FAC Explorer

Audit 329843

FY End
2024-03-31
Total Expended
$3.36M
Findings
4
Programs
2
Organization: Family Medical Center of Michigan, Inc. (MI)
Year: 2024 Accepted: 2024-11-25
Auditor: Yeo & Yeo PC

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
512108 2024-001 Significant Deficiency Yes N
512109 2024-001 Significant Deficiency Yes N
1088550 2024-001 Significant Deficiency Yes N
1088551 2024-001 Significant Deficiency Yes N

Programs

ALN Program Spent Major Findings
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $2.88M Yes 1
93.224 Community Health Centers $476,785 Yes 1

Contacts

Name Title Type
DTGSAZLNB9Y4 Ed Larkins Auditee
7346542169 Brian Dixon Auditor
No contacts on file

Notes to SEFA

Title: General 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 where certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Family Medical Center of Michigan, Inc. has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the Schedule) includes the federal award activity of Family Medical Center of Michigan, Inc. under programs of the federal government for the year ended March 31, 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 Family Medical Center of Michigan, Inc., it is not intended to and does not present the financial position, changes in net assets, or cash flows of Family Medical Center of Michigan, Inc.
Title: Reconciliation to the Financial Statements 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 where certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Family Medical Center of Michigan, Inc. has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. The federal revenues per the financial statements are in agreement with the schedule of expenditures of federal awards.
Title: Subrecipients 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 where certain types of expenditures are not allowable or are limited as to reimbursement. De Minimis Rate Used: N Rate Explanation: Family Medical Center of Michigan, Inc. has elected not to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. No amounts were provided to subrecipients.

Finding Details

Finding 2024-001
Significant Deficiency and Noncompliance – Special Tests Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. Condition: During our testing of sliding fee encounters we noted 2 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, we noted 5 instances where the center was missing supervisor approval on the application. Also, there were 6 instances where ECW was using the old slide fee scale, and 4 instances where ECW rounded patients up to the next slide, resulting in the wrong slide. Questioned Costs: None Cause and Effect: There has been significant turnover in the billing department over the past 4 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients’ slide scale. Recommendation: We recommend that management reviews all current sliding fee patients and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
Finding 2024-001
Significant Deficiency and Noncompliance – Special Tests Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. Condition: During our testing of sliding fee encounters we noted 2 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, we noted 5 instances where the center was missing supervisor approval on the application. Also, there were 6 instances where ECW was using the old slide fee scale, and 4 instances where ECW rounded patients up to the next slide, resulting in the wrong slide. Questioned Costs: None Cause and Effect: There has been significant turnover in the billing department over the past 4 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients’ slide scale. Recommendation: We recommend that management reviews all current sliding fee patients and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
Finding 2024-001
Significant Deficiency and Noncompliance – Special Tests Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. Condition: During our testing of sliding fee encounters we noted 2 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, we noted 5 instances where the center was missing supervisor approval on the application. Also, there were 6 instances where ECW was using the old slide fee scale, and 4 instances where ECW rounded patients up to the next slide, resulting in the wrong slide. Questioned Costs: None Cause and Effect: There has been significant turnover in the billing department over the past 4 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients’ slide scale. Recommendation: We recommend that management reviews all current sliding fee patients and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.
Finding 2024-001
Significant Deficiency and Noncompliance – Special Tests Federal Program: Assistance Listing #93.224 and 93.527, Health Center Program Cluster, Department of Health and Human Services Criteria: Health Centers must prepare and apply a sliding fee discount schedule so that amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. Condition: During our testing of sliding fee encounters we noted 2 instances out of 60 where the patient was not slid the proper amount based on their level of income. Additionally, we noted 5 instances where the center was missing supervisor approval on the application. Also, there were 6 instances where ECW was using the old slide fee scale, and 4 instances where ECW rounded patients up to the next slide, resulting in the wrong slide. Questioned Costs: None Cause and Effect: There has been significant turnover in the billing department over the past 4 years, as well as implementation of new billing software. Many instances are due to improper documentation or manual error in inputting the patients’ slide scale. Recommendation: We recommend that management reviews all current sliding fee patients and ensure that the center has an up to date sliding fee application for each. If the center is not able to locate the sliding fee application, then we recommend that the center obtains the proper application. Additionally, we recommend that the center reviews current applications to ensure that patients are being charged the proper sliding fee scale. Views of Responsible Officials: Management agrees with the finding. Corrective Action Plan: See attached corrective action plan.