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YELLOW SHEET Office of the State Auditor of Missouri |
Report No. 2000-48
June 21, 2000
The following areas of concern were discovered as a result of a review conducted by our office of the Mount Vernon Veterans' Home.
The Mount Vernon Veterans' Home nursing-care facility provides care to Missouri veterans who are unable to support or adequately care for themselves. Residents of the facility are provided room, board, medication, therapy, personal care, and recreational and religious activities. To qualify for admission, applicants must be honorably discharged veterans of the U.S. Armed forces, residents of the state of Missouri for at least thirty days prior to the date of application for admission, and in need of nursing care for a chronic disability of physical ailment.
The cost of care is shared by the resident (based on the ability to pay), and the Federal Veterans' Administration, and the State of Missouri. Standards of care are established by the Federal Veterans' Administration, and the home is inspected annually to ensure compliance with these standards.
The facility conducts background checks prior to hiring its direct-care staff. This includes contacting the Missouri State Highway Patrol, the employee's former employer, and checking the Division of Agings' Employee Disqualification List. Documentation to support the background check with the Missouri State Highway Patrol and the employee's former employer is maintained; however, there is no documentation that the Division of Aging was contacted Adequate documentation is necessary to ensure that only appropriate employees are hired for all direct-care positions.
In addition, the facility should consider expanding their background checks to include contacting the Department of Mental Health who maintains a listing of persons who have been administratively determined to have abused or neglected a Department of Mental Health client, and the Division of Family Services who maintains the Central Registry of Child Abuse and Neglect which contains information related to instances of actual or alleged child abuse.
The facility receives money from various resources and deposits it into bank accounts such as the Residents' Cash Fund account or the Assistance League Fund account. Money received by the facility on behalf of the residents (e.g., social security, pensions, etc.) is deposited into the Residents' Cash Fund account and is used for residents' monthly payments for room and board. Personal spending money of the residents can also be deposited into this account. Nominal amounts of cash can be obtained from the facility's cashier and deducted from this account. Collections from the vending machines and donations are deposited into the Assistance League Fund account.
This money is used by the Assistance League, a not-for-profit organization, to purchase goods and services for the benefit of all residents. During our review of the facility's procedures for handling transactions from these accounts we noted the following weaknesses:
Prenumbered receipt slips are not always issued for monies received for the Assistance League Fund.
The Facility has adopted a policy whereby interest income of the Residents' Cash Fund account is to be expended for the benefit of all residents with the approval of the facility's resident council and administrative personnel. In order for residents to use the Residents' Cash Fund account, they are required to sign a form that states they will not receive interest earned on their monies. Interest is not credited to each individual resident's account. Interest earned on resident funds amounted to $2,819 and $3,760 for the years ended June 30, 1999 and 1998, respectively. Donation of interest income by the residents should be voluntary and should not be made a condition of using the Residents' Cash Fund. The accounts of those residents who do not wish to donate their interest income should be credited with the interest earned on their monies.
On June 30, 1999, the Mount Vernon Veterans' Home controlled fixed assets totaling approximately $557,000. Supervisory approval is not required for any dispositions or adjustments to the fixed asset listing. The lack of adequate procedures on dispositions and adjustments made to the asset balances results in a loss of control over inventory records.
Duties of recording and handling supply inventories are not adequately segregated. Physical counts of inventories are taken by the same employee responsible for the custody and record keeping of these inventories. In addition, no supervisory approval is required for adjustments to the inventory listing.
