Audit 21914

FY End
2022-05-31
Total Expended
$15.57M
Findings
6
Programs
5
Year: 2022 Accepted: 2023-02-02
Auditor: Cohnreznick LLP

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
22609 2022-001 Material Weakness Yes N
22610 2022-001 Material Weakness Yes N
22611 2022-001 Material Weakness Yes N
599051 2022-001 Material Weakness Yes N
599052 2022-001 Material Weakness Yes N
599053 2022-001 Material Weakness Yes N

Contacts

Name Title Type
MX5DULXXCE73 William Bledsoe Auditee
4047568743 Steven D Schwartz Auditor
No contacts on file

Notes to SEFA

Title: Basis of Presentation Accounting Policies: Expenditures reported on the schedule are reported in 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 limted as to reimbursement. De Minimis Rate Used: N Rate Explanation: The center elected not use the de minimis cost rate as allowed under the Uniform Guidance The accompanying schedule of expenditures of federal awards (the "Schedule") includes the federal award activity of The Family Health Centers of Georgia, Inc. (the "Center") under programs of the federal government for the year ended May 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.
Title: COVID-19 - Provider Relief Fund and American Rescue Plan ("ARP") Accounting Policies: Expenditures reported on the schedule are reported in 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 limted as to reimbursement. De Minimis Rate Used: N Rate Explanation: The center elected not use the de minimis cost rate as allowed under the Uniform Guidance For the HHS awards related to the Provider Relief Fund and American Rescue Plan ("ARP") Rural Distribution ("PRF") program, HHS has indicated the amounts on the Schedule be reported corresponding to reporting requirements of the HRSA PRF Reporting Portal. Payments from HHS 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 $122,977 received from HHS between April 10, 2020 through June 30, 2020. In accordance with guidance from HHS, these amounts are related to Period 1 in the HRSA PRF Reporting Portal. The $122,977 was recognized as part of DHHS grants revenue in the financial statements in the year ended May 31, 2021.
Title: COVID-19 - HRSA COVID-19 & COVID-19 Coverage Assistance Fund Accounting Policies: Expenditures reported on the schedule are reported in 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 limted as to reimbursement. De Minimis Rate Used: N Rate Explanation: The center elected not use the de minimis cost rate as allowed under the Uniform Guidance For the HHS 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 May 31, 2022.

