FAC Explorer

Audit 15605

FY End
2023-06-30
Total Expended
$8.14M
Findings
8
Programs
16
Organization: Hcc Network (MO)
Year: 2023 Accepted: 2024-02-05
Auditor: Forvis LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
11773 2023-001 Significant Deficiency Yes N
11774 2023-001 Significant Deficiency Yes N
11775 2023-001 Significant Deficiency Yes N
11776 2023-002 Material Weakness - C
588215 2023-001 Significant Deficiency Yes N
588216 2023-001 Significant Deficiency Yes N
588217 2023-001 Significant Deficiency Yes N
588218 2023-002 Material Weakness - C

Programs

ALN Program Spent Major Findings
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $2.07M Yes 1
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $1.76M Yes 1
93.493 Congressional Directives $1.24M Yes 0
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $843,894 Yes 0
10.766 Community Facilities Loans and Grants $477,299 - 0
32.006 Covid-19 Telehealth Program $285,872 - 0
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $223,122 Yes 1
93.778 Medical Assistance Program $144,860 - 0
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $107,114 - 0
93.107 Area Health Education Centers Point of Service Maintenance and Enhancement Awards $103,876 - 0
93.322 Csels Partnership: Strengthening Public Health Laboratories $100,000 - 0
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $54,566 - 0
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $16,966 - 0
93.800 Organized Approaches to Increase Colorectal Cancer Screening $13,967 - 0
93.969 Pphf Geriatric Education Centers $8,000 - 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $1,050 - 0

Contacts

Name Title Type
JXQAJ5Z7NCC3 Toniann Richard Auditee
6602592440 Justin Kensinger Auditor
No contacts on file

Notes to SEFA

Title: Note 1: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. Negative amounts shown on the Schedule, if any, represents adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: HCC Network has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the “Schedule”) includes the federal award activity of HCC Network under programs of the federal government for the year ended June 30, 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). Because the Schedule presents only a selected portion of the operations of HCC Network it is not intended to and does not present the financial position, results of operations, changes in net assets, or cash flows of HCC Network.
Title: Note 2: Summary of Significant Accounting Principles Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. Negative amounts shown on the Schedule, if any, represents adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: HCC Network has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. Negative amounts shown on the Schedule, if any, represents adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years.
Title: Note 3: Indirect Cost Rate Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. Negative amounts shown on the Schedule, if any, represents adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: HCC Network has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. HCC Network has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance.
Title: Note 4: Federal Loan Program Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. Negative amounts shown on the Schedule, if any, represents adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: HCC Network has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. The federal loan programs listed subsequently are administered directly by HCC Network and balances and transactions relating to these programs are included in HCC Network’s basic financial statements. Loans outstanding at the beginning of the year and loans made during the year are included in the federal expenditures presented in the Schedule. The balance of loans outstanding at June 30, 2023, consists of: See the Notes to the SEFA for chart/table
Title: Note 5: Personal Protective Equipment (PPE) (Unaudited) Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. 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. Negative amounts shown on the Schedule, if any, represents adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: HCC Network has elected not to use the 10 percent de minimis indirect cost rate allowed under the Uniform Guidance. HCC Network did not receive any donated PPE from a federal source during the year ended June 30, 2023.

