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Trustees briefed on upcoming CMS audit, staffing and financial metrics
Summary
Staff told trustees the facility will respond to an upcoming Medicare/Medicaid audit, reported November operational metrics including average daily census, payer mix and overtime, and noted a modest drop in the waiting list.
Lakeland Healthcare staff told trustees on Jan. 22 that the Center is preparing to respond to a claim review from the Centers for Medicare & Medicaid Services (CMS) and summarized recent operational and staffing data.
Denise (Lakeland staff) explained that CMS periodically audits facilities’ billing accuracy and that the audit will request resident records for review. "Our last audit was in 2022... once we get that list and submit it, and they are finished with their audit, we'll come back to you with a final report on it," Denise said. Staff said the 2022 audit showed no issues and they currently do not expect material problems but will report results when the audit concludes. Denise emphasized the audits focus on billing accuracy rather than quality-of-care metrics and that a poor audit outcome could require repayment or suspension of billing privileges.
In the operations report, staff provided monthly and annual figures: total incurred (medical/operational) for 2024 was $27,660; overtime costs for November were $37,332; average daily census was 81; Medicaid payer mix about 61%, Medicare just under 10%, and private pay about 29%. The facility reported one account over 90 days that exceeded $30,000 but said that account was paid in full.
On admissions and staffing, the waiting list has shortened, and staff estimated "maybe 30% decrease" in the waiting list size compared with an earlier period. The HR report for December showed little change among RNs and LPNs and a slight reduction in CNA vacancies. Staff cautioned it is difficult to predict admissions trends; Denise said the facility has been able to fill beds but the waiting list is smaller.
Ending
Staff said they will return with the CMS audit findings after submission and requested trustees contact staff with questions about operational metrics.