Finding Details

Item 2022-001, Special Tests and Provisions - U.S. Department of Health and Human Services, Health Center Program Cluster (Assistance Listing Number 93.224/93.527/COVID-19 93.224) Criteria: Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient's ability to pay and their eligibility. A patient's eligibility and ability to pay is determined on the basis of the official poverty guidelines, as revised by HHC (42 CFR Sections 51c. 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition: When performing our audit, we noted the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on sliding fee scale in effect for the year ended May 31, 2022. Cause: There was deficiency in internal controls to ensure that proper documentation was obtained and that proper sliding fee discounts were being applied to patients in accordance with the Center's sliding fee scale. Effect: The Center did not comply consistently with the special tests and provisions compliance requirement based on the poverty guidelines in effect for the fiscal year 2022. In addition, the Center may not have properly calculated the sliding fee discount given to the patients and the discount given, if any, may not have been based on the patient's ability to pay. Questioned costs: None. Context: When performing our audit, we noted that the Center did not properly determine the sliding fee discount given to 3 out of 60 patients selected for testing based on the sliding fee scale in effect for the year ended May 31, 2022. Identification of Repeat Finding: Condition is repeat finding - see 2021-001. Recommendation: We recommend that proper training be given to employees and that sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. We recommend that the Center improve the implementation of their policy regarding keeping and maintaining the patient's proof of income or self-attestation regarding their income. View of Responsible Official: The Center revised its policies and procedures, trained its employees, and restructured the process for the sliding fee program, including strengthening monitoring and hired a new coordinator.
Item 2022-001, Special Tests and Provisions - U.S. Department of Health and Human Services, Health Center Program Cluster (Assistance Listing Number 93.224/93.527/COVID-19 93.224) Criteria: Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient's ability to pay and their eligibility. A patient's eligibility and ability to pay is determined on the basis of the official poverty guidelines, as revised by HHC (42 CFR Sections 51c. 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition: When performing our audit, we noted the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on sliding fee scale in effect for the year ended May 31, 2022. Cause: There was deficiency in internal controls to ensure that proper documentation was obtained and that proper sliding fee discounts were being applied to patients in accordance with the Center's sliding fee scale. Effect: The Center did not comply consistently with the special tests and provisions compliance requirement based on the poverty guidelines in effect for the fiscal year 2022. In addition, the Center may not have properly calculated the sliding fee discount given to the patients and the discount given, if any, may not have been based on the patient's ability to pay. Questioned costs: None. Context: When performing our audit, we noted that the Center did not properly determine the sliding fee discount given to 3 out of 60 patients selected for testing based on the sliding fee scale in effect for the year ended May 31, 2022. Identification of Repeat Finding: Condition is repeat finding - see 2021-001. Recommendation: We recommend that proper training be given to employees and that sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. We recommend that the Center improve the implementation of their policy regarding keeping and maintaining the patient's proof of income or self-attestation regarding their income. View of Responsible Official: The Center revised its policies and procedures, trained its employees, and restructured the process for the sliding fee program, including strengthening monitoring and hired a new coordinator.
Item 2022-001, Special Tests and Provisions - U.S. Department of Health and Human Services, Health Center Program Cluster (Assistance Listing Number 93.224/93.527/COVID-19 93.224) Criteria: Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient's ability to pay and their eligibility. A patient's eligibility and ability to pay is determined on the basis of the official poverty guidelines, as revised by HHC (42 CFR Sections 51c. 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition: When performing our audit, we noted the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on sliding fee scale in effect for the year ended May 31, 2022. Cause: There was deficiency in internal controls to ensure that proper documentation was obtained and that proper sliding fee discounts were being applied to patients in accordance with the Center's sliding fee scale. Effect: The Center did not comply consistently with the special tests and provisions compliance requirement based on the poverty guidelines in effect for the fiscal year 2022. In addition, the Center may not have properly calculated the sliding fee discount given to the patients and the discount given, if any, may not have been based on the patient's ability to pay. Questioned costs: None. Context: When performing our audit, we noted that the Center did not properly determine the sliding fee discount given to 3 out of 60 patients selected for testing based on the sliding fee scale in effect for the year ended May 31, 2022. Identification of Repeat Finding: Condition is repeat finding - see 2021-001. Recommendation: We recommend that proper training be given to employees and that sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. We recommend that the Center improve the implementation of their policy regarding keeping and maintaining the patient's proof of income or self-attestation regarding their income. View of Responsible Official: The Center revised its policies and procedures, trained its employees, and restructured the process for the sliding fee program, including strengthening monitoring and hired a new coordinator.