Finding Details

Finding 2023-001
Health Center Program Cluster – CFDA Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award No. 6 H80CS26561, February 1, 2023-January 31, 2024 Award No. 6 H80CS26561, February 1, 2022-January 31, 2023 Award No. 1 H8FCS41198, April 1, 2021-March 31, 2023 Award No. 6 C14CS39928, September 1, 2020-August 31, 2023 Award No. 1 H8HCS44996, September 1, 2021-August 31, 2022 Award No. 6 H8HCS44996, September 1, 2022-August 31, 2023 Award No. 6 H2ECS45563, May 1, 2022-April 30, 2023 Award No. 6 H2ECS45563, May 1, 2023-April 30, 2024 Criteria or Specific Requirement – Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR sections 51c.303(g); and 42 CFR sections 56.303 (f)) Condition – Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization’s policy. Questioned cost – None Context – A sample of 40 patients were tested out of the total population of 23,865 encounters. The sampling methodology used is not and is not intended to be statistically valid. Two patients received a sliding fee adjustment that was inconsistent with the approved policy for the proper sliding fee adjustments based on their income documentation. Effect – Sliding fee discounts were given to patients that were inconsistent with the Organization’s sliding fee discount policy. Cause – The Organization did not comply with their sliding fee policy. Identification as a repeat finding, if applicable – Is a repeat finding of 2022-002. Recommendation – We recommend management continue to ensure all personnel understand the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale and the Health Center Program Compliance Manual.
Finding 2023-001
Health Center Program Cluster – CFDA Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award No. 6 H80CS26561, February 1, 2023-January 31, 2024 Award No. 6 H80CS26561, February 1, 2022-January 31, 2023 Award No. 1 H8FCS41198, April 1, 2021-March 31, 2023 Award No. 6 C14CS39928, September 1, 2020-August 31, 2023 Award No. 1 H8HCS44996, September 1, 2021-August 31, 2022 Award No. 6 H8HCS44996, September 1, 2022-August 31, 2023 Award No. 6 H2ECS45563, May 1, 2022-April 30, 2023 Award No. 6 H2ECS45563, May 1, 2023-April 30, 2024 Criteria or Specific Requirement – Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR sections 51c.303(g); and 42 CFR sections 56.303 (f)) Condition – Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization’s policy. Questioned cost – None Context – A sample of 40 patients were tested out of the total population of 23,865 encounters. The sampling methodology used is not and is not intended to be statistically valid. Two patients received a sliding fee adjustment that was inconsistent with the approved policy for the proper sliding fee adjustments based on their income documentation. Effect – Sliding fee discounts were given to patients that were inconsistent with the Organization’s sliding fee discount policy. Cause – The Organization did not comply with their sliding fee policy. Identification as a repeat finding, if applicable – Is a repeat finding of 2022-002. Recommendation – We recommend management continue to ensure all personnel understand the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale and the Health Center Program Compliance Manual.
Finding 2023-001
Health Center Program Cluster – CFDA Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award No. 6 H80CS26561, February 1, 2023-January 31, 2024 Award No. 6 H80CS26561, February 1, 2022-January 31, 2023 Award No. 1 H8FCS41198, April 1, 2021-March 31, 2023 Award No. 6 C14CS39928, September 1, 2020-August 31, 2023 Award No. 1 H8HCS44996, September 1, 2021-August 31, 2022 Award No. 6 H8HCS44996, September 1, 2022-August 31, 2023 Award No. 6 H2ECS45563, May 1, 2022-April 30, 2023 Award No. 6 H2ECS45563, May 1, 2023-April 30, 2024 Criteria or Specific Requirement – Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR sections 51c.303(g); and 42 CFR sections 56.303 (f)) Condition – Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization’s policy. Questioned cost – None Context – A sample of 40 patients were tested out of the total population of 23,865 encounters. The sampling methodology used is not and is not intended to be statistically valid. Two patients received a sliding fee adjustment that was inconsistent with the approved policy for the proper sliding fee adjustments based on their income documentation. Effect – Sliding fee discounts were given to patients that were inconsistent with the Organization’s sliding fee discount policy. Cause – The Organization did not comply with their sliding fee policy. Identification as a repeat finding, if applicable – Is a repeat finding of 2022-002. Recommendation – We recommend management continue to ensure all personnel understand the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale and the Health Center Program Compliance Manual.
Finding 2023-002
Grants for Capital Development in Health Centers – CFDA No. 93.526 U.S. Department of Health and Human Services Award No. 6 C8ECS44310-01-05 Program Year 2023 Criteria or Specific Requirement – Cash Management (45 CFR 75.305) Condition – The Organization’s internal controls over the grant budget and cash drawdown process were not operating effectively to ensure allowed expenditures were incurred prior to drawdown. Questioned cost – None Context – Grant funds were drawn down prior to disbursements of expenditures within the grant period for six draws during the fiscal year ended June 30, 2023. Effect – Grant funds were drawn down sooner than administratively necessary. The final six draws were not earned as of the end of the grant period and are reflected as deferred grant revenue. A budget modification was subsequently approved by the HRSA and the deferred grant revenues were subsequently obligated and expended. Cause – The Organization’s initial grant budget was not in compliance with the grant requirements and required a budget modification subsequent to when the Organization had already completed cash draws. Identification as a repeat finding, if applicable – Is not a repeat finding. Recommendation – The Organization should ensure procedures are followed to prevent cash draws from being drawn down sooner than three days prior to disbursement of allowable expenditures.
Finding 2023-001
