EIN: 566000282
UEI: FVT7YDQ5CAA5
Audited by: Thompson, Price, Scott, Adams & Co., P.A.
Oversight agency: 93 [Department of Health and Human Services]
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Data as of August 28, 2026
Management decision deadline — for entities that funded this organization
The FAC accepted this audit on March 31, 2025. Under 2 CFR 200.521(d), a pass-through entity that provided federal funds to this organization for this audit period must issue a management decision on these findings by October 1, 2025 (333 days ago).
What is a management decision? →There were Nine (9) 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. The errors were as follows: One (1) case did not have accurate income calculations, One (1) case was improperly forced as eligible, One (1) case contained a household size calculation error, Two (2) cases had a failure to complete at least one compliance component, and Four (4) cases contained errors in resource verification or calculations. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 60 Medicaid applicants from a total 59,083 Medicaid claims from the Medicaid beneficiary report provided by the NC Department of Health and Human Services to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2023-001. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Show full finding ▾Hide full finding ▴Criteria: 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, documentation should be present and agree back to the records in the NC FAST system. Any items discovered in the process should be considered resources and explained within the documentation. Condition: There were Nine (9) 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. The errors were as follows: One (1) case did not have accurate income calculations, One (1) case was improperly forced as eligible, One (1) case contained a household size calculation error, Two (2) cases had a failure to complete at least one compliance component, and Four (4) cases contained errors in resource verification or calculations. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 60 Medicaid applicants from a total 59,083 Medicaid claims from the Medicaid beneficiary report provided by the NC Department of Health and Human Services to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2023-001. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Name of contact Person: Stephanie Wyche, Director of Social Services Corrective Action: [1] Agency has completed training with Adult Medicaid caseworkers regarding correct case documentation as it related to vehicles/personal property. Training was completed on September 5, 2024 and included targeted training for vehicles/personal property. MAABD policy sections 2230 V.B1 . (2); MAABD 2230 VIII A 3; MAABD 2230 VII C; MAABD 2230 VII D; and MAABD 2230 VII E were reviewed during this training. Also reviewed was usage of the DMA-5039 Right to Rebut Value of Vehicles. [3] Agency will complete training with all Medicaid caseworkers regarding correct data input into NCFAST, correct base period usage, and the importance of ensuring that accurate calculations are completed when determining Medicaid eligibility. Training has been scheduled for Monday November 25, 2024. [4] Agency will complete training with all Medicaid caseworkers regarding correct data input into NCFAST, correct computation of household composition, correct use of the manual MAGI household composition tool, and the importance of ensuring that data entered into NCFAST is generating the correct household size determination. Training has been scheduled for Monday November 25, 2024. [5] System issues where NCFAST us unable to complete a request of information from the Work Number are much less common than they used to be. Agency will complete training with staff to ensure that data matches are completed outside of NCFAST and documented in the event that OVS or the Work Number is unable to be completed in NCFAST. Staff has been informed that if there is any instance where data matches are unable to be completed in NCFAST, a help desk ticket needs to be submitted and any communications from the state about known issues should be included with documentation on any impacted cases. Training has been scheduled for Monday November 25, 2024. [6] Clear, accurate, and thorough case documentation is critical to the agency's success in ensuring that correct benefits are issued to all clients. Agency will complete training with all Medicaid staff to stress the importance of documenting any action taken on a case. Training has been scheduled for Monday November 25, 2024. Proposed Completion Date: Training for Error Category 1 was completed on September 5, 2024. Training will be completed for Error Categories 2-5 on Monday November 25, 2024.
2023-001
FAC accepted this audit on February 9, 2024 — management decision was due August 9, 2024.
There were eight (3) 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. The errors were as follows: One (1) case did not have accurate resource calculations, Two (2) cases had a failure to complete at least one compliance component. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 120 Medicaid applicants from a total 55,459 Medicaid claims from the Medicaid beneficiary report provided by the NC Department of Health and Human Services to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2022-001. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Show full finding ▾Hide full finding ▴Criteria: 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, documentation should be present and agree back to the records in the NC FAST system. Any items discovered in the process should be considered resources and explained within the documentation. Condition: There were eight (3) 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. The errors were as follows: One (1) case did not have accurate resource calculations, Two (2) cases had a failure to complete at least one compliance component. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 120 Medicaid applicants from a total 55,459 Medicaid claims from the Medicaid beneficiary report provided by the NC Department of Health and Human Services to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2022-001. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Federal Award Findings and Questioned Costs Finding: 2023- 001 Eligibility Errors: No eligibility errors were found. Internal Control Errors: 1. Failure to comply with policy requirement: Two (2) instances of failure to complete at least one compliance component. The work number was not run for all individuals of age with the potential for earned income in one case. 2. Inaccurate Resource Calculation: One (1) instance of inaccurate resource calculations in NC FAST. The values entered in NC FAST evidence and used in the eligibility determination did not match the supporting documentation or was lacking any substantiating documentation. Name of Contact Person: Karen Shuler, Income Maintenance Supervisor Corrective Action: 1. NCF has added functionality that automatically runs TWN at MAGI application and most MAGI recertification times. This will help ensure TWN is always completed on all eligible aged persons in the HH. For Non-MAGI programs, documentation that TWN was completed manually has been added to our Adult Medicaid review document. We have also had training on when TWN must be completed outside of NCF when a system error may be returned. 2. Camden County has implemented an Adult Medicaid review document that summarizes all elements of eligibility to allow easy comparison with NCF to make sure all amounts agree. We have completed training with workers regarding review of eligibility decisions to make sure all elements match. Proposed Completion Date: All above actions have been completed as of November 2, 2023. Questioned Costs: The technical errors did not affect eligibility resulting in no questioned costs.
2022-001
FAC accepted this audit on April 9, 2023 — management decision was due October 9, 2023.
There were eight (8) 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. The errors were as follows: One (1) case did not have accurate resource calculations, Four (4) cases did not have accurate budget calculations, Two (2) cases had a failure to complete at least one compliance component, One (1) case contained input errors. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 120 Medicaid applicants to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2021-001. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Show full finding ▾Hide full finding ▴Criteria: 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, documentation should be present and agree back to the records in the NC FAST system. Any items discovered in the process should be considered resources and explained within the documentation. Condition: There were eight (8) 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. The errors were as follows: One (1) case did not have accurate resource calculations, Four (4) cases did not have accurate budget calculations, Two (2) cases had a failure to complete at least one compliance component, One (1) case contained input errors. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 120 Medicaid applicants to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2021-001. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Corrective Action: Procedures and controls have been established for caseworkers to follow. Additional Training is already scheduled and will continue as needed on the Written Medicaid Corrective Action Plan for FY 2021. This will keep workers reminded to follow each policy and procedure more carefully to minimize errors in the application process for future audits. Director, Supervisor, and Lead Worker will conduct reviews no less than quarterly to verify accuracy. If issues arise, workers will be retrained on the specifics of what is needed. If continued errors arise, Finance Officer will do additional reviews. Proposed Completion Date: Certain controls have been created and are continuing to be reviewed and modified if needed. Management will have 1st training no later than February 1st, 2022. Supervisor and Director will continue to monitor this issue and have additional mandatory trainings for staff that fail to comply with the Written Corrective Action Plan for FY 2021.
2021-001
FAC accepted this audit on March 9, 2022 — management decision was due September 9, 2022.
