Audit 12576

FY End
2022-06-30
Total Expended
$828,288
Findings
2
Programs
3
Year: 2022 Accepted: 2024-01-19
Auditor: Bonadio & CO LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
9211 2022-001 Significant Deficiency - N
585653 2022-001 Significant Deficiency - N

Contacts

Name Title Type
H7S4J8RKKLC6 Tita Marie Bilello Auditee
3472918728 Joseph Weinberger Auditor
No contacts on file

Notes to SEFA

Title: GENERAL Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting and in accordance with accounting principles general accepted in the United States of America. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Metro Community Health Centers, Inc. has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) summarizes all federal award activity of Metro Community Health Centers, Inc. under programs of the federal government for the year ended June 30, 2022. 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). Because the Schedule presents only a selected portion of Metro Community Health Centers, Inc.’s operations, it is not intended to, and does not, present the financial position, change in net assets, or cash flows of Metro Community Health Centers, Inc.
Title: BASIS OF ACCOUNTING Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting and in accordance with accounting principles general accepted in the United States of America. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Metro Community Health Centers, Inc. has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. Expenditures reported on the Schedule are reported on the accrual basis of accounting and in accordance with accounting principles general accepted in the United States of America. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement.
Title: INDIRECT COST RATE Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting and in accordance with accounting principles general accepted in the United States of America. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Metro Community Health Centers, Inc. has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. Metro Community Health Centers, Inc. has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance.
Title: PROVIDER RELIEF FUNDS (PRF) Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting and in accordance with accounting principles general accepted in the United States of America. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Metro Community Health Centers, Inc. has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The amount included in the schedule of expenditures of federal awards is based upon the year Metro Community Health Centers, Inc. was required to report on the use of those funds. Amounts reported on the Schedule for the year ended June 30, 2022 amounted to $161,727.

Finding Details

Criteria - Health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. The health center must demonstrate adjustments to charges are consistent with the health center’s SFDS. Condition - We attempted to recalculate the applied discount using Metro Community Health Centers, Inc.’s policy and the patient documentation provided, noting instances where the adjustments to charges were inconsistent with Metro Community Health Centers, Inc.’s SFDS. Cause – SFDS discounts were inconsistently applied to services provided to individuals who attested to their eligibility. Effect - Out of our sample of 25 selections, we identified eight exceptions based on the SFDS. Recommendation - We recommend evaluating the current process and either changing it to match what is being done or provide education those involved in the process to adhere to Metro Community Health Centers, Inc.’s existing written policies and procedures in this area. We also encourage Metro Community Health Centers, Inc.’ to consider assigning a dedicated individual to regularly review the sliding fee visits to ensure compliance. This should be someone who is knowledgeable of the sliding fee requirements and Metro Community Health Centers, Inc.’s billing processes and procedures. View of Responsible Official – Metro Community Health Centers agrees that the sliding fee process needs to be revised and will implement procedures to match workflow. Additionally, Metro Community Health Centers will retrain all staff and assign a dedicated individual to perform monthly reviews.
Criteria - Health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. The health center must demonstrate adjustments to charges are consistent with the health center’s SFDS. Condition - We attempted to recalculate the applied discount using Metro Community Health Centers, Inc.’s policy and the patient documentation provided, noting instances where the adjustments to charges were inconsistent with Metro Community Health Centers, Inc.’s SFDS. Cause – SFDS discounts were inconsistently applied to services provided to individuals who attested to their eligibility. Effect - Out of our sample of 25 selections, we identified eight exceptions based on the SFDS. Recommendation - We recommend evaluating the current process and either changing it to match what is being done or provide education those involved in the process to adhere to Metro Community Health Centers, Inc.’s existing written policies and procedures in this area. We also encourage Metro Community Health Centers, Inc.’ to consider assigning a dedicated individual to regularly review the sliding fee visits to ensure compliance. This should be someone who is knowledgeable of the sliding fee requirements and Metro Community Health Centers, Inc.’s billing processes and procedures. View of Responsible Official – Metro Community Health Centers agrees that the sliding fee process needs to be revised and will implement procedures to match workflow. Additionally, Metro Community Health Centers will retrain all staff and assign a dedicated individual to perform monthly reviews.