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REPORT ON THE
HOME OFFICE AUDIT
MARINER HEALTH CARE, INC. HOUSTON, TEXAS
FISCAL PERIOD ENDED DECEMBER 31, 2009
Audits Section—Sacramento Financial Audits Branch
Audits and Investigations California Department of Health Care Services
Section Chief: Steven Gary Audit Supervisor: Jeff Sandman Auditor: Stephan Fukasawa
State of California—Health and Human Services Agency
Department of Health Care Services
TOBY DOUGLAS EDMUND G. BROWN JR. Director Governor
June 9, 2011 Ken Pitts Director of Reimbursement Mariner Health Care, Inc. 5300 West Sam Houston Parkway, Suite 100 Houston, TX 77041 MARINER HEALTH CARE, INC. FISCAL PERIOD ENDED DECEMBER 31, 2009 We have examined the Medi-Cal Home Office cost report for the fiscal period ended December 31, 2009. Our examination was made under the authority of Section 14170 of the Welfare and Institutions Code and, accordingly, included such tests of the accounting records and such other auditing procedures as we considered necessary in the circumstances. In our opinion, the data presented in the Summary of Audited Home Office Costs to Health Facilities represents a proper determination of home office allowable costs for the above fiscal period in accordance with Medi-Cal reimbursement principles. The audited home office cost will be incorporated, by separate adjustment, into each applicable facility audit report. This Audit Report includes the:
1. Summary of Audited Home Office Costs to Health Care Facilities 2. Audit Adjustments Schedule
If you disagree with the decision of the Department, the results of the home office audit may only be appealed through each individual facility's audit report. Please refer to the appeal instructions in each facility’s audit report.
Audits & Investigations/Audits Sacramento, MS 2106 P.O. Box 997413, Sacramento, CA 95899-7413 (916) 650-6994 / (916) 650-6990 fax Internet Address: www.dhcs.ca.gov
Ken Pitts Page 2
If you have further questions regarding this report, you may call the Audits Section-Sacramento at (916) 650-6994. Original Signed By Steven Gary, Chief Audits Section-Sacramento Financial Audits Branch Certified
1 - SUMMARY OF AUDITED HOME OFFICE CAPITAL AND NONCAPITAL RELATED COSTS TOCHAIN COMPONENTS
2 - COMPARISON OF REPORTED AND AUDITED HOME OFFICE COSTS
3 - SUMMARY ALLOCATION OF HOME OFFICE COSTS - CAPITAL RELATED
3-1 - SUMMARY ALLOCATION OF HOME OFFICE COSTS - NONCAPITAL RELATED
4 - POOLED ALLOCATION OF HOME OFFICE COSTS TO CHAIN COMPONENTS
5 - FUNCTIONAL ALLOCATION OF EXPENSES TO CHAIN COMPONENTS -CAPITAL RELATED
5-1 - FUNCTIONAL ALLOCATION OF EXPENSES TO CHAIN COMPONENTS -
NONCAPITAL RELATED
6 - FUNCTIONAL ALLOCATION OF EXPENSES TO CHAIN COMPONENTS STATISTICS -CAPITAL RELATED
6-1 - FUNCTIONAL ALLOCATION OF EXPENSES TO CHAIN COMPONENTS STATISTICS -NONCAPITAL RELATED
7 - DIRECT ALLOCATION OF CAPITAL COSTS TO CHAIN COMPONENTS
7-1 - DIRECT ALLOCATION OF NONCAPITAL COSTS TO CHAIN COMPONENTS
8 - TRIAL BALANCE OF EXPENSES
9 - REPORTED HOME OFFICE COSTS
TABLE OF CONTENTS
SCHEDULES
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STATE OF CALIFORNIA SCHEDULE 8
TRIAL BALANCE OF EXPENSES
HOME OFFICE NAME: FISCAL PERIOD ENDED:MARINER HEALTH CARE, INC. DECEMBER 31, 2009
REPORTED ADJ. ADJUSTMENT AUDITEDLINE POOLED ALLOC. NO. AMOUNT(S) POOLEDNO. COST CENTER DESCRIPTION (SCH. B, COL 8) COSTS
CAPITAL-RELATED COSTS - OLD1.00 Old Cap. Related-Buildings & Fixtures $0 $0 $01.01 0 0 02.00 Old Cap. Related-Movable Equipment 0 0 02.01 0 0 03.00 SUBTOTAL (sum of lines 1 through 2.01) $0 $0 $0