Item 2022-001, Special Tests and Provisions - U.S. Department of Health and Human Services, Health Center Program Cluster (Assistance Listing Number 93.224/93.527/COVID-19 93.224) Criteria: Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient's ability to pay and their eligibility. A patient's eligibility and ability to pay is determined on the basis of the official poverty guidelines, as revised by HHC (42 CFR Sections 51c. 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition: When performing our audit, we noted the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on sliding fee scale in effect for the year ended May 31, 2022. Cause: There was deficiency in internal controls to ensure that proper documentation was obtained and that proper sliding fee discounts were being applied to patients in accordance with the Center's sliding fee scale. Effect: The Center did not comply consistently with the special tests and provisions compliance requirement based on the poverty guidelines in effect for the fiscal year 2022. In addition, the Center may not have properly calculated the sliding fee discount given to the patients and the discount given, if any, may not have been based on the patient's ability to pay. Questioned costs: None. Context: When performing our audit, we noted that the Center did not properly determine the sliding fee discount given to 3 out of 60 patients selected for testing based on the sliding fee scale in effect for the year ended May 31, 2022. Identification of Repeat Finding: Condition is repeat finding - see 2021-001. Recommendation: We recommend that proper training be given to employees and that sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. We recommend that the Center improve the implementation of their policy regarding keeping and maintaining the patient's proof of income or self-attestation regarding their income. View of Responsible Official: The Center revised its policies and procedures, trained its employees, and restructured the process for the sliding fee program, including strengthening monitoring and hired a new coordinator.
Item 2022-001, Special Tests and Provisions - U.S. Department of Health and Human Services, Health Center Program Cluster (Assistance Listing Number 93.224/93.527/COVID-19 93.224) Criteria: Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient's ability to pay and their eligibility. A patient's eligibility and ability to pay is determined on the basis of the official poverty guidelines, as revised by HHC (42 CFR Sections 51c. 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition: When performing our audit, we noted the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on sliding fee scale in effect for the year ended May 31, 2022. Cause: There was deficiency in internal controls to ensure that proper documentation was obtained and that proper sliding fee discounts were being applied to patients in accordance with the Center's sliding fee scale. Effect: The Center did not comply consistently with the special tests and provisions compliance requirement based on the poverty guidelines in effect for the fiscal year 2022. In addition, the Center may not have properly calculated the sliding fee discount given to the patients and the discount given, if any, may not have been based on the patient's ability to pay. Questioned costs: None. Context: When performing our audit, we noted that the Center did not properly determine the sliding fee discount given to 3 out of 60 patients selected for testing based on the sliding fee scale in effect for the year ended May 31, 2022. Identification of Repeat Finding: Condition is repeat finding - see 2021-001. Recommendation: We recommend that proper training be given to employees and that sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. We recommend that the Center improve the implementation of their policy regarding keeping and maintaining the patient's proof of income or self-attestation regarding their income. View of Responsible Official: The Center revised its policies and procedures, trained its employees, and restructured the process for the sliding fee program, including strengthening monitoring and hired a new coordinator.
Item 2022-001, Special Tests and Provisions - U.S. Department of Health and Human Services, Health Center Program Cluster (Assistance Listing Number 93.224/93.527/COVID-19 93.224) Criteria: Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of the patient's ability to pay and their eligibility. A patient's eligibility and ability to pay is determined on the basis of the official poverty guidelines, as revised by HHC (42 CFR Sections 51c. 107(b)(5), 56.108(b)(5) and 56.303(f)). The Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition: When performing our audit, we noted the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on sliding fee scale in effect for the year ended May 31, 2022. Cause: There was deficiency in internal controls to ensure that proper documentation was obtained and that proper sliding fee discounts were being applied to patients in accordance with the Center's sliding fee scale. Effect: The Center did not comply consistently with the special tests and provisions compliance requirement based on the poverty guidelines in effect for the fiscal year 2022. In addition, the Center may not have properly calculated the sliding fee discount given to the patients and the discount given, if any, may not have been based on the patient's ability to pay. Questioned costs: None. Context: When performing our audit, we noted that the Center did not properly determine the sliding fee discount given to 3 out of 60 patients selected for testing based on the sliding fee scale in effect for the year ended May 31, 2022. Identification of Repeat Finding: Condition is repeat finding - see 2021-001. Recommendation: We recommend that proper training be given to employees and that sliding fee discounts be reviewed by a supervisor on a periodic basis to ensure compliance with the sliding fee scale. We recommend that the Center improve the implementation of their policy regarding keeping and maintaining the patient's proof of income or self-attestation regarding their income. View of Responsible Official: The Center revised its policies and procedures, trained its employees, and restructured the process for the sliding fee program, including strengthening monitoring and hired a new coordinator.