FAC Explorer

Audit 322404

FY End
2023-12-31
Total Expended
$6.39M
Findings
8
Programs
13
Organization: Lakewood Resource & Referral Center-D/b/a/ Center for Health Education (NJ)
Year: 2023 Accepted: 2024-09-30
Auditor: Cohnreznick LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
499549 2023-002 Significant Deficiency - N
499550 2023-002 Significant Deficiency - N
499551 2023-002 Significant Deficiency - N
499552 2023-002 Significant Deficiency - N
1075991 2023-002 Significant Deficiency - N
1075992 2023-002 Significant Deficiency - N
1075993 2023-002 Significant Deficiency - N
1075994 2023-002 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $942,525 Yes 1
93.224 Community Health Centers $644,678 Yes 1
93.526 Grants for Capital Development in Health Centers $640,924 - 0
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $593,860 - 0
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $442,240 - 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $425,000 Yes 0
93.498 Provider Relief Fund and American Rescue Plan (arp) Rural Distribution $116,698 - 0
93.268 Immunization Cooperative Agreements $51,255 - 0
59.077 Community Navigator Pilot Program $51,000 - 0
93.011 National Organizations of State and Local Officials $34,695 - 0
97.024 Emergency Food and Shelter National Board Program $33,008 - 0
17.225 Unemployment Insurance $21,852 - 0
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $16,574 - 0

Contacts

Name Title Type
K6SBY3E11DV5 Scott Jackson Auditee
7323642144 Steven D. Schwartz 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 and State of New Jersey, Department of Treasury, Office of Management and Budget Circular 15-08, Single Audit Policy for Recipients of Federal Grants, State Grants and State Aid, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The Center has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal and state awards (the "Schedule") includes the federal and state awards of Lakewood Resource and Referral Center, Inc. d/b/a Center for Health Education, Medicine and Dentistry ("Center") under programs of the federal and New Jersey state governments for the year ended December 31, 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") and State of New Jersey, Department of Treasury, Office of Management and Budget Circular 15-08, Single Audit Policy for Recipients of Federal Grants, State Grants and State Aid. 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, change in net assets, or cash flows of the Center.
Title: Note 4 - Preventive and primary care program 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 and State of New Jersey, Department of Treasury, Office of Management and Budget Circular 15-08, Single Audit Policy for Recipients of Federal Grants, State Grants and State Aid, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The Center has elected not to use the 10% de minimis indirect cost rate as allowed under the Uniform Guidance. The Center contracted with the State of New Jersey Department of Health and Senior Services to provide health and medical services to the uninsured population under the Preventive and Primary Care Program. This letter of agreement pays the Center a fixed amount per visit regardless of the actual costs incurred. During the year ended December 31, 2023, the amount earned and recognized as net revenue under this letter of agreement for the contract period July 1, 2022 to June 30, 2023 was $420,941 and for the contract period July 1, 2023 to June 30, 2024 was $496,276. Revenue for this program is included in patient services revenue in the basic financial statements. Allowances are calculated based on expected cash collections.
Title: Note 5 - COVID-19 - Provider Relief Fund and American Rescue Plan (ARP) Rural Distribution – Assistance Listing Number 93.498 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 and State of New Jersey, Department of Treasury, Office of Management and Budget Circular 15-08, Single Audit Policy for Recipients of Federal Grants, State Grants and State Aid, wherein certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: The Center has elected not to use the 10% de minimis indirect 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 $116,698 received from HHS on January 26, 2022. In accordance with guidance from HHS, this amount represents $116,698 for Period 5 and was recognized as DHHS grant revenue in the financial statements for the year ended December 31, 2021.

