Audit 17191

FY End
2022-12-31
Total Expended
$3.57M
Findings
12
Programs
10
Year: 2022 Accepted: 2023-09-09

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
12549 2022-003 Significant Deficiency - L
12550 2022-004 Significant Deficiency - N
12551 2022-003 Significant Deficiency - L
12552 2022-004 Significant Deficiency - N
12553 2022-003 Significant Deficiency - L
12554 2022-004 Significant Deficiency - N
588991 2022-003 Significant Deficiency - L
588992 2022-004 Significant Deficiency - N
588993 2022-003 Significant Deficiency - L
588994 2022-004 Significant Deficiency - N
588995 2022-003 Significant Deficiency - L
588996 2022-004 Significant Deficiency - N

Contacts

Name Title Type
JCHMWC4NXFL4 Shannon Courson Auditee
3098672202 Chris Manderfield Auditor
No contacts on file

Notes to SEFA

Title: BASIS OF PRESENTATION Accounting Policies: Expenditures reported on the of schedule of expenditures of federal awards 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 allowed or limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The accompanying schedule of expenditures of federal awards (SEFA) includes the federal grant activity of the Organization under programs of the federal government for the year ended December 31, 2022. The information in this SEFA 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). As the SEFA 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.
Title: FINANCIAL STATEMENT REVENUE Accounting Policies: Expenditures reported on the of schedule of expenditures of federal awards 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 allowed or limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. The financial statements reflect revenue recognized from the Provider Relief Fund (PRF) of $7,804 and $190,487 for the years ended December 31, 2022 and 2021, respectively. Included in the revenue recognized during the year ended December 31, 2022 is $7,804 received during PRF Period 5. The SEFA does not include this amount as PRF Period 5 is not reported on the SEFA for the year ended December 31, 2022 in accordance with the requirement of the compliance supplement for assistance listing number 93.498.
Title: OTHER MATTERS Accounting Policies: Expenditures reported on the of schedule of expenditures of federal awards 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 allowed or limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Amount of Noncash Assistance - NONE Amount of Insurance - NONEAmount of Loans - NONEAmount of Loan Guarantees - NONE