CAPITAL-RELATED COSTS - NEW4.00 New Cap. Related-Buildings & Fixtures $0 1 $70,278 $70,2784.01 0 0 05.00 New Cap. Related-Movable Equipment 0 0 05.01 0 0 06.00 SUBTOTAL (sum of lines 4 through 5.01) $0 $70,278 $70,278
OTHER CAPITAL-RELATED COSTS7.00 Insurance Premiums $0 $0 $08.00 Taxes and Licenses - Not INCM 0 0 09.00 Other 0 0 0
10.00 SUBTOTAL (sum of lines 7 through 9) $0 $0 $0
NON CAPITAL-RELATED COSTS11.00 Salaries of Officers $0 $0 $012.00 Salaries & Wages of Others 3,147,627 2,3 (911,683) 2,235,94413.00 Payroll Taxes 186,763 2 (15,643) 171,12014.00 Employee Benefits 575,058 2, 4 (83,982) 491,07615.00 Profit Sharing/Pension Plans 0 016.00 Travel & Entertainment 443,254 2, 4-6 (51,268) 391,98617.00 Automobile 0 018.00 Depreciation/Amortization 10,051 1 (10,051) 019.00 Building Rental 53,109 1 (53,109) 020.00 Equipment Rental 7,118 1 (7,118) 021.00 Utilities 0 022.00 Legal and Accounting 0 023.00 Telephone/Telegraph 85,534 2, 4 (4,353) 81,18124.00 Insurance 0 025.00 Taxes & Licenses 14,686 2 (200) 14,48626.00 Corporate Maintenance costs 46,536 2, 4 (2,316) 44,22027.00 Contributions 0 028.00 Interest Expense 0 029.00 Outside Services 1,157,500 7-11 (286,080) 871,42030.00 Office Supplies 33,059 2, 4 (5,762) 27,29731.00 Other - Dues 943 2 (150) 79332.00 Acquisition Cost 0 033.00 Misc 296,627 0 296,62734.00 Training/Employee Programs 0 0 035.00 Other 0 0 035.01 0 0 035.02 0 0 035.03 0 0 035.04 0 0 035.05 0 0 035.06 0 0 035.07 0 0 035.08 0 0 036.00 SUBTOTAL (sum of lines 11 through 35.08) $6,057,865 ($1,431,715) $4,626,150
37.00 TOTAL ALLOWABLE EXPENSES $6,057,865 ($1,361,437) $4,696,428(To Sch. 4)
38.00 NONREIMBURSABLE EXPENSES $0 $0 $0
STATE OF CALIFORNIA SCHEDULE 8
TRIAL BALANCE OF EXPENSES
HOME OFFICE NAME: FISCAL PERIOD ENDED:MARINER HEALTH CARE, INC. DECEMBER 31, 2009
REPORTED ADJ. ADJUSTMENT AUDITEDLINE POOLED ALLOC. NO. AMOUNT(S) POOLEDNO. COST CENTER DESCRIPTION (SCH. B, COL 8) COSTS
CAPITAL-RELATED COSTS - OLDTOTAL EXPENSES $6,057,865 ($1,361,437) $4,696,428
STATE OF CALIFORNIA
HOME OFFICE NAME:MARINER HEALTH CARE, INC.
LINENO. COST CENTER DESCRIPTION
CAPITAL-RELATED COSTS - OLD1.00 Old Cap. Related-Buildings & Fixtures1.01 2.00 Old Cap. Related-Movable Equipment2.01 3.00 SUBTOTAL (sum of lines 1 through 2.01)
CAPITAL-RELATED COSTS - NEW4.00 New Cap. Related-Buildings & Fixtures4.01 5.00 New Cap. Related-Movable Equipment5.01 6.00 SUBTOTAL (sum of lines 4 through 5.01)
OTHER CAPITAL-RELATED COSTS7.00 Insurance Premiums8.00 Taxes and Licenses - Not INCM9.00 Other
10.00 SUBTOTAL (sum of lines 7 through 9)
NON CAPITAL-RELATED COSTS11.00 Salaries of Officers12.00 Salaries & Wages of Others13.00 Payroll Taxes14.00 Employee Benefits15.00 Profit Sharing/Pension Plans16.00 Travel & Entertainment17.00 Automobile18.00 Depreciation/Amortization19.00 Building Rental20.00 Equipment Rental21.00 Utilities22.00 Legal and Accounting23.00 Telephone/Telegraph24.00 Insurance25.00 Taxes & Licenses 26.00 Corporate Maintenance costs27.00 Contributions28.00 Interest Expense29.00 Outside Services30.00 Office Supplies31.00 Other - Dues32.00 Acquisition Cost33.00 Misc34.00 Training/Employee Programs35.00 Other35.01 35.02 35.03 35.04 35.05 35.06 35.07 35.08 36.00 SUBTOTAL (sum of lines 11 through 35.08)
37.00 TOTAL ALLOWABLE EXPENSES
38.00 NONREIMBURSABLE EXPENSES
SCHEDULE 8
TRIAL BALANCE OF EXPENSES
FISCAL PERIOD ENDED:DECEMBER 31, 2009
REPORTED ADJ. ADJUSTMENT AUDITEDDIRECT ALLOC. NO. AMOUNT(S) DIRECT(SCH. B, COL 6) COSTS
$0 $0 $00 0 00 0 00 0 0
$0 $0 $0
$0 $0 $00 0 00 0 00 0 0
$0 $0 $0
$0 $0 $00 0 00 0 0
$0 $0 $0
$0 $0 $00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0
$0 $0 $0
$0 $0 $0(To Sch. 7, 7-1)
$0 $0 $0
STATE OF CALIFORNIA
HOME OFFICE NAME:MARINER HEALTH CARE, INC.
