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Division of Public Health Local Health DepartmenUDistrict <br />~ -rterly Fiscal Monitoring Report-Explanation of Revenue and Expenditure Variances <br />e period ending: December 31, 2008 <br />ITEM Fxplanallon <br />Home Health Eaminga Thera era problems with Home Health Medicare billings on the EMR software put in <br /> piece 1-1/2 years ago. We have artangetl assistance from the software company, a <br /> consulting company for aged acwunts, end new personnel to step up aftons to get <br /> information up-to~date. This situation Is being monitored on a daily basis. <br /> Patient Fees were received et 9.55 % less than anticipated. W e have sent Information <br /> to the NC Debt Set Off protect end anticipate receivables from this effort beginning 3rd <br />Patient Fees quarter. We are also analyzing our patient mix and Increasing our efforts of cellection. <br /> This Is being monitored on a weekly basis. <br />Insurance (Includes Metlicara) Insurance reimbursements are bwer than anticipated due to number of clients coming <br /> In for services at 0 % and no Insurance coverage. <br /> The fatal Medicaid dollars budgeted include $554,000 for iheyear-end cost settlement. <br />Medicaid This amount represents 27% of total budgeted. The amount is not received until the <br /> 4th quarter. <br /> We have not received full payment from eight of our grants. This amount totals <br /> $90,188. Mast of our grants pay after the expenses are Incurred and therefore, we <br />Other Grants (Smart Start, have not received payment to offset expenses. One grant protect has not hatl but <br />Kate B. Reynolds, DSS, etc.) 22% activity and relmbursemant will follow expenses. Remaining funds to <br /> spand/receive =+$130,000. <br />Since the state antl federel grant funds are affective for JUne through May expenses, <br />our June expenditures represent approximately 22°A of our annual stateRederal <br />DHHS State & Fetleral Funds reimbursement. The reimbursement for June expenses are received In Juty and <br />posted to prior year's receivables. So, our agency will receive approximatey$335,787 <br />In atate/federal funds at the end of the fiscal year. <br />The total budgeted Appropriation of Fund Balance was reduced by $29,000 during the <br />Appropriation of Fund Balance second quarter due to receipt of an unbudgeted donation for existing budgeted <br />expenses. <br />The total in the Change in Cash Balance is negative due to the delayed receipt of <br />Change In Cash Balance earned revenues as well as the delayed relmbursemant periods for both Medicaid & <br />State funds. We have a total of $f .2 million outstanding receivahles with our Home <br />Health Medicare billing. <br />S-2 <br />