Audit 21778

FY End
2022-06-30
Total Expended
$21.02M
Findings
6
Programs
11
Organization: Vna Health Care (IL)
Year: 2022 Accepted: 2023-03-02

Organization Exclusion Status:

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Contacts

Name Title Type
KP4GCPMHHL19 Jill Stevens Auditee
6309782532 Chris Manderfield Auditor
No contacts on file

Notes to SEFA

Title: Note 3 - Other Matters 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 represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. VNA has elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. De Minimis Rate Used: Y Rate Explanation: The auditee used the de minimis cost rate. Amount of Noncash Assistance NoneAmount of Insurance NoneAmount of Loans NoneAmount of Loan Guarantees None
Title: Note 4 - Financial Statement Revenue 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 represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. VNA has elected to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. De Minimis Rate Used: Y Rate Explanation: The auditee used the de minimis cost rate. The financial statements for the years ended June 30, 2022 and 2021 reflect revenuerecognized from the Provider Relief Fund (PRF) of $478,543 and $1,024,482, respectively.The SEFA for the year ended June 30, 2022 includes PRF of $478,543 which consists ofPRF received during Reporting Periods 2 and 3, in accordance with the requirement of thecompliance supplement for assistance listing number 93.498.

Finding Details

Finding 2022-001 ? Special Provisions Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Number: H80CS03983-18; H80CS03983-19 Award Periods: March 1, 2021 ? February 28, 2022; March 1, 2022 ? February 28, 2023 Type of Finding: 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: VNA did not have family size and patient income information on file in order to demonstrate the proper sliding fee scale had been assigned to a patient. Questioned Costs: None. Context: Three (3) of forty (40) transactions selected for testing. Cause: Family size and income information was not retained and entered into the electronic medical records prior to assigning the patient to a sliding fee scale. Effect: Patients may not be charged according to VNA?s sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of Responsible Officials: There is no disagreement with the audit finding.
Finding 2022-001 ? Special Provisions Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Number: H80CS03983-18; H80CS03983-19 Award Periods: March 1, 2021 ? February 28, 2022; March 1, 2022 ? February 28, 2023 Type of Finding: 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: VNA did not have family size and patient income information on file in order to demonstrate the proper sliding fee scale had been assigned to a patient. Questioned Costs: None. Context: Three (3) of forty (40) transactions selected for testing. Cause: Family size and income information was not retained and entered into the electronic medical records prior to assigning the patient to a sliding fee scale. Effect: Patients may not be charged according to VNA?s sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of Responsible Officials: There is no disagreement with the audit finding.
Finding 2022-001 ? Special Provisions Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Number: H80CS03983-18; H80CS03983-19 Award Periods: March 1, 2021 ? February 28, 2022; March 1, 2022 ? February 28, 2023 Type of Finding: 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: VNA did not have family size and patient income information on file in order to demonstrate the proper sliding fee scale had been assigned to a patient. Questioned Costs: None. Context: Three (3) of forty (40) transactions selected for testing. Cause: Family size and income information was not retained and entered into the electronic medical records prior to assigning the patient to a sliding fee scale. Effect: Patients may not be charged according to VNA?s sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of Responsible Officials: There is no disagreement with the audit finding.
Finding 2022-001 ? Special Provisions Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Number: H80CS03983-18; H80CS03983-19 Award Periods: March 1, 2021 ? February 28, 2022; March 1, 2022 ? February 28, 2023 Type of Finding: 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: VNA did not have family size and patient income information on file in order to demonstrate the proper sliding fee scale had been assigned to a patient. Questioned Costs: None. Context: Three (3) of forty (40) transactions selected for testing. Cause: Family size and income information was not retained and entered into the electronic medical records prior to assigning the patient to a sliding fee scale. Effect: Patients may not be charged according to VNA?s sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of Responsible Officials: There is no disagreement with the audit finding.
Finding 2022-001 ? Special Provisions Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Number: H80CS03983-18; H80CS03983-19 Award Periods: March 1, 2021 ? February 28, 2022; March 1, 2022 ? February 28, 2023 Type of Finding: 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: VNA did not have family size and patient income information on file in order to demonstrate the proper sliding fee scale had been assigned to a patient. Questioned Costs: None. Context: Three (3) of forty (40) transactions selected for testing. Cause: Family size and income information was not retained and entered into the electronic medical records prior to assigning the patient to a sliding fee scale. Effect: Patients may not be charged according to VNA?s sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of Responsible Officials: There is no disagreement with the audit finding.
Finding 2022-001 ? Special Provisions Federal Agency: U.S. Department of Health and Human Services Federal Program Name: Health Center Cluster Assistance Listing Number: 93.224 and 93.527 Federal Award Number: H80CS03983-18; H80CS03983-19 Award Periods: March 1, 2021 ? February 28, 2022; March 1, 2022 ? February 28, 2023 Type of Finding: 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: VNA did not have family size and patient income information on file in order to demonstrate the proper sliding fee scale had been assigned to a patient. Questioned Costs: None. Context: Three (3) of forty (40) transactions selected for testing. Cause: Family size and income information was not retained and entered into the electronic medical records prior to assigning the patient to a sliding fee scale. Effect: Patients may not be charged according to VNA?s sliding fee scale and their ability to pay. Repeat Finding: No. Recommendation: Management should consider increasing the frequency of its self-reviews of patient encounters or expanding its sample sizes in addition to providing additional training for front desk staff regarding the collection and verification of patient information for each patient. Views of Responsible Officials: There is no disagreement with the audit finding.