.
In accordance with 42 CFR 435, documentation must be obtained as needed to determine if a
recipient meets specific standards, and documentation must be maintained to support eligibility
determinations. In accordance with 2 CFR 200, management should have an adequate system of
internal controls procedures in place to ensure an applicant is properly determined or redetermined
for benefits.
Section II - Financial Statement Findings
Section III - Federal Award Findings and Questioned Costs
The budget should be reviewed and appropriate amendments made during the year.
The County agrees with this finding. Please refer to the corrective action plan for details.
There were 5 errors discovered during our procedures that inaccurate information was entered when
determining eligibility.
We examined 60 cases from a total of 1,168,444 Medicaid claims from the Medicaid beneficiary
report provided by NC Department of Health and Human Services to re-determine eligibility. These
findings are being reported with the financial statement audit as it relates to Medicaid administrative
cost compliance audit.
Section I - Summary of Auditors' Results (continued)
In accordance with North Carolina General Statutes § 143C, Budget revisions must be requested and
approved prior to any commitment and/or expenditure that would exceed the amount budgeted.
Entities should not overspend the authorized budget.
At June 30, 2024, the Tourism Fund reported expenditures over appropriations of $242,126 due to
not budgeting for the entire amount of a new GASB 87 lease entered into in the current year.
The Board spent funds that were not available for those respective functions and funds.
Amendments were not made to account for the GASB 87 implementation to record the initial lease
values.
185Nash County, North Carolina
Schedule of Findings and Questioned Costs
For the Year Ended June 30, 2024
Effect:
Identification of a repeat
finding:
Cause:
Recommendation:
Views of responsible officials
and planned corrective
U.S. Department of Health and Human Services
Passed through the NC Department of Health and Human Services
Program Name: Medicaid Assistance Program (Medicaid; Title XIX)
AL# 93.778
Finding: 2024-003 Inaccurate Resources Entry
SIGNIFICANT DEFICIENCY
Eligibility
Criteria:
Condition:
Questioned Cost:
Context:
Effect:
Identification of a repeat
finding:
Cause:
We examined 60 cases from a total of 1,168,444 Medicaid claims from the Medicaid beneficiary
report provided by NC Department of Health and Human Services to re-determine eligibility. These
findings are being reported with the financial statement audit as it relates to Medicaid administrative
cost compliance audit.
For those certifications/re-certifications there was a chance that information was not properly
documented and reconciled to NC FAST and a participant could have been approved for benefits for
which they were not eligible.
Ineffective record keeping and ineffective case review process, incomplete documentation, and
incorrect application of rules for purposes of determining eligibility.
In accordance with Medicaid Manual MA-2230, Medicaid for Aged, Blind and Disabled case
records should contain documentation that verifications were done in preparation of the application
and these items will agree to reports in the NC FAST system. In this process, the countable
resources should be calculated correctly and agree back to the amounts in the NC FAST system. Any
items discovered in the verification process should be considered countable or non-countable
resources and explained within the documentation.
There were no known affects to eligibility and there were no known questioned costs.
The County agrees with the finding and is implementing actions to correct these issues, which are
further discussed in the corrective action plan.
This is a repeat finding from the immediate previous audit, 2023-003.
There were 4 errors discovered during our procedures that resources in the county documentation
and those same resources contained in NC FAST were not the same amounts or files containing
resources were not properly documented to be considered countable or non-countable.
Files should be reviewed internally to ensure proper documentation is in place for eligibility.
Workers should be retrained on what files should contain and the importance of complete and
accurate record keeping. We recommend that all files include online verifications, documented
resources of income and those amounts agree to information in NC FAST. The results found or
documentation made in case notes should clearly indicate what actions were performed and the
results of those actions.
This is a repeat finding from the immediate previous audit, 2023-002.
Section III - Federal Award Findings and Questioned Costs (Continued)
For those certifications/re-certifications there was a chance that information was not properly
documented and reconciled to NC FAST and a participant could have been approved for benefits for
which they were not eligible.
Ineffective record keeping and ineffective case review process, incomplete documentation, and
incorrect application of rules for purposes of determining eligibility.
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