LINENO. COST CENTER DESCRIPTION
CAPITAL-RELATED COSTS - OLDTOTAL EXPENSES
SCHEDULE 8
TRIAL BALANCE OF EXPENSES
FISCAL PERIOD ENDED:DECEMBER 31, 2009
REPORTED ADJ. ADJUSTMENT AUDITEDDIRECT ALLOC. NO. AMOUNT(S) DIRECT(SCH. B, COL 6) COSTS
$0 $0 $0
STATE OF CALIFORNIA
HOME OFFICE NAME:MARINER HEALTH CARE, INC.
LINENO. COST CENTER DESCRIPTION
CAPITAL-RELATED COSTS - OLD1.00 Old Cap. Related-Buildings & Fixtures1.01 2.00 Old Cap. Related-Movable Equipment2.01 3.00 SUBTOTAL (sum of lines 1 through 2.01)
CAPITAL-RELATED COSTS - NEW4.00 New Cap. Related-Buildings & Fixtures4.01 5.00 New Cap. Related-Movable Equipment5.01 6.00 SUBTOTAL (sum of lines 4 through 5.01)
OTHER CAPITAL-RELATED COSTS7.00 Insurance Premiums8.00 Taxes and Licenses - Not INCM9.00 Other
10.00 SUBTOTAL (sum of lines 7 through 9)
NON CAPITAL-RELATED COSTS11.00 Salaries of Officers12.00 Salaries & Wages of Others13.00 Payroll Taxes14.00 Employee Benefits15.00 Profit Sharing/Pension Plans16.00 Travel & Entertainment17.00 Automobile18.00 Depreciation/Amortization19.00 Building Rental20.00 Equipment Rental21.00 Utilities22.00 Legal and Accounting23.00 Telephone/Telegraph24.00 Insurance25.00 Taxes & Licenses 26.00 Corporate Maintenance costs27.00 Contributions28.00 Interest Expense29.00 Outside Services30.00 Office Supplies31.00 Other - Dues32.00 Acquisition Cost33.00 Misc34.00 Training/Employee Programs35.00 Other35.01 35.02 35.03 35.04 35.05 35.06 35.07 35.08 36.00 SUBTOTAL (sum of lines 11 through 35.08)
37.00 TOTAL ALLOWABLE EXPENSES
38.00 NONREIMBURSABLE EXPENSES
SCHEDULE 8
TRIAL BALANCE OF EXPENSES
FISCAL PERIOD ENDED:DECEMBER 31, 2009
REPORTED ADJ. ADJUSTMENT AUDITEDFUNCTIONAL COSTS NO. AMOUNT(S) FUNCTIONAL
(SCH. B, COL 7) COSTS
$0 $0 $00 0 00 0 00 0 0
$0 $0 $0
$0 $0 $00 0 00 0 00 0 0
$0 $0 $0
$0 $0 $00 0 00 0 0
$0 $0 $0
$0 $0 $00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 0
$0 $0 $0
$0 $0 $0(To Sch. 6, 6-1)
$0 $0 $0
STATE OF CALIFORNIA
HOME OFFICE NAME:MARINER HEALTH CARE, INC.
LINENO. COST CENTER DESCRIPTION
CAPITAL-RELATED COSTS - OLDTOTAL EXPENSES
SCHEDULE 8
TRIAL BALANCE OF EXPENSES
FISCAL PERIOD ENDED:DECEMBER 31, 2009
REPORTED ADJ. ADJUSTMENT AUDITEDFUNCTIONAL COSTS NO. AMOUNT(S) FUNCTIONAL
(SCH. B, COL 7) COSTS
$0 $0 $0
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