There were thirty one (31) 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. The errors were as follows: Nine (9) cases did not have accurate resource calculations, Eight (8) cases did not have accurate budget calculations, Thirteen (13) cases had a failure to complete at least one compliance component, One (1) case contained input errors. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 120 Medicaid applicants to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2020-001. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Show full finding ▾Hide full finding ▴Significant Deficiency/Noncompliance US Department of Health and Human Services Passed through the NC Dept. of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) CFDA # 93.778 Finding: 2021 ? 001 Eligibility Criteria: 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, documentation should be present and agree back to the records in the NC FAST system. Any items discovered in the process should be considered resources and explained within the documentation. Condition: There were thirty one (31) 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. The errors were as follows: Nine (9) cases did not have accurate resource calculations, Eight (8) cases did not have accurate budget calculations, Thirteen (13) cases had a failure to complete at least one compliance component, One (1) case contained input errors. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 120 Medicaid applicants to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2020-001. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Name of contact Person: Craig Patterson, Director of Social Services Corrective Action: Procedures and controls have been established for caseworkers to follow. Additional Training is already scheduled and will continue as needed on the Written Medicaid Corrective Action Plan for FY 2021. This will keep workers reminded to follow each policy and procedure more carefully to minimize errors in the application process for future audits. Director, Supervisor, and Lead Worker will conduct reviews no less than quarterly to verify accuracy. If issues arise, workers will be retrained on the specifics of what is needed. If continued errors arise, Finance Officer will do additional reviews. Proposed Completion Date: Certain controls have been created and are continuing to be reviewed and modified if needed. Management will have 1st training no later than February 1st, 2022. Supervisor and Director will continue to monitor this issue and have additional mandatory trainings for staff that fail to comply with the Written Corrective Action Plan for FY 2021.
2020-001
FAC accepted this audit on March 23, 2021 — management decision was due September 23, 2021.
There were five errors discovered during our procedures that inaccurate information was entered when determining eligibility. Five applicant/beneficiaries that received assistance for which the recipient was not eligible Questioned Costs: The amount of claims paid on behalf of the above ineligible participants for fiscal year ending 6/30/2020 did not exceed the threshold for a questioned cost determination. Context: We examined 60 Medicaid applicants to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2019-002. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Show full finding ▾Hide full finding ▴Significant Deficiency/Noncompliance US Department of Agriculture Passed through the NC Dept. of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) CFDA # 93.778 Finding: 2020 ? 001 Eligibility Criteria: 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. Condition: There were five errors discovered during our procedures that inaccurate information was entered when determining eligibility. Five applicant/beneficiaries that received assistance for which the recipient was not eligible Questioned Costs: The amount of claims paid on behalf of the above ineligible participants for fiscal year ending 6/30/2020 did not exceed the threshold for a questioned cost determination. Context: We examined 60 Medicaid applicants to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2019-002. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
2020 ? 001 Eligibility Name of contact Person: Craig Patterson, Director of Social Services Corrective Action: Procedures and controls are being developed for caseworkers to follow. Medicaid caseworkers will receive additional training on the newly created ?Documentation Policy? to remind each of the policies and procedures to be followed in the application process. Supervisors will review action reports regularly to determine if correct was taken and that action was correctly closed out. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. Proposed Completion Date: Certain controls are currently being created and reviewed. Management will continue to monitor the progress of this issue and modify the controls as needed.
2019-002
There were twenty five (25) technical 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. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 60 Medicaid applicants to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2019-001. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Show full finding ▾Hide full finding ▴Significant Deficiency US Department of Agriculture Passed through the NC Dept. of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) CFDA # 93.778 Finding: 2020 ? 002 Eligibility Criteria: 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, documentation should be present and agree back to the records in the NC FAST system. Any items discovered in the process should be considered resources and explained within the documentation. Condition: There were twenty five (25) technical 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. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 60 Medicaid applicants to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2019-001. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
2020 - 002 Eligibility Name of contact Person: Craig Patterson, Director of Social Services Corrective Action: Procedures and controls are being developed for caseworkers to follow. Medicaid caseworkers will receive additional training on the newly created ?Documentation Policy? to remind each of the policies and procedures to be followed in the application process. Supervisors will review action reports regularly to determine if correct was taken and that action was correctly closed out. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. Proposed Completion Date: Certain controls are currently being created and reviewed. Management will continue to monitor the progress of this issue and modify the controls as needed.
2019-001
FAC accepted this audit on May 18, 2020 — management decision was due November 18, 2020.
