U.S. flag

An official website of the United States government

Dot gov

The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Skip to Content

Department of Health and Human Services

Office of Inspector General -- AUDIT

"Operation Restore Trust Audit of Presbyterian Hospital Skilled Nursing Facility, Dallas, Texas," (A-04-96-01149)

April 22, 1997


Complete Text of Report is available in PDF format (846 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.

EXECUTIVE SUMMARY:

The primary objective of the review was to evaluate the medical necessity of the care and services provided and the reasonableness of the charges and reimbursements made during the period from January 1995 through March 1996.

The Operation Restore Trust reviewers questioned $198,663 of the $1,006,495 in charges for 40 beneficiaries in our sample. This amount is comprised of $100,549 for unallowable services, $51,802 for services which were not reasonable or medically necessary and $46,312 for services for which the skilled nursing facility (SNF) could not produce adequate supporting documentation. Therefore, we are recommending an adjustment of the above charges. In addition, we request that a detailed review of all rehabilitative therapies and physician orders for these therapies be conducted by the fiscal intermediary and State agency in order to recoup overpayments made to the SNF and to implement corrective action by the facility.