FAC Explorer

Audit 329406

FY End
2024-06-30
Total Expended
$5.72M
Findings
10
Programs
10
Organization: Generations Family Health Center, Inc. (CT)
Year: 2024 Accepted: 2024-11-22
Auditor: Cohnreznick LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
509736 2024-001 Significant Deficiency Yes N
509737 2024-001 Significant Deficiency Yes N
509738 2024-001 Significant Deficiency Yes N
509739 2024-001 Significant Deficiency Yes N
509740 2024-001 Significant Deficiency Yes N
1086178 2024-001 Significant Deficiency Yes N
1086179 2024-001 Significant Deficiency Yes N
1086180 2024-001 Significant Deficiency Yes N
1086181 2024-001 Significant Deficiency Yes N
1086182 2024-001 Significant Deficiency Yes N

Programs

ALN Program Spent Major Findings
93.236 Grants to States to Support Oral Health Workforce Activities $323,143 - 0
93.918 Grants to Provide Outpatient Early Intervention Services with Respect to Hiv Disease $263,267 - 0
93.268 Immunization Cooperative Agreements $219,300 - 0
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $109,197 Yes 1
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $80,334 Yes 1
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $55,042 - 0
93.994 Maternal and Child Health Services Block Grant to the States $32,192 - 0
93.153 Coordinated Services and Access to Research for Women, Infants, Children, and Youth $31,612 - 0
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $2,055 - 0
21.027 Coronavirus State and Local Fiscal Recovery Funds $1,101 - 0

Contacts

Name Title Type
RP5CMH69RWV7 Debra Savoie Auditee
8604236271 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 Center has elected to not use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance. Pass-through entity identifying numbers are presented where available. The accompanying schedule of expenditures of federal awards (the "Schedule") includes the federal award activity of Generations Family Health Center, Inc. (the "Center") under programs of the federal government for the year ended June 30, 2024. 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 Center, it is not intended to and does not present the financial position, changes in net assets, or cash flows of the Center.
Title: LOAN 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, 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 to not use the 10-percent de minimis indirect cost rate as allowed under the Uniform Guidance. Pass-through entity identifying numbers are presented where available. The following is a summary of the loan program activity for the year ended June 30, 2024: United States Department of Agriculture Community Facilities Loans and Grants (Federal Assistance Listing Number 10.766): Issue date 12/21/2011 Interest rate 3.75% Original amount 7,000,000$ Balance, beginning of year 5,913,974$ Paid during fiscal year 136,260 Balance, end of year 5,777,714

Finding Details

Finding 2024-001
Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 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 Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2024-001
Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 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 Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2024-001
Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 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 Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2024-001
Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 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 Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2024-001
Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 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 Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2024-001
Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 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 Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2024-001
Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 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 Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2024-001
Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 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 Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2024-001
Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 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 Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.
Finding 2024-001
Finding 2024.001: Special Tests and Provisions - Sliding Fee Discounts - Significant Deficiency Grantor: U.S. Department of Health and Human Services Federal Program Names: Health Center Program Cluster Community Health Centers COVID-19 - Community Health Centers Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program COVID-19 - Affordable Care Act (ACA) Grants for New and Expanded Services Under the Health Center Program Federal Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Numbers: H8000155 - 2023 and 2024, H8F41721 - 2023, H8G47852 - 2023, H8L50889 - 2024 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 Center should be implementing and monitoring procedures to properly determine, calculate and review sliding fee discounts issued to patients in accordance with the Center's sliding fee scale. Condition The Center did not always apply the sliding fee discount accurately based on the Center's sliding fee discount policy. Cause The Center did not have adequate internal controls in place to effectively ensure that all sliding fee discounts were properly calculated based on approved documentation. Effect The Center did not comply with the appropriate Special Tests and Provisions rules and regulations as per the Uniform Guidance. Questioned Costs None. Context A test of 40 discount transactions was performed and resulted in one instance of a sliding fee discount not being properly calculated based on the respective patient family size and income. Our sample was a statistically valid sample. Identification of Repeat Finding Yes. See Finding 2023.001. Recommendation The Center should establish a system of internal controls to ensure that all sliding fee discounts are properly calculated based on family size and income. Views of Responsible Officials Management agrees with the audit finding and will strengthen internal controls and accountability to correct the deficiency.