Audit 323494

FY End

2024-02-29

Total Expended

$2.78M

Findings

4

Programs

2

Organization: Pureview Health Center (MT)

Year: 2024 Accepted: 2024-10-01

Auditor: Kcoe Isom LLP

Organization Exclusion Status:

Checking exclusion status...

ID	Ref	Severity	Repeat	Requirement
501227	2024-001	Significant Deficiency	-	N
501228	2024-001	Significant Deficiency	-	N
1077669	2024-001	Significant Deficiency	-	N
1077670	2024-001	Significant Deficiency	-	N

ALN	Program	Spent	Major	Findings
93.527	Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program	$2.10M	Yes	1
93.224	Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program	$674,367	Yes	1

Contacts

Name	Title	Type
WHJEHJN1PKN3	Marina Kuntz	Auditee
4064570000	Megan Connors	Auditor
No contacts on file

Notes to SEFA

Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards (Schedule) includes the federal award activity of PureView Health Center (PureView) as described in note 1 of the accompanying notes to the financial statements. 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 PureView, it is not intended to and does not present the financial position, changes in net assets, or cash flows of PureView. Expenditures reported on the Schedule are reported on the accrual basis of accounting as described in note 1 of the accompanying notes to the financial statements. 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. All federal awards PureView received are considered conditional grants and therefore revenue is recognized when qualifying expenses have been incurred. De Minimis Rate Used: N Rate Explanation: Subject to the terms of individual grant awards, indirect costs are generally charged to federal grants using a negotiated rate. Therefore, PureView has not elected to use the de minimis rate of 10% provided for by 2 CFR 200.414(f).

Finding Details

Finding 2024-001

Condition: As a result of our audit procedures, we found five errors in the application of the sliding fee scale. Criteria: The sliding fee scale discount is based on patient income and demographic information. Controls should be in place to ensure the sliding fee scale is consistently applied for each patient. Effect: Continued noncompliance could result in a loss of funding. Additionally, it could result in inequitable access to healthcare services for patients and expose the Center to reputational risks. Context: During our testing, we found 5 of the 60 patients tested were not billed for the proper slide category based on the sliding fee scale provided by the PureView. No questioned costs were identified. Cause: The errors resulted from claims where the sliding scale was improperly recorded within the claim. There was no check to verify that the claim scale matched the scale within the patient files. These claims were missed during the billing department’s internal review of scale application. Individuals responsible for the primary and secondary review of sliding fee scale applications requires additional training and resources to ensure errors are detected timely. Recommendation: We recommend that PureView strengthen its internal controls by reviewing claims to ensure proper application of the sliding fee scale. Management Response: See Corrective Action Plan.

Finding 2024-001

Condition: As a result of our audit procedures, we found five errors in the application of the sliding fee scale. Criteria: The sliding fee scale discount is based on patient income and demographic information. Controls should be in place to ensure the sliding fee scale is consistently applied for each patient. Effect: Continued noncompliance could result in a loss of funding. Additionally, it could result in inequitable access to healthcare services for patients and expose the Center to reputational risks. Context: During our testing, we found 5 of the 60 patients tested were not billed for the proper slide category based on the sliding fee scale provided by the PureView. No questioned costs were identified. Cause: The errors resulted from claims where the sliding scale was improperly recorded within the claim. There was no check to verify that the claim scale matched the scale within the patient files. These claims were missed during the billing department’s internal review of scale application. Individuals responsible for the primary and secondary review of sliding fee scale applications requires additional training and resources to ensure errors are detected timely. Recommendation: We recommend that PureView strengthen its internal controls by reviewing claims to ensure proper application of the sliding fee scale. Management Response: See Corrective Action Plan.

Finding 2024-001

Condition: As a result of our audit procedures, we found five errors in the application of the sliding fee scale. Criteria: The sliding fee scale discount is based on patient income and demographic information. Controls should be in place to ensure the sliding fee scale is consistently applied for each patient. Effect: Continued noncompliance could result in a loss of funding. Additionally, it could result in inequitable access to healthcare services for patients and expose the Center to reputational risks. Context: During our testing, we found 5 of the 60 patients tested were not billed for the proper slide category based on the sliding fee scale provided by the PureView. No questioned costs were identified. Cause: The errors resulted from claims where the sliding scale was improperly recorded within the claim. There was no check to verify that the claim scale matched the scale within the patient files. These claims were missed during the billing department’s internal review of scale application. Individuals responsible for the primary and secondary review of sliding fee scale applications requires additional training and resources to ensure errors are detected timely. Recommendation: We recommend that PureView strengthen its internal controls by reviewing claims to ensure proper application of the sliding fee scale. Management Response: See Corrective Action Plan.

Finding 2024-001

Condition: As a result of our audit procedures, we found five errors in the application of the sliding fee scale. Criteria: The sliding fee scale discount is based on patient income and demographic information. Controls should be in place to ensure the sliding fee scale is consistently applied for each patient. Effect: Continued noncompliance could result in a loss of funding. Additionally, it could result in inequitable access to healthcare services for patients and expose the Center to reputational risks. Context: During our testing, we found 5 of the 60 patients tested were not billed for the proper slide category based on the sliding fee scale provided by the PureView. No questioned costs were identified. Cause: The errors resulted from claims where the sliding scale was improperly recorded within the claim. There was no check to verify that the claim scale matched the scale within the patient files. These claims were missed during the billing department’s internal review of scale application. Individuals responsible for the primary and secondary review of sliding fee scale applications requires additional training and resources to ensure errors are detected timely. Recommendation: We recommend that PureView strengthen its internal controls by reviewing claims to ensure proper application of the sliding fee scale. Management Response: See Corrective Action Plan.