Finding 573743 (2023-016)

Significant Deficiency
Requirement
E
Questioned Costs
-
Year
2023
Accepted
2025-08-18
Audit: 364406
Organization: Caswell County (NC)

AI Summary

  • Core Issue: Inaccurate resource entries in Medicaid case records and lack of internal controls over state programs.
  • Impacted Requirements: Eligibility documentation must match NC FAST records; effective internal controls are needed for grant fund usage.
  • Recommended Follow-Up: Review files for proper documentation, retrain workers on record-keeping, and ensure all entries are verified and reconciled with NC FAST.

Finding Text

CASWELL COUNTY, NORTH CAROLINA Schedule of Findings and Questioned Costs For the Year Ended June 30, 2023 Recommendation: Views of Responsible officials and corrective action plans: US 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: 2023-016 Inaccurate Resource Entry SIGNIFICANT DEFICIENCY Eligibility Criteria: Condition: Questioned Costs: Context: Effect: Section III. Federal Award Findings and Questioned Costs (continued) 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 2 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 noncountable. There was no known affect to eligibility and there were no known questioned costs. We examined 60 cases from of a total of 229,178 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 North Carolina Families Accessing Services through Technology (NC FAST) and a participant could have been approved for benefits for which they were not eligible. 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. The county agrees with the finding. Please refer to the corrective action plan for details. 129CASWELL COUNTY, NORTH CAROLINA Schedule of Findings and Questioned Costs For the Year Ended June 30, 2023 Cause: Recommendation: Views of Responsible officials and corrective action plans: Program Name: Medical Assistance Program (Medicaid; Title XIX) AL #: 93.778 N.C. Department of Commerce Program Name: Building Reuse Program Finding: 2023-017 Lack of Internal Control Procedures Over State Programs SIGNIFICANT DEFICIENCY Activities Allowed or Unallowed, Allowable Costs/Cost Principles Criteria: Condition: Effect: Section III. Federal Award Findings and Questioned Costs (continued) In accordance with the Uniform Guidance, the County is reponsible for establishing and maintaining effective internal control over compliance with the types of compliance requirements that could have direct and material effect on a major state program. The County did not receive supporting documents from the property owner to ensure the grant fund was used for allowed activities and costs when the property owner requesting the grant fund, and there were no effective internal control procedures in place to detect or correct this issue. The grant fund could be used for unallowed activities and costs. SIGNIFICANT DEFICENCY: Findings 2023-013, 2023-014, 2023-015, 2023-016 also apply to State requirements and State Awards. Section IV. State Award Findings and Questioned Costs Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. 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. The county agrees with the finding. Please refer to the corrective action plan for details. 130

Corrective Action Plan

CASWELL COUNTY 144 Court Square, Yanceyville, NC 27379 www.caswellcountync.gov 336/694-4193 Corrective Action Plan For the Year Ended June 30, 2023 Finding: 2023-016 Inaccurate Resource Entry Name of contact person: Corrective Action: Proposed Completion Date: Heather Starr Thomas, Medicaid Supervisor Cases will be reviewed internally to ensure proper documentation is in place for eligibility. Workers will be retrained on what cases should contain and the importance of complete and accurate record keeping. All cases will include online verifications ran timely, documented resources, income and make certain those amounts agree to information input into NC FAST. The results found or documentation made in case notes should clearly indicate what actions were performed by the caseworker and the results of those actions. Information must be updated at every application/recertification and change in circumstance adhering to Medicaid Policy. Templates have been updated to address request for information, income verifications, reasonable compatibility and to include electronic resources are ran with verification of date ran. Transfer of Asset policy and procedures will be reviewed with applicable caseworkers. TOA evaluation and clear documentation of Transfers and Resolutions must be documented. Help Desk tickets should be submitted timely if information or functionality is not working properly. All avenues available to caseworker must be exhausted before requesting information from client, unless information provided and information obtained is questionable. We will continue to train on this issue, and it will also be addressed in new worker Trainings. Training in the learning gateway is also available. May 1, 2024 Section III - Federal Award Findings and Question Costs (continued) 141

Categories

Allowable Costs / Cost Principles Eligibility Significant Deficiency

Other Findings in this Audit

  • 573740 2023-013
    Significant Deficiency Repeat
  • 573741 2023-014
    Significant Deficiency Repeat
  • 573742 2023-015
    Significant Deficiency Repeat
  • 1150182 2023-013
    Significant Deficiency Repeat
  • 1150183 2023-014
    Significant Deficiency Repeat
  • 1150184 2023-015
    Significant Deficiency Repeat
  • 1150185 2023-016
    Significant Deficiency

Programs in Audit

ALN Program Name Expenditures
21.027 Coronavirus State and Local Fiscal Recovery Funds $2.79M
14.871 Section 8 Housing Choice Vouchers $1.03M
93.778 Medical Assistance Program $659,101
93.563 Child Support Services $353,946
93.558 Temporary Assistance for Needy Families $328,539
20.509 Formula Grants for Rural Areas and Tribal Transit Program $301,469
93.667 Social Services Block Grant $242,663
93.045 Special Programs for the Aging, Title Iii, Part C, Nutrition Services $205,790
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $196,571
93.568 Low-Income Home Energy Assistance $144,081
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $120,994
93.658 Foster Care Title IV-E $110,025
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $93,374
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $75,616
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $70,021
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $67,980
93.268 Immunization Cooperative Agreements $62,746
93.044 Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers $41,496
97.042 Emergency Management Performance Grants $39,032
93.217 Family Planning Services $32,941
93.053 Nutrition Services Incentive Program $25,820
45.310 Grants to States $24,787
93.994 Maternal and Child Health Services Block Grant to the States $22,637
93.991 Preventive Health and Health Services Block Grant $22,574
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $17,997
93.767 Children's Health Insurance Program $13,111
93.069 Public Health Emergency Preparedness $10,974
93.659 Adoption Assistance $7,174
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $2,638
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $1,844
93.645 Stephanie Tubbs Jones Child Welfare Services Program $1,671
93.556 Marylee Allen Promoting Safe and Stable Families Program $1,500
93.000 Foster Care $344
93.977 Sexually Transmitted Diseases (std) Prevention and Control Grants $100