FAC Explorer

Audit 301755

FY End
2023-06-30
Total Expended
$15.26M
Findings
4
Programs
7
Organization: Umpqua Community Health Center, Inc. Dba Aviva Health (OR)
Year: 2023 Accepted: 2024-04-01
Auditor: Cliftonlarsonallen LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
391157 2023-001 Significant Deficiency - N
391158 2023-001 Significant Deficiency - N
967599 2023-001 Significant Deficiency - N
967600 2023-001 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
10.766 Community Facilities Loans and Grants $9.67M - 0
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $2.55M Yes 1
93.224 Covid-19 American Rescue Plan Act Funding for Health Centers $1.40M Yes 0
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $863,664 Yes 1
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $322,088 Yes 0
93.926 Healthy Start Initiative $235,908 - 0
93.107 Area Health Education Centers Point of Service Maintenance and Enhancement Awards $225,565 - 0

Contacts

Name Title Type
W9GHPK4T7JX6 Leah Woods Auditee
5416729596 Kyla Delgado Auditor
No contacts on file

Notes to SEFA

Title: NOTE 1 - BASIS OF PRESENTATION 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. De Minimis Rate Used: Both Rate Explanation: Aviva Health has elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance; however, the award agreements with the Department of Health and Human Services do not include an indirect cost reimbursement, so there were no indirect costs charged to the federal award programs for the year ended June 30, 2023. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal awards activity of Aviva Health under programs of the federal government for the year ended June 30, 2023. 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 Aviva Health, it is not intended to, and does not, present the financial position, changes in net assets, or cash flows for Aviva Health.
Title: NOTE 2 - SUMMARY OF SIGNIFICANT ACCOUNTING POLICIES 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. De Minimis Rate Used: Both Rate Explanation: Aviva Health has elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance; however, the award agreements with the Department of Health and Human Services do not include an indirect cost reimbursement, so there were no indirect costs charged to the federal award programs for the year ended June 30, 2023. 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.
Title: NOTE 3 - INDIRECT COST RATE 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. De Minimis Rate Used: Both Rate Explanation: Aviva Health has elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance; however, the award agreements with the Department of Health and Human Services do not include an indirect cost reimbursement, so there were no indirect costs charged to the federal award programs for the year ended June 30, 2023. Aviva Health has elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance; however, the award agreements with the Department of Health and Human Services do not include an indirect cost reimbursement, so there were no indirect costs charged to the federal award programs for the year ended June 30, 2023.
Title: NOTE 4 - FEDERAL LOANS 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. De Minimis Rate Used: Both Rate Explanation: Aviva Health has elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance; however, the award agreements with the Department of Health and Human Services do not include an indirect cost reimbursement, so there were no indirect costs charged to the federal award programs for the year ended June 30, 2023. Aviva Health was approved by the United States Department of Agriculture and received a loan guarantee. The amount listed for this loan includes the beginning of the period loan balance plus proceeds used during the year. The balance outstanding at the end of the period is $9,618,681.

