Cost reports are used to calculate a nursing facility’s Medicaid reimbursement rate and should only include expenses that are reasonable, allowable and in accordance with state and federal rules, regulations and reimbursement principles.
Auditors determined that AltaCare’s home office cost reports submitted in 2014, 2015 and 2016 each contained non-allowable amounts. These included legal expenses, unsupported expenses, late fees, penalties, expenses not related to AltaCare, and donations.
Additionally, auditors found that some personal expenses of AltaCare’s director, Doug Mittleider, were also included on the 2015 cost report. These included expenses for his wife’s flight from Sanborn, New York to France, church donations, a veterinarian expense, a guitar center purchase and other unspecified personal expenses.
Because the home office cost reports include amounts allocated to nursing facilities in other states, auditors determined that $855,679.32 of the $3.2 million can be attributed to The Cambridge House in Bristol, Tennessee. As a result of these non-allowable expenses, The Cambridge House was overpaid an estimated $324,999 between July 1, 2015 and June 30, 2018.
Auditors with the comptroller’s office are continuing to review these matters.
To view the audit report online, click here.