Summary: The management of patients' funds at Kane Nursing Home included the practice of charging to patient funds for services that should have been paid by Medicare and Medicaid. Erroneous charges were also made to patients' funds for facility-based physician services and laboratory and x-ray services that could have amounted to as much as $600,000 from 1972 through 1974. In April 1970, Kane began investing patients' personal funds in interest bearing savings certificates. A comparison was made of Medicare and Medicaid audited reports for 1972-1974. In addition to charges made to Medicare Part B, Kane also charged Medicaid for the costs of the same facility-based physician services and x-ray and laboratory services. The true overpayment was the Federal share of the overcharges, or about $655,000, which was in addition to the erroneous charges to patients' funds. A check on staffing practices revealed that seven part-time doctors were receiving length-of-service credit for the county retirement system as if they were full-time employees. Also, the number of general care nursing hours available to Kane patients during February 1976 did not meet minimum State requirements. No evidence was found of coercion in obtaining contributions from patients' families, but it did not appear that Kane adequately explained that contributions were voluntary. (SW)