Finding Details

Finding 2023-001
Program Name/ALN Title: Health Center Cluster Federal Assistance Listing Number: 93.224/93.527 Federal Agency: U.S Department of Health and Human Services Award Period: 7/1/2022 – 06/31/2023 Federal Award Number: N/A Type of Finding: Significant Deficiency Criteria: Under the compliance requirement for Special Tests and Provisions for ALN 93.224/93.527, “health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay”. In one identified instance, an incorrect sliding fee discount was applied, resulting in the patient being overcharged for services provided. Condition: CLA identified one instance of the key control not being met while performing testing over the special tests and provisions compliance requirements. Context: CLA identified one instance out of 25 total tested of which the key control was not being met while performing testing over the special tests and provisions compliance requirement. Cause: The sliding fee application effective for the transaction tested indicated the patient qualified for a Level B sliding fee discount. However, upon recalculation the patient should have been noted as Level A sliding fee discount. Effect: Incorrect sliding fee discount was applied to the transaction tested resulting in the patient being overcharged for services. Recommendation: We recommend that Aviva Health implement a process to internally audit the new applications on a monthly or quarterly basis. Views of the Responsible Officials: There is no disagreement with the audit finding. Corrective Action Plan: Aviva health has scheduled a mandatory training to refresh all staff that evaluate and approve sliding fee. the organization has and continues to follow their policy and procedure for review of sliding fee determination prior to adjustment.
Finding 2023-001
Program Name/ALN Title: Health Center Cluster Federal Assistance Listing Number: 93.224/93.527 Federal Agency: U.S Department of Health and Human Services Award Period: 7/1/2022 – 06/31/2023 Federal Award Number: N/A Type of Finding: Significant Deficiency Criteria: Under the compliance requirement for Special Tests and Provisions for ALN 93.224/93.527, “health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay”. In one identified instance, an incorrect sliding fee discount was applied, resulting in the patient being overcharged for services provided. Condition: CLA identified one instance of the key control not being met while performing testing over the special tests and provisions compliance requirements. Context: CLA identified one instance out of 25 total tested of which the key control was not being met while performing testing over the special tests and provisions compliance requirement. Cause: The sliding fee application effective for the transaction tested indicated the patient qualified for a Level B sliding fee discount. However, upon recalculation the patient should have been noted as Level A sliding fee discount. Effect: Incorrect sliding fee discount was applied to the transaction tested resulting in the patient being overcharged for services. Recommendation: We recommend that Aviva Health implement a process to internally audit the new applications on a monthly or quarterly basis. Views of the Responsible Officials: There is no disagreement with the audit finding. Corrective Action Plan: Aviva health has scheduled a mandatory training to refresh all staff that evaluate and approve sliding fee. the organization has and continues to follow their policy and procedure for review of sliding fee determination prior to adjustment.
Finding 2023-001
Program Name/ALN Title: Health Center Cluster Federal Assistance Listing Number: 93.224/93.527 Federal Agency: U.S Department of Health and Human Services Award Period: 7/1/2022 – 06/31/2023 Federal Award Number: N/A Type of Finding: Significant Deficiency Criteria: Under the compliance requirement for Special Tests and Provisions for ALN 93.224/93.527, “health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay”. In one identified instance, an incorrect sliding fee discount was applied, resulting in the patient being overcharged for services provided. Condition: CLA identified one instance of the key control not being met while performing testing over the special tests and provisions compliance requirements. Context: CLA identified one instance out of 25 total tested of which the key control was not being met while performing testing over the special tests and provisions compliance requirement. Cause: The sliding fee application effective for the transaction tested indicated the patient qualified for a Level B sliding fee discount. However, upon recalculation the patient should have been noted as Level A sliding fee discount. Effect: Incorrect sliding fee discount was applied to the transaction tested resulting in the patient being overcharged for services. Recommendation: We recommend that Aviva Health implement a process to internally audit the new applications on a monthly or quarterly basis. Views of the Responsible Officials: There is no disagreement with the audit finding. Corrective Action Plan: Aviva health has scheduled a mandatory training to refresh all staff that evaluate and approve sliding fee. the organization has and continues to follow their policy and procedure for review of sliding fee determination prior to adjustment.
Finding 2023-001
Program Name/ALN Title: Health Center Cluster Federal Assistance Listing Number: 93.224/93.527 Federal Agency: U.S Department of Health and Human Services Award Period: 7/1/2022 – 06/31/2023 Federal Award Number: N/A Type of Finding: Significant Deficiency Criteria: Under the compliance requirement for Special Tests and Provisions for ALN 93.224/93.527, “health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay”. In one identified instance, an incorrect sliding fee discount was applied, resulting in the patient being overcharged for services provided. Condition: CLA identified one instance of the key control not being met while performing testing over the special tests and provisions compliance requirements. Context: CLA identified one instance out of 25 total tested of which the key control was not being met while performing testing over the special tests and provisions compliance requirement. Cause: The sliding fee application effective for the transaction tested indicated the patient qualified for a Level B sliding fee discount. However, upon recalculation the patient should have been noted as Level A sliding fee discount. Effect: Incorrect sliding fee discount was applied to the transaction tested resulting in the patient being overcharged for services. Recommendation: We recommend that Aviva Health implement a process to internally audit the new applications on a monthly or quarterly basis. Views of the Responsible Officials: There is no disagreement with the audit finding. Corrective Action Plan: Aviva health has scheduled a mandatory training to refresh all staff that evaluate and approve sliding fee. the organization has and continues to follow their policy and procedure for review of sliding fee determination prior to adjustment.