There were three (3) 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. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 60 Medicaid applicants to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2018-001. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Show full finding ▾Hide full finding ▴MATERIAL WEAKNESS MATERIAL NONCOMPLIANCE US Department of Agriculture Passed through the NC Dept. of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) CFDA # 93.778 Finding: 2019 ? 001 Eligibility Criteria: 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, documentation should be present and agree back to the records in the NC FAST system. Any items discovered in the process should be considered resources and explained within the documentation. Condition: There were three (3) 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. Questioned Costs: There was no affect to eligibility and there were no questioned costs. Context: We examined 60 Medicaid applicants to re-determine eligibility. These findings were disclosed in a separately issued spreadsheet to the North Carolina Department of Health and Human Services and are being reported with the financial statement audit as it relates to Medicaid administrative cost compliance audit. Effect: For those certifications/re-certifications there was a chance that information was not properly documented and reconciled to NC FAST which affect countable resource and a participant could have been approved for benefits that they were not eligible. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility Identification of a repeat finding: This is a repeat finding from the immediate previous audit, 2018-001. Recommendation: 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. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Finding 2019 ? 001 Name of contact person: Craig Patterson, Director of Social Services Corrective Action: Procedures and controls are being developed for caseworkers to follow. Medicaid caseworkers will receive additional training on the newly created ?Documentation Policy? to remind each of the policies and procedures to be followed in the application process. Supervisors will review action reports regularly to determine if correct was taken and that action was correctly closed out. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process. Proposed Completion Date: Certain controls are currently being created and reviewed. Management will continue to monitor the progress of this issue and modify the controls as needed.
2018-001
There was one (1) error in one (1) file dealing with verifying real property ownership and the determination of whether it is a countable resource or is exempt from resource calculations. Questioned Costs: There were questioned cost of $14,376 on this\ case. This amount was determined by totaling all the aid received by the applicant who was not eligible. Context: Of the 3,424 case files, we examined 60 applicants and determined that one applicant received assistance for which eligibility was not properly determined. Effect: For that certification/recertification there was a chance that property was owned that would not have been treated as a countable resource and a person could have been approved for benefits that they were not eligible. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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 a print out as evidence that the Register of Deeds was checked and the results found or documentation made in case notes that clearly indicates what actions were performed and the results of those actions. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Show full finding ▾Hide full finding ▴MATERIAL WEAKNESS MATERIAL NONCOMPLIANCE US Department of Agriculture Passed through the NC Dept. of Health and Human Services Program Name: Medical Assistance Program (Medicaid; Title XIX) CFDA # 93.778 Finding: 2019 ? 002 Eligibility Criteria: Medicaid for Aged, Blind and Disabled case records should contain documentation that tax records and Register of Deeds were checked to verify if the individual owns property. The files should also contain documentation on any property found as to whether it is a countable resource or is exempt from the resources calculation. Condition: There was one (1) error in one (1) file dealing with verifying real property ownership and the determination of whether it is a countable resource or is exempt from resource calculations. Questioned Costs: There were questioned cost of $14,376 on this\ case. This amount was determined by totaling all the aid received by the applicant who was not eligible. Context: Of the 3,424 case files, we examined 60 applicants and determined that one applicant received assistance for which eligibility was not properly determined. Effect: For that certification/recertification there was a chance that property was owned that would not have been treated as a countable resource and a person could have been approved for benefits that they were not eligible. Cause: Ineffective record keeping and ineffective case review process, incomplete documentation, and incorrect application of rules for purposes of determining eligibility. Recommendation: 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 a print out as evidence that the Register of Deeds was checked and the results found or documentation made in case notes that clearly indicates what actions were performed and the results of those actions. Views of responsible officials and planned corrective actions: The County agrees with the finding. Supervisors will perform second party reviews to ensure proper documentation is contained in files to support eligibility determinations. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process.
Finding 2019 ? 002 Name of contact person: Craig Patterson, Director of Social Services Corrective Action: Procedures and controls are being developed for caseworkers to follow. Medicaid caseworkers will receive additional training on the newly created ?Documentation Policy? to remind each of the policies and procedures to be followed in the application process. Supervisors will review action reports regularly to determine if correct was taken and that action was correctly closed out. Workers will be retrained on what information should be maintained in case files, the importance of complete and accurate record keeping, and reserve calculations. The County finance office will also participating in the review process. Proposed Completion Date: Certain controls are currently being created and reviewed. Management will continue to monitor the progress of this issue and modify the controls as needed.
FAC accepted this audit on January 17, 2018 — management decision was due July 17, 2018.
FAC accepted this audit on February 14, 2017 — management decision was due August 14, 2017.
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