Health Center Program Cluster – CFDA Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award No. 6 H80CS26561, February 1, 2023-January 31, 2024 Award No. 6 H80CS26561, February 1, 2022-January 31, 2023 Award No. 1 H8FCS41198, April 1, 2021-March 31, 2023 Award No. 6 C14CS39928, September 1, 2020-August 31, 2023 Award No. 1 H8HCS44996, September 1, 2021-August 31, 2022 Award No. 6 H8HCS44996, September 1, 2022-August 31, 2023 Award No. 6 H2ECS45563, May 1, 2022-April 30, 2023 Award No. 6 H2ECS45563, May 1, 2023-April 30, 2024 Criteria or Specific Requirement – Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR sections 51c.303(g); and 42 CFR sections 56.303 (f)) Condition – Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization’s policy. Questioned cost – None Context – A sample of 40 patients were tested out of the total population of 23,865 encounters. The sampling methodology used is not and is not intended to be statistically valid. Two patients received a sliding fee adjustment that was inconsistent with the approved policy for the proper sliding fee adjustments based on their income documentation. Effect – Sliding fee discounts were given to patients that were inconsistent with the Organization’s sliding fee discount policy. Cause – The Organization did not comply with their sliding fee policy. Identification as a repeat finding, if applicable – Is a repeat finding of 2022-002. Recommendation – We recommend management continue to ensure all personnel understand the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale and the Health Center Program Compliance Manual.
Finding 2023-001
Health Center Program Cluster – CFDA Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award No. 6 H80CS26561, February 1, 2023-January 31, 2024 Award No. 6 H80CS26561, February 1, 2022-January 31, 2023 Award No. 1 H8FCS41198, April 1, 2021-March 31, 2023 Award No. 6 C14CS39928, September 1, 2020-August 31, 2023 Award No. 1 H8HCS44996, September 1, 2021-August 31, 2022 Award No. 6 H8HCS44996, September 1, 2022-August 31, 2023 Award No. 6 H2ECS45563, May 1, 2022-April 30, 2023 Award No. 6 H2ECS45563, May 1, 2023-April 30, 2024 Criteria or Specific Requirement – Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR sections 51c.303(g); and 42 CFR sections 56.303 (f)) Condition – Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization’s policy. Questioned cost – None Context – A sample of 40 patients were tested out of the total population of 23,865 encounters. The sampling methodology used is not and is not intended to be statistically valid. Two patients received a sliding fee adjustment that was inconsistent with the approved policy for the proper sliding fee adjustments based on their income documentation. Effect – Sliding fee discounts were given to patients that were inconsistent with the Organization’s sliding fee discount policy. Cause – The Organization did not comply with their sliding fee policy. Identification as a repeat finding, if applicable – Is a repeat finding of 2022-002. Recommendation – We recommend management continue to ensure all personnel understand the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale and the Health Center Program Compliance Manual.
Finding 2023-001
Health Center Program Cluster – CFDA Nos. 93.224 and 93.527 U.S. Department of Health and Human Services Award No. 6 H80CS26561, February 1, 2023-January 31, 2024 Award No. 6 H80CS26561, February 1, 2022-January 31, 2023 Award No. 1 H8FCS41198, April 1, 2021-March 31, 2023 Award No. 6 C14CS39928, September 1, 2020-August 31, 2023 Award No. 1 H8HCS44996, September 1, 2021-August 31, 2022 Award No. 6 H8HCS44996, September 1, 2022-August 31, 2023 Award No. 6 H2ECS45563, May 1, 2022-April 30, 2023 Award No. 6 H2ECS45563, May 1, 2023-April 30, 2024 Criteria or Specific Requirement – Special Tests and Provisions: Sliding Fee Discounts (42 USC 254(k)(3)(g); 42 CFR sections 51c.303(g); and 42 CFR sections 56.303 (f)) Condition – Patients received a sliding fee discount that was inconsistent with the stated sliding fee discount categories under the Organization’s policy. Questioned cost – None Context – A sample of 40 patients were tested out of the total population of 23,865 encounters. The sampling methodology used is not and is not intended to be statistically valid. Two patients received a sliding fee adjustment that was inconsistent with the approved policy for the proper sliding fee adjustments based on their income documentation. Effect – Sliding fee discounts were given to patients that were inconsistent with the Organization’s sliding fee discount policy. Cause – The Organization did not comply with their sliding fee policy. Identification as a repeat finding, if applicable – Is a repeat finding of 2022-002. Recommendation – We recommend management continue to ensure all personnel understand the sliding fee scale policy and adhere to the requirements and guidelines set forth in the policy. Procedures should be implemented to ensure that eligible patients receive discounts in accordance with the sliding fee scale and the Health Center Program Compliance Manual.
Finding 2023-002
Grants for Capital Development in Health Centers – CFDA No. 93.526 U.S. Department of Health and Human Services Award No. 6 C8ECS44310-01-05 Program Year 2023 Criteria or Specific Requirement – Cash Management (45 CFR 75.305) Condition – The Organization’s internal controls over the grant budget and cash drawdown process were not operating effectively to ensure allowed expenditures were incurred prior to drawdown. Questioned cost – None Context – Grant funds were drawn down prior to disbursements of expenditures within the grant period for six draws during the fiscal year ended June 30, 2023. Effect – Grant funds were drawn down sooner than administratively necessary. The final six draws were not earned as of the end of the grant period and are reflected as deferred grant revenue. A budget modification was subsequently approved by the HRSA and the deferred grant revenues were subsequently obligated and expended. Cause – The Organization’s initial grant budget was not in compliance with the grant requirements and required a budget modification subsequent to when the Organization had already completed cash draws. Identification as a repeat finding, if applicable – Is not a repeat finding. Recommendation – The Organization should ensure procedures are followed to prevent cash draws from being drawn down sooner than three days prior to disbursement of allowable expenditures.