Finding Details

Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Significant deficiency in internal control over compliance Criteria: ? 200.329(b) of the Uniform Guidance requires that the Federal awarding agency must use OMB-approved common information collections, as applicable, when providing financial and performance reporting information. As appropriate and in accordance with above mentioned information collections, the Federal awarding agency must require the recipient to relate financial data and accomplishments to performance goals and objectives of the Federal award. Condition: Management inadvertently excluded expenses of $196,816 incurred under the grant award and required to be reported on Line 10e. - Federal share of expenditures on the Federal Financial Report (SF-425) for the reporting period end date of December 31, 2022. Questioned Costs: None. Context: This condition impacts $196,816 out of total line 10 e. federal share of expenditures of $3,186,941. Cause: During the reconciliation process of line 10 e. of the SF-425 report, management reconciled to cash receipts reflected in the Payment Management System (PMS) for the reporting period ended, but was unaware that a drawdown of $196,816 it had received on December 30, 2022 was not reflected in the PMS until January 2023. Effect: Federal share of expenditures reported may differ from actual expenditures creating a circumstance of less effective monitoring of the organization's award by oversight agencies. Repeat Finding: No. Recommendation: We recommend management implement a second layer of review and approval as well as carefully review the key line items on the FFR, including reconciling cash receipts from PMS to the Organization's records of its revenue and expense, prior to submitting the report. Section III ? Federal Award Findings and Questioned Costs (Continued) Finding 2022-003 ? Reporting (continued) Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Compliance and Significant deficiency in internal control over compliance Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization charged one (1) patient the full self-pay rate for a visit instead of the appropriate sliding fee discounted rate based on the patient's eligibility determined by their family size and income. Questioned Costs: None. Context: This condition occurred in one (1) of forty (40) transactions selected for testing. Cause: Patient had a credit balance on their account which was incorrectly applied to the full charge for the patient's visit. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should refine and expand its internal audits of patient visits to identify instances where a patient was either assigned to the incorrect sliding fee category or billed the incorrect charges. Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Significant deficiency in internal control over compliance Criteria: ? 200.329(b) of the Uniform Guidance requires that the Federal awarding agency must use OMB-approved common information collections, as applicable, when providing financial and performance reporting information. As appropriate and in accordance with above mentioned information collections, the Federal awarding agency must require the recipient to relate financial data and accomplishments to performance goals and objectives of the Federal award. Condition: Management inadvertently excluded expenses of $196,816 incurred under the grant award and required to be reported on Line 10e. - Federal share of expenditures on the Federal Financial Report (SF-425) for the reporting period end date of December 31, 2022. Questioned Costs: None. Context: This condition impacts $196,816 out of total line 10 e. federal share of expenditures of $3,186,941. Cause: During the reconciliation process of line 10 e. of the SF-425 report, management reconciled to cash receipts reflected in the Payment Management System (PMS) for the reporting period ended, but was unaware that a drawdown of $196,816 it had received on December 30, 2022 was not reflected in the PMS until January 2023. Effect: Federal share of expenditures reported may differ from actual expenditures creating a circumstance of less effective monitoring of the organization's award by oversight agencies. Repeat Finding: No. Recommendation: We recommend management implement a second layer of review and approval as well as carefully review the key line items on the FFR, including reconciling cash receipts from PMS to the Organization's records of its revenue and expense, prior to submitting the report. Section III ? Federal Award Findings and Questioned Costs (Continued) Finding 2022-003 ? Reporting (continued) Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Compliance and Significant deficiency in internal control over compliance Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization charged one (1) patient the full self-pay rate for a visit instead of the appropriate sliding fee discounted rate based on the patient's eligibility determined by their family size and income. Questioned Costs: None. Context: This condition occurred in one (1) of forty (40) transactions selected for testing. Cause: Patient had a credit balance on their account which was incorrectly applied to the full charge for the patient's visit. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should refine and expand its internal audits of patient visits to identify instances where a patient was either assigned to the incorrect sliding fee category or billed the incorrect charges. Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Significant deficiency in internal control over compliance Criteria: ? 200.329(b) of the Uniform Guidance requires that the Federal awarding agency must use OMB-approved common information collections, as applicable, when providing financial and performance reporting information. As appropriate and in accordance with above mentioned information collections, the Federal awarding agency must require the recipient to relate financial data and accomplishments to performance goals and objectives of the Federal award. Condition: Management inadvertently excluded expenses of $196,816 incurred under the grant award and required to be reported on Line 10e. - Federal share of expenditures on the Federal Financial Report (SF-425) for the reporting period end date of December 31, 2022. Questioned Costs: None. Context: This condition impacts $196,816 out of total line 10 e. federal share of expenditures of $3,186,941. Cause: During the reconciliation process of line 10 e. of the SF-425 report, management reconciled to cash receipts reflected in the Payment Management System (PMS) for the reporting period ended, but was unaware that a drawdown of $196,816 it had received on December 30, 2022 was not reflected in the PMS until January 2023. Effect: Federal share of expenditures reported may differ from actual expenditures creating a circumstance of less effective monitoring of the organization's award by oversight agencies. Repeat Finding: No. Recommendation: We recommend management implement a second layer of review and approval as well as carefully review the key line items on the FFR, including reconciling cash receipts from PMS to the Organization's records of its revenue and expense, prior to submitting the report. Section III ? Federal Award Findings and Questioned Costs (Continued) Finding 2022-003 ? Reporting (continued) Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Compliance and Significant deficiency in internal control over compliance Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization charged one (1) patient the full self-pay rate for a visit instead of the appropriate sliding fee discounted rate based on the patient's eligibility determined by their family size and income. Questioned Costs: None. Context: This condition occurred in one (1) of forty (40) transactions selected for testing. Cause: Patient had a credit balance on their account which was incorrectly applied to the full charge for the patient's visit. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should refine and expand its internal audits of patient visits to identify instances where a patient was either assigned to the incorrect sliding fee category or billed the incorrect charges. Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Significant deficiency in internal control over compliance Criteria: ? 