FAC Explorer

Audit 19108

FY End
2022-03-31
Total Expended
$4.39M
Findings
2
Programs
4
Organization: San Francisco Medical Center Outpatient Improvement Programs, Inc. (CA)
Year: 2022 Accepted: 2022-12-28
Auditor: Chw LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
21814 2022-001 Significant Deficiency Yes N
598256 2022-001 Significant Deficiency Yes N

Programs

ALN Program Spent Major Findings
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $645,496 Yes 0
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $143,700 - 0
93.498 Provider Relief Fund $131,781 - 0
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $102,660 Yes 0

Contacts

Name Title Type
UDDBB7B9H335 Daniel Winokur Auditee
4087713195 Robert Church Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. For ALN 93.498, the amount included on the Schedule is based on the Period 1 and Period 2 PRF reports. 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 represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. The Organization elected to use the 10% de minimis cost rate. De Minimis Rate Used: Y Rate Explanation: The auditee used the de minimis cost rate. The accompanying Schedule of Expenditures of Federal Awards (the Schedule) summarizes the expenditures of San Francisco Medical Center Outpatient Improvement Programs, Inc. (the Organization) under programs of the federal government for the year ended March 31, 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 the operations of the Organization, it is not intended to, and does not, present the financial position, changes in net assets, or cash flows for the Organization.

Finding Details

Finding 2022-001
2022-001 Sliding Fee Discount Determination CFDA Number: 93.224 Program: Community Health Center Cluster Agency: US Department of Health and Human Services Compliance Requirement: N- Special Tests and Provisions Repeat Finding: Yes ? see prior year finding 2021-003 Criteria: Federal grant compliance provisions require that the Organization correctly identify a patient's ability to pay and that the rates for services be adjusted accordingly based on the sliding fee schedule. The Organization is required to follow its sliding fee policy when providing discounts to eligible patients. Finding/ Condition: In our sample of 40 tested items, in five samples patient information was inadequate to determine the proper sliding fee discount and in seven samples the patient was given incorrect discounts based on information provided. Questioned Cost: None. Effect: Lack of strict enforcement of the policy of sliding fee eligibility determination and compliance may have resulted in the Organization providing discounted services greater to or less than the appropriate amounts to beneficiaries. Cause: Inadequate understanding of the sliding fee program requirements and Organization policies by employees involved in sliding fee determination and billing. Recommendation: Training should be provided to employees on the sliding fee program requirements. The Organization should perform regular audits of sliding fee transactions to identify weaknesses in compliance. Views of Responsible Officials and Corrective Action Plan: The Organization agrees with the finding and will implement additional controls to ensure that this does not recur. Please refer to the corrective action plan on page 32.
Finding 2022-001
2022-001 Sliding Fee Discount Determination CFDA Number: 93.224 Program: Community Health Center Cluster Agency: US Department of Health and Human Services Compliance Requirement: N- Special Tests and Provisions Repeat Finding: Yes ? see prior year finding 2021-003 Criteria: Federal grant compliance provisions require that the Organization correctly identify a patient's ability to pay and that the rates for services be adjusted accordingly based on the sliding fee schedule. The Organization is required to follow its sliding fee policy when providing discounts to eligible patients. Finding/ Condition: In our sample of 40 tested items, in five samples patient information was inadequate to determine the proper sliding fee discount and in seven samples the patient was given incorrect discounts based on information provided. Questioned Cost: None. Effect: Lack of strict enforcement of the policy of sliding fee eligibility determination and compliance may have resulted in the Organization providing discounted services greater to or less than the appropriate amounts to beneficiaries. Cause: Inadequate understanding of the sliding fee program requirements and Organization policies by employees involved in sliding fee determination and billing. Recommendation: Training should be provided to employees on the sliding fee program requirements. The Organization should perform regular audits of sliding fee transactions to identify weaknesses in compliance. Views of Responsible Officials and Corrective Action Plan: The Organization agrees with the finding and will implement additional controls to ensure that this does not recur. Please refer to the corrective action plan on page 32.