FAC Explorer

Audit 300892

FY End
2023-06-30
Total Expended
$8.10M
Findings
2
Programs
10
Organization: Neighborhood Health Care, INC (OH)
Year: 2023 Accepted: 2024-03-29
Auditor: Hw&co

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
389984 2023-001 Significant Deficiency - N
966426 2023-001 Significant Deficiency - 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) $3.35M Yes 1
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $1.19M Yes 0
93.566 Refugee and Entrant Assistance_state Administered Programs $330,500 - 0
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $238,323 - 0
93.914 Hiv Emergency Relief Project Grants $202,839 - 0
59.008 Disaster Assistance Loans $150,000 - 0
93.738 Pphf: Racial and Ethnic Approaches to Community Health Program Financed Solely by Public Prevention and Health Funds $45,924 - 0
14.218 Community Development Block Grants/entitlement Grants $25,391 - 0
93.576 Refugee and Entrant Assistance_discretionary Grants $23,983 - 0
93.604 Assistance for Torture Victims $17,723 - 0

Contacts

Name Title Type
H652CS58ZAM1 Christine Porter Auditee
2162818945 Michael Muniak Auditor
No contacts on file

Notes to SEFA

Title: Donated personal protective equipment Accounting Policies: (1) 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. (2) NFP has elected not to use the 10 percent de minimis cost rate as allowed under the Uniform Guidance, except when required by the granting agency. (3) No awards passed through to subrecipients. De Minimis Rate Used: N Rate Explanation: NFP has elected not to use the 10 percent de minimis cost rate as allowed under the Uniform Guidance, except when required by the granting agency. During the year ended June 30, 2023, NFP did not receive donated personal protective equipment.
Title: Small Business Administration Disaster Assistance loan program Accounting Policies: (1) 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. (2) NFP has elected not to use the 10 percent de minimis cost rate as allowed under the Uniform Guidance, except when required by the granting agency. (3) No awards passed through to subrecipients. De Minimis Rate Used: N Rate Explanation: NFP has elected not to use the 10 percent de minimis cost rate as allowed under the Uniform Guidance, except when required by the granting agency. NFP received a Small Business Administration Disaster Assistance loan during the year ended June 30, 2021. The loan balance outstanding at the beginning of the year is included in the Federal expenditures presented in the Schedule. NFP received no additional loans during the year. The balance of the loan outstanding was $150,000 at June 30, 2023.

Finding Details

Finding 2023-001
Condition: NFP improperly applied sliding fee discounts to numerous unverified patients and services. NFP applied sliding fee scale discounts not in accordance with established policies and did not have appropriate controls in place to prevent and detect the application of improper sliding scale fee discounts. Criteria: NFP is required by HRSA to comply with the requirements of the sliding fee discount schedule (SFDS) and apply sliding fee scale discounts in accordance with established NFP policies. NFP is required to design and implement controls to ensure sliding scale fee discounts are only applied to qualifying individuals and families, and sliding fee scale discounts are applied only to services that meet NFP’s established policies. Cause: An error in NFP’s automated write-off rules in its patient software caused certain patients and services to be written off as a sliding scale discount. NFP had not designed and implemented internal controls to prevent and detect improper application of sliding fee scale discounts. Effect: Non-compliance with the requirements of the sliding scale discount program. Recommendation: We recommend NFP ensures sliding scale fee discounts are only applied to income-verified individuals and no sliding fee scale discount applied to individuals and families above 200 percent of the Federal Poverty Guidelines (FPG). We recommend NFP review its processes, procedures and controls to ensure they are appropriately designed, implemented and operating effectively to prevent, detect and correct improper sliding fee scale discounts. Views of Responsible Officials and Planned Corrective Actions: NFP concurs with this finding and notes the $52,982 of questioned costs were written off to the wrong adjustment code due to the automated write-off with the patient software. NFP identified the issue in December of 2022 and the Vice President of Compliance and Chief Financial Officer performed a root cause analysis as to the starting point. Management corrected the write-off with the patient software that was causing the automated adjustments when initially identified. Management will continue to audit and review the automated write-off with the patient software on a quarterly/monthly basis (as determined) going forward as well as implementing procedures to ensure the sliding scale eligible visits are properly documented and adjusted in the billing system.
Finding 2023-001
Condition: NFP improperly applied sliding fee discounts to numerous unverified patients and services. NFP applied sliding fee scale discounts not in accordance with established policies and did not have appropriate controls in place to prevent and detect the application of improper sliding scale fee discounts. Criteria: NFP is required by HRSA to comply with the requirements of the sliding fee discount schedule (SFDS) and apply sliding fee scale discounts in accordance with established NFP policies. NFP is required to design and implement controls to ensure sliding scale fee discounts are only applied to qualifying individuals and families, and sliding fee scale discounts are applied only to services that meet NFP’s established policies. Cause: An error in NFP’s automated write-off rules in its patient software caused certain patients and services to be written off as a sliding scale discount. NFP had not designed and implemented internal controls to prevent and detect improper application of sliding fee scale discounts. Effect: Non-compliance with the requirements of the sliding scale discount program. Recommendation: We recommend NFP ensures sliding scale fee discounts are only applied to income-verified individuals and no sliding fee scale discount applied to individuals and families above 200 percent of the Federal Poverty Guidelines (FPG). We recommend NFP review its processes, procedures and controls to ensure they are appropriately designed, implemented and operating effectively to prevent, detect and correct improper sliding fee scale discounts. Views of Responsible Officials and Planned Corrective Actions: NFP concurs with this finding and notes the $52,982 of questioned costs were written off to the wrong adjustment code due to the automated write-off with the patient software. NFP identified the issue in December of 2022 and the Vice President of Compliance and Chief Financial Officer performed a root cause analysis as to the starting point. Management corrected the write-off with the patient software that was causing the automated adjustments when initially identified. Management will continue to audit and review the automated write-off with the patient software on a quarterly/monthly basis (as determined) going forward as well as implementing procedures to ensure the sliding scale eligible visits are properly documented and adjusted in the billing system.