200.329(b) of the Uniform Guidance requires that the Federal awarding agency must use OMB-approved common information collections, as applicable, when providing financial and performance reporting information. As appropriate and in accordance with above mentioned information collections, the Federal awarding agency must require the recipient to relate financial data and accomplishments to performance goals and objectives of the Federal award. Condition: Management inadvertently excluded expenses of $196,816 incurred under the grant award and required to be reported on Line 10e. - Federal share of expenditures on the Federal Financial Report (SF-425) for the reporting period end date of December 31, 2022. Questioned Costs: None. Context: This condition impacts $196,816 out of total line 10 e. federal share of expenditures of $3,186,941. Cause: During the reconciliation process of line 10 e. of the SF-425 report, management reconciled to cash receipts reflected in the Payment Management System (PMS) for the reporting period ended, but was unaware that a drawdown of $196,816 it had received on December 30, 2022 was not reflected in the PMS until January 2023. Effect: Federal share of expenditures reported may differ from actual expenditures creating a circumstance of less effective monitoring of the organization's award by oversight agencies. Repeat Finding: No. Recommendation: We recommend management implement a second layer of review and approval as well as carefully review the key line items on the FFR, including reconciling cash receipts from PMS to the Organization's records of its revenue and expense, prior to submitting the report. Section III ? Federal Award Findings and Questioned Costs (Continued) Finding 2022-003 ? Reporting (continued) Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Compliance and Significant deficiency in internal control over compliance Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization charged one (1) patient the full self-pay rate for a visit instead of the appropriate sliding fee discounted rate based on the patient's eligibility determined by their family size and income. Questioned Costs: None. Context: This condition occurred in one (1) of forty (40) transactions selected for testing. Cause: Patient had a credit balance on their account which was incorrectly applied to the full charge for the patient's visit. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should refine and expand its internal audits of patient visits to identify instances where a patient was either assigned to the incorrect sliding fee category or billed the incorrect charges. Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Significant deficiency in internal control over compliance Criteria: ? 200.329(b) of the Uniform Guidance requires that the Federal awarding agency must use OMB-approved common information collections, as applicable, when providing financial and performance reporting information. As appropriate and in accordance with above mentioned information collections, the Federal awarding agency must require the recipient to relate financial data and accomplishments to performance goals and objectives of the Federal award. Condition: Management inadvertently excluded expenses of $196,816 incurred under the grant award and required to be reported on Line 10e. - Federal share of expenditures on the Federal Financial Report (SF-425) for the reporting period end date of December 31, 2022. Questioned Costs: None. Context: This condition impacts $196,816 out of total line 10 e. federal share of expenditures of $3,186,941. Cause: During the reconciliation process of line 10 e. of the SF-425 report, management reconciled to cash receipts reflected in the Payment Management System (PMS) for the reporting period ended, but was unaware that a drawdown of $196,816 it had received on December 30, 2022 was not reflected in the PMS until January 2023. Effect: Federal share of expenditures reported may differ from actual expenditures creating a circumstance of less effective monitoring of the organization's award by oversight agencies. Repeat Finding: No. Recommendation: We recommend management implement a second layer of review and approval as well as carefully review the key line items on the FFR, including reconciling cash receipts from PMS to the Organization's records of its revenue and expense, prior to submitting the report. Section III ? Federal Award Findings and Questioned Costs (Continued) Finding 2022-003 ? Reporting (continued) Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Compliance and Significant deficiency in internal control over compliance Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization charged one (1) patient the full self-pay rate for a visit instead of the appropriate sliding fee discounted rate based on the patient's eligibility determined by their family size and income. Questioned Costs: None. Context: This condition occurred in one (1) of forty (40) transactions selected for testing. Cause: Patient had a credit balance on their account which was incorrectly applied to the full charge for the patient's visit. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should refine and expand its internal audits of patient visits to identify instances where a patient was either assigned to the incorrect sliding fee category or billed the incorrect charges. Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Significant deficiency in internal control over compliance Criteria: ? 200.329(b) of the Uniform Guidance requires that the Federal awarding agency must use OMB-approved common information collections, as applicable, when providing financial and performance reporting information. As appropriate and in accordance with above mentioned information collections, the Federal awarding agency must require the recipient to relate financial data and accomplishments to performance goals and objectives of the Federal award. Condition: Management inadvertently excluded expenses of $196,816 incurred under the grant award and required to be reported on Line 10e. - Federal share of expenditures on the Federal Financial Report (SF-425) for the reporting period end date of December 31, 2022. Questioned Costs: None. Context: This condition impacts $196,816 out of total line 10 e. federal share of expenditures of $3,186,941. Cause: During the reconciliation process of line 10 e. of the SF-425 report, management reconciled to cash receipts reflected in the Payment Management System (PMS) for the reporting period ended, but was unaware that a drawdown of $196,816 it had received on December 30, 2022 was not reflected in the PMS until January 2023. Effect: Federal share of expenditures reported may differ from actual expenditures creating a circumstance of less effective monitoring of the organization's award by oversight agencies. Repeat Finding: No. Recommendation: We recommend management implement a second layer of review and approval as well as carefully review the key line items on the FFR, including reconciling cash receipts from PMS to the Organization's records of its revenue and expense, prior to submitting the report. Section III ? Federal Award Findings and Questioned Costs (Continued) Finding 2022-003 ? Reporting (continued) Views of Responsible Officials: There is no disagreement with the audit finding.
Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Program Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Identification Number: H80CS00192 Award Period: January 1, 2022 ? December 31, 2022 Type of Finding: Compliance and Significant deficiency in internal control over compliance Criteria: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient?s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization charged one (1) patient the full self-pay rate for a visit instead of the appropriate sliding fee discounted rate based on the patient's eligibility determined by their family size and income. Questioned Costs: None. Context: This condition occurred in one (1) of forty (40) transactions selected for testing. Cause: Patient had a credit balance on their account which was incorrectly applied to the full charge for the patient's visit. Effect: Applicants assessed are not charged according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should refine and expand its internal audits of patient visits to identify instances where a patient was either assigned to the incorrect sliding fee category or billed the incorrect charges. Views of Responsible Officials: There is no disagreement with the audit finding.