SafetyNet Solutions
July 11, 2017 · Read the full official report (PDF) ↗
Published July 11, 2017 Audit covers July 1, 2011 – June 30, 2016 Under Suzanne M. Bump · 2011–2023
source
“Our audit revealed no significant instances of noncompliance by the provider that must be reported under generally accepted government auditing standards in the areas covered by our audit objective.”
Read the plain-English breakdown
This is a Massachusetts State Auditor performance audit of SafetyNet Solutions, a Springfield company paid by MassHealth to provide group adult foster care services.
“I am pleased to provide this performance audit of SafetyNet Solutions, Inc.”
Auditors checked whether SafetyNet followed the rules and contract requirements for its group adult foster care program.
“The purpose of this audit was to determine whether SNS administered its GAFC program in accordance with applicable regulations and contractual requirements.”
The audit matters because these services are paid for with public MassHealth dollars, and the auditor was looking for accountability, transparency, and cost-effectiveness.
“This audit was conducted as part of OSA’s ongoing efforts to audit human-service contracting activity by state agencies and to promote accountability, transparency, and cost-effectiveness in state contracting.”
For residents who use these services, the goal is help with daily tasks so they can stay in the community instead of moving into a more expensive long-term-care facility.
“The Adult Foster Care and Group Adult Foster Care Programs are designed to provide sufficient assistance to allow members to continue to live independently and avoid the high cost of a long-term-care facility.”
SafetyNet itself was not found to have major reportable compliance problems, but the auditor said MassHealth allowed payments that may have been improper or inefficient.
“MassHealth allowed SafetyNet Solutions, Inc. to bill as much as $1,848,082 for unallowable group adult foster care.”
The report says SafetyNet should work with MassHealth on whether MassHealth will stop paying for services the auditor viewed as duplicative, and MassHealth said it planned to clarify future rules.
“SNS should collaborate with MassHealth to find out whether MassHealth intends to cease paying for these duplicative services.”
The biggest statewide issue was cost: MassHealth spent about $1.4 billion on adult foster care and group adult foster care during the audit period, and the auditor said changes to medication administration could save money.
“MassHealth paid providers approximately $1.4 billion for adult foster care (AFC) and GAFC during the audit period.”
ADLs are basic daily activities like eating, dressing, bathing, and walking; IADLs are related household and independence tasks like shopping, laundry, transportation, meals, and medication management.
“ADLs include activities such as eating, toileting, dressing, bathing, and walking.”
6 figure(s) pending source verification - not shown
What the Auditor checked
- Complied Did SNS properly administer its group adult foster care (GAFC) program?
What the Auditor found
Why it matters: MassHealth paid as much as $1,848,082 for services the Auditor considered duplicative and unallowable.
Standard: Section 408.437 of Title 130 of the Code of Massachusetts Regulations and 651 CMR 3.01(2). ( Section 408.437 of Title 130 of the Code of Massachusetts Regulations; 651 CMR 3.01(2); 130 CMR 408.402; 130 CMR 408.415(B) )
1 recommendation
- SNS should collaborate with MassHealth to determine whether MassHealth intends to stop paying for duplicative services.agency: disagreed
Agency response & Auditor reply
Agency: "SafetyNet strongly disagrees with your report’s characterization of services for which it billed MassHealth as “duplicative” and “not allowable under MassHealth regulations.”"
Auditor: "Although we agree that MassHealth’s regulations allow people in GAFC to receive skilled nursing, we do not agree that they allow it to be provided through a separate program such as the Home Health Services Program."
Why it matters: The Auditor estimated potential savings of as much as $2.8 million at SNS alone and potentially greater savings statewide.
Standard: 105 CMR 700.003(F)(2) and the MAP Policy Manual. ( 105 CMR 700.003(F)(2) )
1 recommendation
- MassHealth should further investigate using certified nursing assistants certified in medication management to provide both home health and medication management services when it could save money.
Agency response & Auditor reply
Agency: "MassHealth appreciates the purpose and intent of the [Office of the State Auditor’s] recommendation for possible cost savings that might be achieved through a change in the design of the GAFC program."
Auditor: "We do not dispute that GAFC program participants may need both personal care and skilled nursing."