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$1 Million Paid to Deceased Nursing Home Residents in Illinois

Tue, 04/04/2000 - 11:00pm — Karen Stevenson
Description: 

In 1997-1998, the State of Illinois paid over $1 million to nursing home providers for residents who were deceased. Although the payments were eventually corrected, there was concern that the providers effectively got an interest-free loan during the time they held the overpayment. The Office of the Inspector General of the Illinois Department of Public Aid (OIG) investigated the cause of these overpayments, to determine whether the providers were not properly notifying the Department, or if the State had not properly processed the notifications. In their report, they identified many problems, attributable both to the state and to the providers.

Files in both the nursing homes and the DHS offices were missing the appropriate death notification form (IDPA 1156). About 20% of the forms were missing from nursing home files, and 73% were completed past the required date. Only about 40% of the forms investigators located in nursing home files could be found in the DHS files, but investigators were unable to prove whether or not the forms had been filed, since Department staff were unable to even find the case file 24% of the time.

Investigators found many other problems. For example, IDPA notified providers in April 1998 that they must notify the Department within 5 days of the death of a resident. The Department provided a mailing address and said a fax machine would be installed to expedite the reporting of the death of a beneficiary, however, the fax machine was not installed for another year, and it was another six months after that before IDPA notified providers of the fax number.

In 1997-1998, the State of Illinois paid over $1 million to nursing home providers for residents who were deceased. Although the payments were eventually corrected, there was concern that the providers effectively got an interest-free loan during the time they held the overpayment. The Office of the Inspector General of the Illinois Department of Public Aid (OIG) investigated the cause of these overpayments, to determine whether the providers were not properly notifying the Department, or if the State had not properly processed the notifications. In their report, they identified many problems, attributable both to the state and to the providers.

Files in both the nursing homes and the DHS offices were missing the appropriate death notification form (IDPA 1156). About 20% of the forms were missing from nursing home files, and 73% were completed past the required date. Only about 40% of the forms investigators located in nursing home files could be found in the DHS files, but investigators were unable to prove whether or not the forms had been filed, since Department staff were unable to even find the case file 24% of the time.

Investigators found many other problems. For example, IDPA notified providers in April 1998 that they must notify the Department within 5 days of the death of a resident. The Department provided a mailing address and said a fax machine would be installed to expedite the reporting of the death of a beneficiary, however, the fax machine was not installed for another year, and it was another six months after that before IDPA notified providers of the fax number.