Open Recommendations

Establish recurring communication with appropriate support office personnel to ensure necessary PP&E information is available for analysis.

Consult with appropriate support office personnel to perform a detailed analysis of estimated useful lives of PP&E.

Formalize and document a policy over prepaid expenses, including consideration of compliance with GAAP.

Design a control to identify, analyze, and respond to risks related to the reporting of pre-paid expenses.

We recommend that the Colorado Department of Health Care Policy & Financing follow up with the 20 nursing homes reviewed in this audit that demonstrated life safety, emergency preparedness, and infection control deficiencies to ensure that they have taken corrective actions.

We recommend that the Colorado Department of Health Care Policy & Financing work with CMS to develop a risk-based approach to identify nursing homes at which surveys would be conducted more frequently than once every 15 months, such as those with a history of multiple high-risk deficiencies or frequent management turnover.

We recommend that the Colorado Department of Health Care Policy & Financing work with CMS to develop standardized life safety training for nursing home staff.

We recommend that the Massachusetts Department of Public health work with CMS to develop standardized life safety training for nursing home staff.

Where cost effective, expand existing initiatives to obtain earnings information electronically.

Automate printing applicants’ responses to the earnings-test questions on the application summary SSA provides beneficiaries when they request to start receiving their Old-Age, Survivor, and Disability Insurance benefits.

Revise systems to ensure the Agency requests monthly earnings information from beneficiaries eligible for the monthly earnings test before it assesses an overpayment.

Add language to overpayment notices informing beneficiaries who are eligible for the monthly earnings test their overpayment may be reduced or eliminated if they had monthly wages below the applicable limit.

Expand controls to detect potential underpayments based on discrepancies between the Master Beneficiary Record and Master Earnings File.

Implement systems changes to automatically grant earnings-test-related monthly benefit increases at, or closer to, the date they are first allowed by policy.

Clarify policy to inform employees of criteria that must be met to grant earnings-test-related monthly benefit increases and what actions they must take to release payments to beneficiaries.

Determine the costs associated with collecting earnings-test overpayments and re-evaluate the threshold established in policy and systems to exclude overpayments from the earnings enforcement process if the estimated cost to recover the resulting overpayment exceeds the potential collections.

Correct the remaining error cases from the sample reviews.

SNL management develops a process to accurately identify, assess, and approve Controlled Articles before these items are allowed into security areas;

SNL policies addressing Controlled Articles do not allow SNL management to grant exceptions to processes that require approval from the ODFSA;

SFO’s approved guidance regarding Controlled Articles at SNL is up to date, aligns with current Department policies, and meets the approval of the ODFSA;

SNL determines if an Incident of Security Concern occurred and takes appropriate action.

SNL management develops a process to accurately identify, assess, and approve Controlled Articles before these items are allowed into security areas;

SNL policies addressing Controlled Articles do not allow SNL management to grant exceptions to processes that require approval from the ODFSA;

SFO’s approved guidance regarding Controlled Articles at SNL is up to date, aligns with current Department policies, and meets the approval of the ODFSA; and

SNL determines if an Incident of Security Concern occurred and takes appropriate action.