The staff determines the amount of public assistance which was paid out and files claims against the estate to recover the costs. Property Referrals - Transfer to Heir Case File after death of client if real property still exists. Transfer to Reports of Deceased Person when client dies without real property. The Financial Audit Unit audits Nursing Facility Financial Statements to determine appropriate Medicaid cost reimbursement amounts for each facility. Fifty percent of the facilities receive full scope audits each year and all facilities receive desk reviews.
Auditors review billing rates, revenue classifications and accuracy of reporting.
They also review for appropriateness costs claimed for reimbursement by the facility and per resident. Audits result in settlements regarding reimbursement for the facility's costs over the past year, and in rate setting for the following year. The Unit also evaluates and develops potential changes to the nursing facility reimbursement system and reports findings to Division management. Evaluation of the nursing facility reimbursement system is documented in Nursing Facility Reimbursement System Reports. 036 Nursing Facility Audit Files - Retain 7 years, destroy.