Finding Details

Finding 2023-002
U.S. Department of Health and Human Services, COVID-19 Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2023-002 - Special Tests and Provisions 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)). Statement of Condition While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Cause The condition can be attributed to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being maintained and applied. Effect The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended December 31, 2023. In addition, the Center may not have properly calculated the sliding fee or 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 While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to two out of forty three patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Identification as a Repeat Finding This is not a repeat finding. Recommendation We recommend that proper training be given to employees at registration to ensure that the sliding fee discounts are being properly calculated. Supervisors should monitor and review the sliding fee calculations on a periodic basis to ensure compliance with the sliding fee scale. In addition, management should conduct internal audits to ensure the sliding fee is calculated properly. Views of Responsible Official Management of the Center has reached out to necessary employees with guidelines to ensure that sliding fee discounts are given to eligible patients. Additionally, procedures have been put in place to ensure that the sliding scale fees are calculated properly.
Finding 2023-002
U.S. Department of Health and Human Services, COVID-19 Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2023-002 - Special Tests and Provisions 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)). Statement of Condition While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Cause The condition can be attributed to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being maintained and applied. Effect The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended December 31, 2023. In addition, the Center may not have properly calculated the sliding fee or 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 While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to two out of forty three patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Identification as a Repeat Finding This is not a repeat finding. Recommendation We recommend that proper training be given to employees at registration to ensure that the sliding fee discounts are being properly calculated. Supervisors should monitor and review the sliding fee calculations on a periodic basis to ensure compliance with the sliding fee scale. In addition, management should conduct internal audits to ensure the sliding fee is calculated properly. Views of Responsible Official Management of the Center has reached out to necessary employees with guidelines to ensure that sliding fee discounts are given to eligible patients. Additionally, procedures have been put in place to ensure that the sliding scale fees are calculated properly.
Finding 2023-002
U.S. Department of Health and Human Services, COVID-19 Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2023-002 - Special Tests and Provisions 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)). Statement of Condition While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Cause The condition can be attributed to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being maintained and applied. Effect The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended December 31, 2023. In addition, the Center may not have properly calculated the sliding fee or 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 While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to two out of forty three patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Identification as a Repeat Finding This is not a repeat finding. Recommendation We recommend that proper training be given to employees at registration to ensure that the sliding fee discounts are being properly calculated. Supervisors should monitor and review the sliding fee calculations on a periodic basis to ensure compliance with the sliding fee scale. In addition, management should conduct internal audits to ensure the sliding fee is calculated properly. Views of Responsible Official Management of the Center has reached out to necessary employees with guidelines to ensure that sliding fee discounts are given to eligible patients. Additionally, procedures have been put in place to ensure that the sliding scale fees are calculated properly.
Finding 2023-002
U.S. Department of Health and Human Services, COVID-19 Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2023-002 - Special Tests and Provisions 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)). Statement of Condition While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Cause The condition can be attributed to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being maintained and applied. Effect The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended December 31, 2023. In addition, the Center may not have properly calculated the sliding fee or 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 While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to two out of forty three patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Identification as a Repeat Finding This is not a repeat finding. Recommendation We recommend that proper training be given to employees at registration to ensure that the sliding fee discounts are being properly calculated. Supervisors should monitor and review the sliding fee calculations on a periodic basis to ensure compliance with the sliding fee scale. In addition, management should conduct internal audits to ensure the sliding fee is calculated properly. Views of Responsible Official Management of the Center has reached out to necessary employees with guidelines to ensure that sliding fee discounts are given to eligible patients. Additionally, procedures have been put in place to ensure that the sliding scale fees are calculated properly.
Finding 2023-002
U.S. Department of Health and Human Services, COVID-19 Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2023-002 - Special Tests and Provisions 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)). Statement of Condition While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Cause The condition can be attributed to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being maintained and applied. Effect The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended December 31, 2023. In addition, the Center may not have properly calculated the sliding fee or 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 While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to two out of forty three patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Identification as a Repeat Finding This is not a repeat finding. Recommendation We recommend that proper training be given to employees at registration to ensure that the sliding fee discounts are being properly calculated. Supervisors should monitor and review the sliding fee calculations on a periodic basis to ensure compliance with the sliding fee scale. In addition, management should conduct internal audits to ensure the sliding fee is calculated properly. Views of Responsible Official Management of the Center has reached out to necessary employees with guidelines to ensure that sliding fee discounts are given to eligible patients. Additionally, procedures have been put in place to ensure that the sliding scale fees are calculated properly.
Finding 2023-002
U.S. Department of Health and Human Services, COVID-19 Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2023-002 - Special Tests and Provisions 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)). Statement of Condition While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Cause The condition can be attributed to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being maintained and applied. Effect The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended December 31, 2023. In addition, the Center may not have properly calculated the sliding fee or 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 While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to two out of forty three patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Identification as a Repeat Finding This is not a repeat finding. Recommendation We recommend that proper training be given to employees at registration to ensure that the sliding fee discounts are being properly calculated. Supervisors should monitor and review the sliding fee calculations on a periodic basis to ensure compliance with the sliding fee scale. In addition, management should conduct internal audits to ensure the sliding fee is calculated properly. Views of Responsible Official Management of the Center has reached out to necessary employees with guidelines to ensure that sliding fee discounts are given to eligible patients. Additionally, procedures have been put in place to ensure that the sliding scale fees are calculated properly.
Finding 2023-002
U.S. Department of Health and Human Services, COVID-19 Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2023-002 - Special Tests and Provisions 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)). Statement of Condition While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Cause The condition can be attributed to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being maintained and applied. Effect The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended December 31, 2023. In addition, the Center may not have properly calculated the sliding fee or 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 While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to two out of forty three patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Identification as a Repeat Finding This is not a repeat finding. Recommendation We recommend that proper training be given to employees at registration to ensure that the sliding fee discounts are being properly calculated. Supervisors should monitor and review the sliding fee calculations on a periodic basis to ensure compliance with the sliding fee scale. In addition, management should conduct internal audits to ensure the sliding fee is calculated properly. Views of Responsible Official Management of the Center has reached out to necessary employees with guidelines to ensure that sliding fee discounts are given to eligible patients. Additionally, procedures have been put in place to ensure that the sliding scale fees are calculated properly.
Finding 2023-002
U.S. Department of Health and Human Services, COVID-19 Health Center Program Cluster (Assistance Listing Number 93.224/93.527) Item 2023-002 - Special Tests and Provisions 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)). Statement of Condition While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to certain patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Cause The condition can be attributed to human error and the lack of internal controls to review and ensure that the proper sliding fee documentation is being maintained and applied. Effect The Center did not comply with the determination of sliding fee discounts based on the federal poverty guidelines in effect for the year ended December 31, 2023. In addition, the Center may not have properly calculated the sliding fee or 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 While performing our audit, we noted that the Center did not properly determine the sliding fee discount category given to two out of forty three patients selected for testing based on the sliding fee scale in effect for the year ended December 31, 2023. Identification as a Repeat Finding This is not a repeat finding. Recommendation We recommend that proper training be given to employees at registration to ensure that the sliding fee discounts are being properly calculated. Supervisors should monitor and review the sliding fee calculations on a periodic basis to ensure compliance with the sliding fee scale. In addition, management should conduct internal audits to ensure the sliding fee is calculated properly. Views of Responsible Official Management of the Center has reached out to necessary employees with guidelines to ensure that sliding fee discounts are given to eligible patients. Additionally, procedures have been put in place to ensure that the sliding scale fees are calculated properly.