Office of the Chief Medical Examiner
August 11, 2017 · Read the full official report (PDF) ↗
Published August 11, 2017 Audit covers July 1, 2013 – June 30, 2016 Under Suzanne M. Bump · 2011–2023
source
“OCME did not monitor the completion of toxicology examinations or complete autopsies and death certificates within established timeframes.”
Read the plain-English breakdown
This is a Massachusetts State Auditor performance audit of the Office of the Chief Medical Examiner covering July 1, 2013 through June 30, 2016.
“This report details the audit objectives, scope, methodology, findings, and recommendations for the audit period, July 1, 2013 through June 30, 2016.”
Auditors checked whether OCME was doing key work on time and properly handling fees, reports, inventory, and internal controls.
“We also reviewed OCME’s processes for collecting cremation view fees, filing mandated reports, managing inventory, and completing an internal control plan (ICP).”
Delays can affect families and court cases, including insurance payments and criminal investigations.
“Such delays in processing could delay court cases and prevent family members from receiving insurance proceeds when needed.”
If your family needs a death certificate, autopsy report, or related benefits after a death, delays or poor tracking could make an already hard process harder.
“Lastly, of the 18,899 death certificates that should have been completed, 6,020 (32%) were not completed within 90 calendar days after the report of death; 639 of these were pending or incomplete for more than one year.”
The office needed better systems to track cases, handle cremation fees, support reports to lawmakers, manage assets, and control risks.
“OCME’s ICP needs improvement.”
The auditor recommended that OCME improve data entry, reduce backlogs, strengthen accounting, reconcile fees, document reports, inventory assets, and update its internal control plan.
“OCME should develop a complete and updated ICP based on a current department-wide risk assessment that includes all aspects of OCME’s business operations (i.e., financial and case management activities).”
The issues mattered because OCME’s credibility and accreditation can affect law enforcement, families, investigations, court cases, and insurance claims.
“Although accreditation is not legally required, loss of accreditation could have negative ramifications for law enforcement and families of victims.”
A toxicology exam is a test that looks for substances such as drugs that may help explain how someone died.
“A toxicology examination studies the interaction between foreign compounds, such as drugs, and previously living organisms to determine a cause of death.”
6 figure(s) pending source verification - not shown
What the Auditor checked
- Did not comply Does OCME ensure that 90% of autopsy reports are completed within 90 calendar days after the date of the autopsy, in accordance with its established policies and the National Association of Medical Examiners’ (NAME’s) accreditation requirements?
- Did not comply Does OCME ensure that 90% of toxicology examinations are completed within 90 calendar days after case submission, in accordance with its established policies and NAME’s accreditation requirements?
- Did not comply Does OCME ensure that death certificates are completed within a reasonable timeframe of 90 calendar days after the date of death?
- Did not comply Does OCME ensure that revenue (i.e., cremation view fees) that is billed, collected, and retained is accurately recorded?
- Did not comply Are the number of cases and other required information reported to the state Legislature via annual reports accurate and supported by underlying data?
- Did not comply Does OCME adequately safeguard its property and equipment?
What the Auditor found
Why it matters: Delays could slow court cases and prevent families from receiving insurance proceeds when needed.
Standard: National Association of Medical Examiners standards establish a 90-day timeframe for completing toxicology examinations and autopsy reports; the audit used 90 days as a reasonable standard for death certificates. ( National Association of Medical Examiners Inspection and Accreditation Checklist )
3 recommendations
- OCME should ensure that all data fields are entered accurately and completely in CMTS so that OCME can properly monitor cases for timely completion.agency: already implemented
- OCME should continue to identify and implement process improvements that reduce medical examiners’ administrative functions.
- OCME should formalize and fully implement procedures to effectively reduce, and monitor progress in reducing, the backlog.agency: agreed
Agency response & Auditor reply
Agency: "The report recommends that the OCME should formalize and fully implement procedures to effectively reduce and monitor progress in reducing the backlog."
Auditor: "Based on its response, OCME took measures to address our concerns in this area both during and after our audit period."
Why it matters: Not properly accounting for these fees, recording them, and reporting them as revenue could lead to loss, theft, or misuse.
