Audit 19676

FY End
2022-12-31
Total Expended
$8.55M
Findings
12
Programs
13
Organization: Community Health Services, Inc. (CT)
Year: 2022 Accepted: 2023-05-30
Auditor: Cohnreznick LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
20234 2022-001 Significant Deficiency Yes N
20235 2022-001 Significant Deficiency Yes N
20236 2022-001 Significant Deficiency Yes N
20237 2022-001 Significant Deficiency Yes N
20238 2022-001 Significant Deficiency Yes N
20239 2022-001 Significant Deficiency Yes N
596676 2022-001 Significant Deficiency Yes N
596677 2022-001 Significant Deficiency Yes N
596678 2022-001 Significant Deficiency Yes N
596679 2022-001 Significant Deficiency Yes N
596680 2022-001 Significant Deficiency Yes N
596681 2022-001 Significant Deficiency Yes N

Contacts

Name Title Type
VMJQQXR4GSU3 Dianna Kulmacz Auditee
8602499625 James Lacroix Auditor
No contacts on file

Notes to SEFA

Title: COVID-19 - Provider Relief Fund and American Rescue Plan Accounting Policies: The accompanying schedule of expenditures of federal awards (the "Schedule") includes the federal award activity of Community Health Services, Inc. (the "Center") under programs of the federal government for the year ended December 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 Center, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Center. 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. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The Center has elected to not use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. For the DHHS awards related to the Provider Relief Fund ("PRF") and American Rescue Plan (ARP) Rural Distribution program, DHHS has indicated the amounts on the schedule be reported corresponding to reporting requirements of the HRSA PRF Reporting Portal. Payments from DHHS for PRF are assigned to 'Payment Received Periods' (each, a Period) based upon the date each payment from the PRF was received. Each Period has a specified Period of Availability and timing of reporting requirements. Entities report into the HRSA PRF Reporting Portal after each Period's deadline to use the funds (i.e., after the end of the Period of Availability). The schedule includes $5,920 received from DHHS between July 1, 2021 through December 31, 2021. In accordance with guidance from DHHS, this amount represents Period 4 funding. Such amounts were recognized as government grants in the financial statements in the year ended December 31, 2021.
Title: COVID-19 - HRSA COVID-19 Claims Reimbursement for the Uninsured Program Accounting Policies: The accompanying schedule of expenditures of federal awards (the "Schedule") includes the federal award activity of Community Health Services, Inc. (the "Center") under programs of the federal government for the year ended December 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 Center, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Center. 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. Pass-through entity identifying numbers are presented where available. De Minimis Rate Used: N Rate Explanation: The Center has elected to not use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. For the DHHS awards related to the HRSA COVID-19 Claims Reimbursement for the Uninsured Program and the COVID-19 Coverage Assistance Fund program (the Uninsured/CAF Program), the amounts on the schedule relate to the amount of revenue recognized in the financial statements during the year ended December 31, 2022.

Finding Details

Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.
Finding 2022.001: Sliding Fee Scale Documentation Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster: Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), COVID-19 Health Center Program (Community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care), Grants for New and Expanded Services Under the Health Center Program, COVID-19 Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Criteria In accordance with the Uniform Guidance, the Center must prepare and apply a sliding fee discount policy and schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on a patient's poverty level, which is determined by the patient's income and family size. Condition The Center did not always have the proper sliding fee documentation entered into the system for the patients, therefore, was not able to apply the sliding fee discount based on income levels. Context A test of 40 sliding fee discount transactions was performed and resulted in two instances where a patient was charged the incorrect sliding fee discount. Our sample was a statistically valid sample. Questioned Costs None. Cause The Center did not have adequate internal controls in place to effectively ensure that the proper slide fee discount is applied. Effect The Center did not comply with the appropriate rules and regulations as per the Uniform Guidance. Identification of Repeat Finding Yes ? 2021.001. Recommendation The Center should implement controls to ensure proper sliding fee discounts are provided. Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding.