FAC Explorer

Audit 316663

FY End
2023-11-30
Total Expended
$6.69M
Findings
16
Programs
11
Organization: Richland Medical Center, Inc. D/b/a Central Ozarks Medical Center (MO)
Year: 2023 Accepted: 2024-08-05
Auditor: Cohnreznick LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
480482 2023-001 Significant Deficiency Yes N
480483 2023-001 Significant Deficiency Yes N
480484 2023-001 Significant Deficiency Yes N
480485 2023-001 Significant Deficiency Yes N
480486 2023-002 Significant Deficiency - A
480487 2023-002 Significant Deficiency - A
480488 2023-002 Significant Deficiency - A
480489 2023-002 Significant Deficiency - A
1056924 2023-001 Significant Deficiency Yes N
1056925 2023-001 Significant Deficiency Yes N
1056926 2023-001 Significant Deficiency Yes N
1056927 2023-001 Significant Deficiency Yes N
1056928 2023-002 Significant Deficiency - A
1056929 2023-002 Significant Deficiency - A
1056930 2023-002 Significant Deficiency - A
1056931 2023-002 Significant Deficiency - A

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) $768,417 Yes 2
93.268 Immunization Cooperative Agreements $351,364 - 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $310,073 - 0
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $212,783 Yes 2
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $209,335 - 0
93.778 Medical Assistance Program $175,746 - 0
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $135,284 - 0
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $127,538 - 0
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $72,420 - 0
93.283 Centers for Disease Control and Prevention_investigations and Technical Assistance $27,565 - 0
93.185 Immunization Research, Demonstration, Public Information and Education_training and Clinical Skills Improvement Projects $26,064 - 0

Contacts

Name Title Type
NLFPGRZYWAD3 Kelly Miller Auditee
8738367071 James Lacroix Auditor
No contacts on file

Notes to SEFA

Title: 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. De Minimis Rate Used: N Rate Explanation: The Organization has elected to not use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. Pass-through entity dentifying numbers are presented where available. The accompanying schedule of expenditures of federal awards (the "Schedule") includes the federal award activity of Richland Medical Center, Inc. d/b/a Central Ozarks Medical Center (the "Organization") under programs of the federal government for the year ended November 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 the Organization, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Organization.

Finding Details

Finding 2023-001
Finding 2023.001: Special Tests and Provisions 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 Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always appropriately apply the sliding fee discount based on income levels. Cause The Organization did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 slide fee discount transactions was performed and resulted in six instances of sliding fee discounts not being properly calculated based on the respective patient family size and income or was not in agreement with the supporting documentation. Our sample was a statistically valid sample. Identification as Repeat Finding Yes - Finding 2022.001. Recommendation The Organization should strengthen internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2023-001
Finding 2023.001: Special Tests and Provisions 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 Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always appropriately apply the sliding fee discount based on income levels. Cause The Organization did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 slide fee discount transactions was performed and resulted in six instances of sliding fee discounts not being properly calculated based on the respective patient family size and income or was not in agreement with the supporting documentation. Our sample was a statistically valid sample. Identification as Repeat Finding Yes - Finding 2022.001. Recommendation The Organization should strengthen internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2023-001
Finding 2023.001: Special Tests and Provisions 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 Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always appropriately apply the sliding fee discount based on income levels. Cause The Organization did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 slide fee discount transactions was performed and resulted in six instances of sliding fee discounts not being properly calculated based on the respective patient family size and income or was not in agreement with the supporting documentation. Our sample was a statistically valid sample. Identification as Repeat Finding Yes - Finding 2022.001. Recommendation The Organization should strengthen internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2023-001
Finding 2023.001: Special Tests and Provisions 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 Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always appropriately apply the sliding fee discount based on income levels. Cause The Organization did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 slide fee discount transactions was performed and resulted in six instances of sliding fee discounts not being properly calculated based on the respective patient family size and income or was not in agreement with the supporting documentation. Our sample was a statistically valid sample. Identification as Repeat Finding Yes - Finding 2022.001. Recommendation The Organization should strengthen internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2023-002
Finding 2023.002: Activities Allowed or Unallowed 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 According to 2 CFR, Part 200.430(i)(1) charges to Federal awards for salaries and wages must be based on records that accurately reflect the actual work performed, which must, among other things: (i) be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated; (ii) be incorporated into the official records of the non-Federal entity; (iii) and reasonably reflect the total activity for which the employee is compensated by the non-Federal entity. Condition There was no evidence that management reviewed and approved the payroll cost charged to the major program to ensure it was an allowable cost under the Uniform Guidance, as evidenced by a reviewer's signature on the labor report. Cause The Center's internal controls over payroll were not consistently followed. Effect Unallowable expenses could be charged to the grant. Questioned Costs None. Context Out of the 25 payroll transactions selected for testing, none of them illustrated documentation of formal approval. Identification as Repeat Finding Not a repeat finding. Recommendation We recommend that the Organization consistently enforce its internal controls over payroll to ensure that all labor reports are reviewed and show formal approval before payroll is submitted. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will implement additional controls to ensure payroll expenditures are being formally reviewed and approved.
Finding 2023-002
Finding 2023.002: Activities Allowed or Unallowed 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 According to 2 CFR, Part 200.430(i)(1) charges to Federal awards for salaries and wages must be based on records that accurately reflect the actual work performed, which must, among other things: (i) be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated; (ii) be incorporated into the official records of the non-Federal entity; (iii) and reasonably reflect the total activity for which the employee is compensated by the non-Federal entity. Condition There was no evidence that management reviewed and approved the payroll cost charged to the major program to ensure it was an allowable cost under the Uniform Guidance, as evidenced by a reviewer's signature on the labor report. Cause The Center's internal controls over payroll were not consistently followed. Effect Unallowable expenses could be charged to the grant. Questioned Costs None. Context Out of the 25 payroll transactions selected for testing, none of them illustrated documentation of formal approval. Identification as Repeat Finding Not a repeat finding. Recommendation We recommend that the Organization consistently enforce its internal controls over payroll to ensure that all labor reports are reviewed and show formal approval before payroll is submitted. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will implement additional controls to ensure payroll expenditures are being formally reviewed and approved.
Finding 2023-002
Finding 2023.002: Activities Allowed or Unallowed 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 According to 2 CFR, Part 200.430(i)(1) charges to Federal awards for salaries and wages must be based on records that accurately reflect the actual work performed, which must, among other things: (i) be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated; (ii) be incorporated into the official records of the non-Federal entity; (iii) and reasonably reflect the total activity for which the employee is compensated by the non-Federal entity. Condition There was no evidence that management reviewed and approved the payroll cost charged to the major program to ensure it was an allowable cost under the Uniform Guidance, as evidenced by a reviewer's signature on the labor report. Cause The Center's internal controls over payroll were not consistently followed. Effect Unallowable expenses could be charged to the grant. Questioned Costs None. Context Out of the 25 payroll transactions selected for testing, none of them illustrated documentation of formal approval. Identification as Repeat Finding Not a repeat finding. Recommendation We recommend that the Organization consistently enforce its internal controls over payroll to ensure that all labor reports are reviewed and show formal approval before payroll is submitted. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will implement additional controls to ensure payroll expenditures are being formally reviewed and approved.
Finding 2023-002
Finding 2023.002: Activities Allowed or Unallowed 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 According to 2 CFR, Part 200.430(i)(1) charges to Federal awards for salaries and wages must be based on records that accurately reflect the actual work performed, which must, among other things: (i) be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated; (ii) be incorporated into the official records of the non-Federal entity; (iii) and reasonably reflect the total activity for which the employee is compensated by the non-Federal entity. Condition There was no evidence that management reviewed and approved the payroll cost charged to the major program to ensure it was an allowable cost under the Uniform Guidance, as evidenced by a reviewer's signature on the labor report. Cause The Center's internal controls over payroll were not consistently followed. Effect Unallowable expenses could be charged to the grant. Questioned Costs None. Context Out of the 25 payroll transactions selected for testing, none of them illustrated documentation of formal approval. Identification as Repeat Finding Not a repeat finding. Recommendation We recommend that the Organization consistently enforce its internal controls over payroll to ensure that all labor reports are reviewed and show formal approval before payroll is submitted. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will implement additional controls to ensure payroll expenditures are being formally reviewed and approved.
Finding 2023-001
Finding 2023.001: Special Tests and Provisions 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 Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always appropriately apply the sliding fee discount based on income levels. Cause The Organization did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 slide fee discount transactions was performed and resulted in six instances of sliding fee discounts not being properly calculated based on the respective patient family size and income or was not in agreement with the supporting documentation. Our sample was a statistically valid sample. Identification as Repeat Finding Yes - Finding 2022.001. Recommendation The Organization should strengthen internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2023-001
Finding 2023.001: Special Tests and Provisions 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 Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always appropriately apply the sliding fee discount based on income levels. Cause The Organization did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 slide fee discount transactions was performed and resulted in six instances of sliding fee discounts not being properly calculated based on the respective patient family size and income or was not in agreement with the supporting documentation. Our sample was a statistically valid sample. Identification as Repeat Finding Yes - Finding 2022.001. Recommendation The Organization should strengthen internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2023-001
Finding 2023.001: Special Tests and Provisions 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 Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always appropriately apply the sliding fee discount based on income levels. Cause The Organization did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 slide fee discount transactions was performed and resulted in six instances of sliding fee discounts not being properly calculated based on the respective patient family size and income or was not in agreement with the supporting documentation. Our sample was a statistically valid sample. Identification as Repeat Finding Yes - Finding 2022.001. Recommendation The Organization should strengthen internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2023-001
Finding 2023.001: Special Tests and Provisions 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 Health centers are required to have a corresponding schedule of discounts applied and adjusted on the basis of patients' ability to pay and their eligibility. A patient's eligibility to pay is determined on the basis of the official poverty guideline, as revised by DHHS (42 CFR Sections 51c, 107(b)(5), 56.108(b)(5) and 56.303(f)). The Organization should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Organization's sliding fee scale. Condition The Organization did not always appropriately apply the sliding fee discount based on income levels. Cause The Organization did not have adequate internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Effect The Organization did not comply with the appropriate rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 slide fee discount transactions was performed and resulted in six instances of sliding fee discounts not being properly calculated based on the respective patient family size and income or was not in agreement with the supporting documentation. Our sample was a statistically valid sample. Identification as Repeat Finding Yes - Finding 2022.001. Recommendation The Organization should strengthen internal controls in place to effectively ensure that patients receive the correct sliding fee discount. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2023-002
Finding 2023.002: Activities Allowed or Unallowed 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 According to 2 CFR, Part 200.430(i)(1) charges to Federal awards for salaries and wages must be based on records that accurately reflect the actual work performed, which must, among other things: (i) be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated; (ii) be incorporated into the official records of the non-Federal entity; (iii) and reasonably reflect the total activity for which the employee is compensated by the non-Federal entity. Condition There was no evidence that management reviewed and approved the payroll cost charged to the major program to ensure it was an allowable cost under the Uniform Guidance, as evidenced by a reviewer's signature on the labor report. Cause The Center's internal controls over payroll were not consistently followed. Effect Unallowable expenses could be charged to the grant. Questioned Costs None. Context Out of the 25 payroll transactions selected for testing, none of them illustrated documentation of formal approval. Identification as Repeat Finding Not a repeat finding. Recommendation We recommend that the Organization consistently enforce its internal controls over payroll to ensure that all labor reports are reviewed and show formal approval before payroll is submitted. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will implement additional controls to ensure payroll expenditures are being formally reviewed and approved.
Finding 2023-002
Finding 2023.002: Activities Allowed or Unallowed 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 According to 2 CFR, Part 200.430(i)(1) charges to Federal awards for salaries and wages must be based on records that accurately reflect the actual work performed, which must, among other things: (i) be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated; (ii) be incorporated into the official records of the non-Federal entity; (iii) and reasonably reflect the total activity for which the employee is compensated by the non-Federal entity. Condition There was no evidence that management reviewed and approved the payroll cost charged to the major program to ensure it was an allowable cost under the Uniform Guidance, as evidenced by a reviewer's signature on the labor report. Cause The Center's internal controls over payroll were not consistently followed. Effect Unallowable expenses could be charged to the grant. Questioned Costs None. Context Out of the 25 payroll transactions selected for testing, none of them illustrated documentation of formal approval. Identification as Repeat Finding Not a repeat finding. Recommendation We recommend that the Organization consistently enforce its internal controls over payroll to ensure that all labor reports are reviewed and show formal approval before payroll is submitted. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will implement additional controls to ensure payroll expenditures are being formally reviewed and approved.
Finding 2023-002
Finding 2023.002: Activities Allowed or Unallowed 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 According to 2 CFR, Part 200.430(i)(1) charges to Federal awards for salaries and wages must be based on records that accurately reflect the actual work performed, which must, among other things: (i) be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated; (ii) be incorporated into the official records of the non-Federal entity; (iii) and reasonably reflect the total activity for which the employee is compensated by the non-Federal entity. Condition There was no evidence that management reviewed and approved the payroll cost charged to the major program to ensure it was an allowable cost under the Uniform Guidance, as evidenced by a reviewer's signature on the labor report. Cause The Center's internal controls over payroll were not consistently followed. Effect Unallowable expenses could be charged to the grant. Questioned Costs None. Context Out of the 25 payroll transactions selected for testing, none of them illustrated documentation of formal approval. Identification as Repeat Finding Not a repeat finding. Recommendation We recommend that the Organization consistently enforce its internal controls over payroll to ensure that all labor reports are reviewed and show formal approval before payroll is submitted. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will implement additional controls to ensure payroll expenditures are being formally reviewed and approved.
Finding 2023-002
Finding 2023.002: Activities Allowed or Unallowed 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 According to 2 CFR, Part 200.430(i)(1) charges to Federal awards for salaries and wages must be based on records that accurately reflect the actual work performed, which must, among other things: (i) be supported by a system of internal control which provides reasonable assurance that the charges are accurate, allowable, and properly allocated; (ii) be incorporated into the official records of the non-Federal entity; (iii) and reasonably reflect the total activity for which the employee is compensated by the non-Federal entity. Condition There was no evidence that management reviewed and approved the payroll cost charged to the major program to ensure it was an allowable cost under the Uniform Guidance, as evidenced by a reviewer's signature on the labor report. Cause The Center's internal controls over payroll were not consistently followed. Effect Unallowable expenses could be charged to the grant. Questioned Costs None. Context Out of the 25 payroll transactions selected for testing, none of them illustrated documentation of formal approval. Identification as Repeat Finding Not a repeat finding. Recommendation We recommend that the Organization consistently enforce its internal controls over payroll to ensure that all labor reports are reviewed and show formal approval before payroll is submitted. Views of Responsible Officials and Planned Corrective Actions Management agrees with the audit finding and will implement additional controls to ensure payroll expenditures are being formally reviewed and approved.