Standard: OSC accounts receivable and cash recognition policies, OSC closing instructions, OCME internal controls, and 505 CMR 4.03(3). ( Section 4.03(3) of Title 505 of the Code of Massachusetts Regulations; OSC Accounts Receivable—Receivable Recognition and Reconciliation Policy; OSC Accounts Receivable—Cash Recognition and Reconciliation Policy )
5 recommendations
- OCME should develop policies and procedures detailing all required accounting activities related to the billing of cremation view fees.
- OCME should use BARS as a detailed permanent accounts-receivable tracking and reporting system for cremation view fees that provides information such as amounts owed, payments received, adjustments made, and balances due for any given period.agency: already implemented
- OCME should deposit cremation view fee revenue daily.agency: already implemented
- OCME should reconcile bank statement deposits and revenue monthly.
- OCME should review and update its policies and procedures for collecting, and accounting for, cremation view fee revenue.
Agency response & Auditor reply
Agency: "The OCME acknowledges that the Comptroller’s approved accounting system (BARS) was not used."
Auditor: "OSA disagrees with OCME’s response that the risk was “minimal” for payments made under the check depositing process in place."
Why it matters: There is inadequate assurance that the information in the reports was complete and accurate.
Standard: General Appropriation Acts of 2013, 2014, and 2015 and OSC Internal Control Guides. ( General Appropriation Acts of 2013, 2014, and 2015; OSC Internal Control Guides )
1 recommendation
- OCME should establish written policies and procedures for preparing and retaining documentation that supports all the information in the annual reports submitted to the state Legislature.
Agency response & Auditor reply
Agency: "While the report depicts a snapshot of information, it is complete and accurate as reported to the Legislature and is retrievable."
Auditor: "Although OCME asserts that the data that support the information in its fiscal year 2013 and 2014 annual reports to the state Legislature are retrievable, the office was not able to provide OSA with this information when we requested it during our audit."
Why it matters: OCME assets are at a higher risk of loss, theft, or misuse.
Standard: OCME Finance Office Internal Controls, Chapter 647 of the Acts of 1989, and OSC fixed asset policies. ( Section F of Chapter 647 of the Acts of 1989; OSC and Operational Services Division Fixed Assets—Acquisition Policy; OSC Fixed Assets—Accounting and Management Policy )
4 recommendations
- OCME’s management should develop sufficient oversight and monitoring procedures for property and equipment to ensure that prescribed policies and procedures are consistently followed.
- OCME should conduct periodic physical inventories of all property.agency: already implemented
- OCME should properly maintain its asset management database by including all appropriate additions (i.e., purchases) and deletions (i.e., disposals) and reconciling them with the results of the physical inventory (i.e., maintenance).agency: already implemented
- OCME should update its non-GAAP asset inventory lists to include at least the date of purchase, historical cost, description, location, and date of disposal of each item.
Agency response & Auditor reply
Agency: "The OCME’s finance office did tag and record all assets at the Boston and satellite offices, but did so in a system (Laboratory Information Management System [or LIMS]), not designed to support the inventory of these assets."
Auditor: "Based on its response, OCME is taking measures to address our concerns about the administration of fixed assets."
Why it matters: OCME risks not meeting operational objectives efficiently or complying with laws, regulations, grants, and contractual agreements.
Standard: OSC Internal Control Guide requires departments to develop, document, review, and update internal control plans based on risk assessments. ( OSC Internal Control Guide )
1 recommendation
- OCME should develop a complete and updated ICP based on a current department-wide risk assessment that includes all aspects of OCME’s business operations (i.e., financial and case management activities).
Agency response & Auditor reply
Agency: "The OCME recognizes the importance of updating and formalizing all internal controls and risk assessments into one document."
Auditor: "We acknowledge that the OCME has undergone various independent reviews since 2003, with each review focusing on one or more distinct part(s) of its operations."
Verified dollar findings
Identified dollar findings that do not fall in a named band.
Prior findings revisited
"Prior OSA audits of OCME identified the same problems with its cremation view fees."
More audits of this entity
Other Office of the State Auditor reports on Office of the Chief Medical Examiner , including the prior audits referenced above.
- Audit of the Office of the Chief Medical Examiner (December 19, 2024)State Agency / Office · December 19, 2024