Audit 15618

FY End
2023-06-30
Total Expended
$7.74M
Findings
12
Programs
3
Organization: La Familia Medical Center (NM)
Year: 2023 Accepted: 2024-02-05

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
11782 2023-001 Significant Deficiency - N
11783 2023-002 Significant Deficiency - I
11784 2023-001 Significant Deficiency - N
11785 2023-002 Significant Deficiency - I
11786 2023-001 Significant Deficiency - N
11787 2023-002 Significant Deficiency - I
588224 2023-001 Significant Deficiency - N
588225 2023-002 Significant Deficiency - I
588226 2023-001 Significant Deficiency - N
588227 2023-002 Significant Deficiency - I
588228 2023-001 Significant Deficiency - N
588229 2023-002 Significant Deficiency - I

Programs

ALN Program Spent Major Findings
93.224 Consolidated Health Centers $5.44M Yes 2
93.224 Covid-19: American Rescue Plan Act Funding for Health Centers $2.30M Yes 2
93.527 Consolidated Health Centers $0 Yes 2

Contacts

Name Title Type
MJG8KCGNLXF5 Brandy Van Pelt-Ramirez Auditee
5054245683 James Mann Auditor
No contacts on file

Notes to SEFA

Accounting Policies: This note is included to meet the requirements of 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance) requirement that the schedule of expenditures of federal awards (the Schedule) include notes that describe the significant accounting policies used in preparing the Schedule. The accompanying Schedule is prepared on the accrual basis of accounting and includes the federal award activity of the Organization 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 the Uniform Guidance. The Organization has not elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. Because the Schedule presents only a selected portion of the operations of the Organization, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Organization. De Minimis Rate Used: N Rate Explanation: The Organization has not elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance.

