Performance Audit Finds Department of Health Can Increase Efficiency and Streamline Process
Changes Could Save $1.1 Million for Taxpayers, Funeral Directors and Registrars
Columbus – Using data driven decision-making, the Ohio Department of Health can protect vulnerable populations in the state’s nursing homes and related long-term care facilities more efficiently, according to a performance audit released today by Auditor of State Dave Yost.
By better balancing the makeup of the complaint-response teams that investigate problems in nursing homes, residential care facilities and intermediate care facilities, the department can reduce staff turnover, saving time and money spent in training new investigators, the audit found. The primary recommendation is to reduce the proportion of registered nurses hired for survey work because of the high turnover in their ranks. Doing so could save the department $120,499 annually, auditors estimate.
Auditors also recommended that the department analyze the location and frequency of care complaints and of the time necessary to investigate them in order to deploy dedicated complaint-investigation teams more efficiently.
“Thousands of Ohio families rely on the Department of Health to ensure that their loved ones are well-cared-for in nursing homes and similar facilities,” Auditor Yost said. “Those same families also benefit when their tax dollars are used in the most cost-effective manner to provide that protection.”
The audit also found that the department is likely to save funeral directors and local registrars $933,000 a year as it expands its electronic system for the filing of birth and death certificates.
Until recently, the department was using a complicated hybrid system that was partly electronic and partly based on paper documentation, imposing significant costs on those reporting births and deaths, as well as slowing the filing of the data. Updates introduced during the audit period aim to increase the use of electronic filing and reduce the paperwork component of the process. Once implemented, the changes also are projected to save the department $97,900 annually by reducing staff time spent on filing and data entry.
The audit was performed in accordance with Ohio Revised Code § 117.46, which provides that the Auditor of State conduct performance audits of at least four state agencies each budget biennium. The audit was conducted from October 2015 to June 2017.
Auditors examined the department’s Bureau of Long Term Care, Bureau of Vital Statistics, Finance Operations, Certificate of Need, and Laboratory Operations.
Other recommendations of the audit included:
- Improving the financial accounting system to reduce the time spent on updating information.
- Working with the state Legislature to streamline the Certificate of Need program for long-term-care facilities.
- Improving tracking of the location and ownership of long-term-care beds throughout the state. The Department began work on this recommendation while the audit was under way.
- Developing a laboratory information system that will allow management to analyze workload data and improve the efficiency of laboratory testing operations.
Auditors also highlighted the department’s participation in a laboratory integration project with the Ohio Department of Agriculture and the Ohio Environmental Protection Agency. The aim is to align the fiscal operations of all state labs to share resources and compare lab operations. The project includes sharing equipment and facilities, combining capital equipment budgets, and purchasing jointly to obtain lower prices. The Auditor of State encourages efforts that lower costs and improve the efficiency of government.
A full copy of this report is available online.
The Auditor of State’s office, one of five independently elected statewide offices in Ohio, is responsible for auditing more than 5,900 state and local government agencies. Under the direction of Auditor Dave Yost, the office also provides financial services to local governments, investigates and prevents fraud in public agencies and promotes transparency in government.