Audit 1048

FY End
2023-01-31
Total Expended
$8.41M
Findings
2
Programs
6
Year: 2023 Accepted: 2023-10-23

Organization Exclusion Status:

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Contacts

Name Title Type
XQX3CKDWZBA4 Michael Glas Auditee
9034555986 Tommy Nelson Auditor
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Notes to SEFA

Title: BASIS OF PRESENTATION Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. State expenditures are recognized following TxGMS. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of the financial statements. De Minimis Rate Used: N Rate Explanation: Community Health Service Agency, Inc. has contracted with the respective granting agencies for indirect cost rates, if applicable. Allowable indirect costs for each award are determined by the related terms and conditions developed by the awarding agency for each program. Community Health Service Agency, Inc. has not elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal and state awards (the "Schedule") includes the federal and state award activity of Community Health Service Agency, Inc. (Carevide) under programs of the federal or state government for the year ended January 31, 2023. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) and Texas Grant Management Standards (TxGMS). Because the Schedule presents only a selected portion of the operations of Community Health Service Agency, Inc., it is not intended to and does not present the financial position, changes in net assets, or cash flows of Community Health Service Agency, Inc.
Title: NATURE OF ACTIVITIES Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. State expenditures are recognized following TxGMS. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of the financial statements. De Minimis Rate Used: N Rate Explanation: Community Health Service Agency, Inc. has contracted with the respective granting agencies for indirect cost rates, if applicable. Allowable indirect costs for each award are determined by the related terms and conditions developed by the awarding agency for each program. Community Health Service Agency, Inc. has not elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Community Health Service Agency, Inc. receives various grants to cover costs of specified programs. Final determination of eligibility costs will be made by the grantors. Should any costs be found ineligible, Community Health Service Agency, Inc. will be responsible for reimbursing the grantors for these amounts.
Title: RELATIONSHIP TO BASIC FINANCIAL STATEMENTS Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following, as applicable, the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. State expenditures are recognized following TxGMS. Therefore, some amounts presented in the Schedule may differ from amounts presented in, or used in the preparation of the financial statements. De Minimis Rate Used: N Rate Explanation: Community Health Service Agency, Inc. has contracted with the respective granting agencies for indirect cost rates, if applicable. Allowable indirect costs for each award are determined by the related terms and conditions developed by the awarding agency for each program. Community Health Service Agency, Inc. has not elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Federal program adjustments to the schedule relate to Provider Relief Funds (ALN 93.498). Per guidance issued by 0MB, Provider Relief Funds should not be presented on the schedule of expenditures of federal awards until such time as they have been reported through the federal Provider Relief Fund reporting portal (reporting portal) in the appropriate period. Pursuant to this guidance, Provider Relief Funds recognized as current year revenue in the amount of $492,614 that were reported in Period 4 through the reporting portal are included on the schedule. This amount agreed to the Period 4 report filed by the Center. Provider Relief Funds recognized as revenue in the current year in the amount of $175,960 had not yet met the portal filing requirement. This amount was excluded from the schedule. Following is a reconciliation of the financial statement presentation to the schedule of federal and state awards: Federal expenditures per schedule $8,410,684 + Provider Relief Funds CFDA 93.498 (Has not met the portal filing requirement) $175,960 = Federal revenues per basic financial statement $8,586,644

Finding Details

Criteria: The Health Center Cluster requires the Organization to perform a financial assessment on consumers in order to place them on a sliding fee scale. The sliding fee scale must be based on the current Federal Poverty Guidelines at the time of assessment. Condition: Consumers are not always placed correctly on the sliding fee scale based on their household size and income level. Questioned Costs: None Context: We tested 25 consumer files for proper placement on the sliding fee scale. During this test we found 1 consumer file where the consumer was incorrectly placed on sliding fee scale D. The consumer should have been placed on sliding fee scale E (100% self-pay). Effect: Consumers may not be appropriately placed on the sliding fee scale. Cause: The Organization's controls over placement of consumers on the sliding fee scale necessary for financial assessment of consumers are not operating effectively. Recommendation: The Organization should review procedures and training regarding the sliding fee scale calculation and placement.
Criteria: The Health Center Cluster requires the Organization to perform a financial assessment on consumers in order to place them on a sliding fee scale. The sliding fee scale must be based on the current Federal Poverty Guidelines at the time of assessment. Condition: Consumers are not always placed correctly on the sliding fee scale based on their household size and income level. Questioned Costs: None Context: We tested 25 consumer files for proper placement on the sliding fee scale. During this test we found 1 consumer file where the consumer was incorrectly placed on sliding fee scale D. The consumer should have been placed on sliding fee scale E (100% self-pay). Effect: Consumers may not be appropriately placed on the sliding fee scale. Cause: The Organization's controls over placement of consumers on the sliding fee scale necessary for financial assessment of consumers are not operating effectively. Recommendation: The Organization should review procedures and training regarding the sliding fee scale calculation and placement.