Finding Details

Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), “Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient’s ability to pay.” Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization corrected the claim on November 15, 2023 to give the patient the appropriate sliding fee discount. The Organization has provided education to staff instructing them that the charges quoted at a patient's slide will change if the slide is different at the time of service. IT has also added verbiage to the dental treatment plans stating that the slide at the time of service will be applied even if the quoted price was at a different slide.
Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Award requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context We noted the Organization is not in compliance with requirements related to Procurement, Suspension and Debarment. During our testing, we noted the following exception: • For two of the five procurement transactions tested the Organization did not retain support to document the procurement methods followed (I.e., sole source, small purchases, sealed bids, proposals, etc.). Effect The auditor noted instances of noncompliance. Noncompliance results in possible federal funds provided to ineligible subrecipients and/or vendors. Questioned Costs None identified. Cause The Organization lacked a process to ensure all supporting procurement documentation is retained to support the procurement method used. Recommendation We recommend the Organization retain all documentation and support to show that the procurement policy was followed. Views of Responsible Officials The Organization does have a policy for Procurement, Suspension, and Debarment. The procurement documents were misfiled and staff have not been able to locate the documents. The Organization provided education to staff on the importance of retention of records and ensuring documents are filed in the correct folders.
Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), “Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient’s ability to pay.” Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization corrected the claim on November 15, 2023 to give the patient the appropriate sliding fee discount. The Organization has provided education to staff instructing them that the charges quoted at a patient's slide will change if the slide is different at the time of service. IT has also added verbiage to the dental treatment plans stating that the slide at the time of service will be applied even if the quoted price was at a different slide.
Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Award requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context We noted the Organization is not in compliance with requirements related to Procurement, Suspension and Debarment. During our testing, we noted the following exception: • For two of the five procurement transactions tested the Organization did not retain support to document the procurement methods followed (I.e., sole source, small purchases, sealed bids, proposals, etc.). Effect The auditor noted instances of noncompliance. Noncompliance results in possible federal funds provided to ineligible subrecipients and/or vendors. Questioned Costs None identified. Cause The Organization lacked a process to ensure all supporting procurement documentation is retained to support the procurement method used. Recommendation We recommend the Organization retain all documentation and support to show that the procurement policy was followed. Views of Responsible Officials The Organization does have a policy for Procurement, Suspension, and Debarment. The procurement documents were misfiled and staff have not been able to locate the documents. The Organization provided education to staff on the importance of retention of records and ensuring documents are filed in the correct folders.
Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), “Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient’s ability to pay.” Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization corrected the claim on November 15, 2023 to give the patient the appropriate sliding fee discount. The Organization has provided education to staff instructing them that the charges quoted at a patient's slide will change if the slide is different at the time of service. IT has also added verbiage to the dental treatment plans stating that the slide at the time of service will be applied even if the quoted price was at a different slide.
Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Award requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context We noted the Organization is not in compliance with requirements related to Procurement, Suspension and Debarment. During our testing, we noted the following exception: • For two of the five procurement transactions tested the Organization did not retain support to document the procurement methods followed (I.e., sole source, small purchases, sealed bids, proposals, etc.). Effect The auditor noted instances of noncompliance. Noncompliance results in possible federal funds provided to ineligible subrecipients and/or vendors. Questioned Costs None identified. Cause The Organization lacked a process to ensure all supporting procurement documentation is retained to support the procurement method used. Recommendation We recommend the Organization retain all documentation and support to show that the procurement policy was followed. Views of Responsible Officials The Organization does have a policy for Procurement, Suspension, and Debarment. The procurement documents were misfiled and staff have not been able to locate the documents. The Organization provided education to staff on the importance of retention of records and ensuring documents are filed in the correct folders.
Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), “Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient’s ability to pay.” Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization corrected the claim on November 15, 2023 to give the patient the appropriate sliding fee discount. The Organization has provided education to staff instructing them that the charges quoted at a patient's slide will change if the slide is different at the time of service. IT has also added verbiage to the dental treatment plans stating that the slide at the time of service will be applied even if the quoted price was at a different slide.
Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Award requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context We noted the Organization is not in compliance with requirements related to Procurement, Suspension and Debarment. During our testing, we noted the following exception: • For two of the five procurement transactions tested the Organization did not retain support to document the procurement methods followed (I.e., sole source, small purchases, sealed bids, proposals, etc.). Effect The auditor noted instances of noncompliance. Noncompliance results in possible federal funds provided to ineligible subrecipients and/or vendors. Questioned Costs None identified. Cause The Organization lacked a process to ensure all supporting procurement documentation is retained to support the procurement method used. Recommendation We recommend the Organization retain all documentation and support to show that the procurement policy was followed. Views of Responsible Officials The Organization does have a policy for Procurement, Suspension, and Debarment. The procurement documents were misfiled and staff have not been able to locate the documents. The Organization provided education to staff on the importance of retention of records and ensuring documents are filed in the correct folders.
Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), “Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient’s ability to pay.” Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization corrected the claim on November 15, 2023 to give the patient the appropriate sliding fee discount. The Organization has provided education to staff instructing them that the charges quoted at a patient's slide will change if the slide is different at the time of service. IT has also added verbiage to the dental treatment plans stating that the slide at the time of service will be applied even if the quoted price was at a different slide.
Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Award requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context We noted the Organization is not in compliance with requirements related to Procurement, Suspension and Debarment. During our testing, we noted the following exception: • For two of the five procurement transactions tested the Organization did not retain support to document the procurement methods followed (I.e., sole source, small purchases, sealed bids, proposals, etc.). Effect The auditor noted instances of noncompliance. Noncompliance results in possible federal funds provided to ineligible subrecipients and/or vendors. Questioned Costs None identified. Cause The Organization lacked a process to ensure all supporting procurement documentation is retained to support the procurement method used. Recommendation We recommend the Organization retain all documentation and support to show that the procurement policy was followed. Views of Responsible Officials The Organization does have a policy for Procurement, Suspension, and Debarment. The procurement documents were misfiled and staff have not been able to locate the documents. The Organization provided education to staff on the importance of retention of records and ensuring documents are filed in the correct folders.
Criteria or Specific Requirement Per Title 42 Chapter 1 Subchapter D Section 51c303(f), “Health centers must have a schedule of fees or payments for the provision of their health services consistent with locally prevailing rates or charges designed to cover their reasonable costs of operation. They are also required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient’s ability to pay.” Condition and Context During our testing of forty sliding fee discounts for health center patients qualifying for reduced charge visits, we identified one visit that received the incorrect sliding fee discount. Effect Potential that a patient would not receive the appropriate sliding fee discount. Questioned Costs None identified. Cause Clerical error in which the incorrect discount was applied due to lack of an oversight process in place. Recommendation We recommend the Organization to review internal controls in regards to the determination, recording, and monitoring of the sliding fee process to ensure that appropriate sliding fee rates/categories are utilized for each sliding fee encounter. Views of Responsible Officials The Organization corrected the claim on November 15, 2023 to give the patient the appropriate sliding fee discount. The Organization has provided education to staff instructing them that the charges quoted at a patient's slide will change if the slide is different at the time of service. IT has also added verbiage to the dental treatment plans stating that the slide at the time of service will be applied even if the quoted price was at a different slide.
Criteria or Specific Requirement 2 CFR Part 200 Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Award requires compliance with the provisions of procurement and suspension and debarment. The Organization should have internal controls designed to ensure compliance with these provisions. Condition and Context We noted the Organization is not in compliance with requirements related to Procurement, Suspension and Debarment. During our testing, we noted the following exception: • For two of the five procurement transactions tested the Organization did not retain support to document the procurement methods followed (I.e., sole source, small purchases, sealed bids, proposals, etc.). Effect The auditor noted instances of noncompliance. Noncompliance results in possible federal funds provided to ineligible subrecipients and/or vendors. Questioned Costs None identified. Cause The Organization lacked a process to ensure all supporting procurement documentation is retained to support the procurement method used. Recommendation We recommend the Organization retain all documentation and support to show that the procurement policy was followed. Views of Responsible Officials The Organization does have a policy for Procurement, Suspension, and Debarment. The procurement documents were misfiled and staff have not been able to locate the documents. The Organization provided education to staff on the importance of retention of records and ensuring documents are filed in the correct folders.