FAC Explorer

Audit 331851

FY End
2023-06-30
Total Expended
$6.88M
Findings
4
Programs
16
Organization: Tca Health, Inc. (IL)
Year: 2023 Accepted: 2024-12-11
Auditor: Cliftonlarsonallen LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
513846 2023-002 Material Weakness Yes N
513847 2023-002 Material Weakness Yes N
1090288 2023-002 Material Weakness Yes N
1090289 2023-002 Material Weakness Yes N

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) $3.40M Yes 1
93.527 Affordable Care Act (aca) Grants for New and Expanded Services Under the Health Center Program $992,144 Yes 1
93.498 Provider Relief Fund $370,502 - 0
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $236,049 - 0
93.495 Community Health Workers for Public Health Response and Resilient $213,182 - 0
14.218 Community Development Block Grants/entitlement Grants $166,974 - 0
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $165,227 - 0
93.558 Temporary Assistance for Needy Families $164,580 - 0
93.332 Cooperative Agreement to Support Navigators in Federally-Facilitated and State Partnership Marketplaces $136,474 - 0
93.994 Maternal and Child Health Services Block Grant to the States $113,261 - 0
93.268 Immunization Cooperative Agreements $92,809 - 0
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $88,832 - 0
93.136 Injury Prevention and Control Research and State and Community Based Programs $82,277 - 0
10.557 Special Supplemental Nutrition Program for Women, Infants, and Children $58,070 - 0
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $48,117 - 0
10.572 Wic Farmers' Market Nutrition Program (fmnp) $997 - 0

Contacts

Name Title Type
V9WWULEWWUM5 Veronica Clarke Auditee
7739956300 Chris Manderfield Auditor
No contacts on file

Notes to SEFA

Title: Note 1 Basis of Presentation Accounting Policies: Expenditures reported on the SEFA 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. Negative amounts shown on the SEFA represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: The Organization has not elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (SEFA) includes the federal award activity of the Organization under programs of the federal government for the year ended June 30, 2023. The information in this SEFA is presented in accordance with the requirements of 2 CFR Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). As the SEFA 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.
Title: Note 2 Summary of Significant Accounting Policies Accounting Policies: Expenditures reported on the SEFA 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. Negative amounts shown on the SEFA represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: The Organization has not elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Expenditures reported on the SEFA 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. Negative amounts shown on the SEFA represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. The Organization has not elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance.
Title: Note 3 Financial Statement Revenue Accounting Policies: Expenditures reported on the SEFA 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. Negative amounts shown on the SEFA represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: The Organization has not elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. The financial statements for the years ended June 30, 2023 and 2022 reflect revenue recognized from the Provider Relief Fund (PRF) of $370,502 and $166,160, respectively. The SEFA for the years ended June 30, 2023 and June 30, 2022 includes PRF of $370,502 and $166,160, respectively, which is in accordance with the requirements of the compliance supplement for assistance listing number 93.498.
Title: Note 4 Other Matters Accounting Policies: Expenditures reported on the SEFA 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. Negative amounts shown on the SEFA represent adjustments or credits made in the normal course of business to amounts reported as expenditures in prior years. De Minimis Rate Used: N Rate Explanation: The Organization has not elected to use the 10 percent de minimis indirect cost rate as allowed under the Uniform Guidance. Amount of Noncash Assistance: None Amount of Insurance: None Amount of Loans: None Amount of Loan Guarantees: None Amount Provided to Subrecipients: None

Finding Details

Finding 2023-002
Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Health Center Program Cluster Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Number and Year: H80CS00109-21; H80CS00109-22 Award Period: May 1, 2022 – April 30, 2023; May 1, 2023 – April 30, 2024 Type of Finding: Material Weakness in Internal Control over Compliance and Material Noncompliance Criteria or specific requirement: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization did not maintain documentation to show that patients had been evaluated for eligibility under its sliding fee scale policy and did not assign patients a sliding fee category. Questioned costs: None. Context: Twenty-five (25) of forty (40) encounters did not have current documentation of family size and income to assess sliding fee discount eligibility, and twenty-five (25) of twenty-five (25) were not assigned a sliding fee category. Cause: This matter was identified during a prior audit and corrected during the second half of calendar year 2023. As a result of when this matter was first identified, corrective active was not able to occur prior to the year ended June 30, 2023 audit. Corrective action occurring during the second half of calendar year 2023. Effect: Patients may not be assessed a correct sliding fee discount according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: Yes, prior year finding 2022-003. Recommendation: Management should continue to work with its third-party vendors to ensure the accuracy and completeness of the patient information within its billing software in addition to continuing to conduct internal audits of patient visits to determine all required patient information has been obtained in accordance with TCA’s policies. Views of responsible officials: There is no disagreement with this finding.
Finding 2023-002
Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Health Center Program Cluster Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Number and Year: H80CS00109-21; H80CS00109-22 Award Period: May 1, 2022 – April 30, 2023; May 1, 2023 – April 30, 2024 Type of Finding: Material Weakness in Internal Control over Compliance and Material Noncompliance Criteria or specific requirement: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization did not maintain documentation to show that patients had been evaluated for eligibility under its sliding fee scale policy and did not assign patients a sliding fee category. Questioned costs: None. Context: Twenty-five (25) of forty (40) encounters did not have current documentation of family size and income to assess sliding fee discount eligibility, and twenty-five (25) of twenty-five (25) were not assigned a sliding fee category. Cause: This matter was identified during a prior audit and corrected during the second half of calendar year 2023. As a result of when this matter was first identified, corrective active was not able to occur prior to the year ended June 30, 2023 audit. Corrective action occurring during the second half of calendar year 2023. Effect: Patients may not be assessed a correct sliding fee discount according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: Yes, prior year finding 2022-003. Recommendation: Management should continue to work with its third-party vendors to ensure the accuracy and completeness of the patient information within its billing software in addition to continuing to conduct internal audits of patient visits to determine all required patient information has been obtained in accordance with TCA’s policies. Views of responsible officials: There is no disagreement with this finding.
Finding 2023-002
Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Health Center Program Cluster Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Number and Year: H80CS00109-21; H80CS00109-22 Award Period: May 1, 2022 – April 30, 2023; May 1, 2023 – April 30, 2024 Type of Finding: Material Weakness in Internal Control over Compliance and Material Noncompliance Criteria or specific requirement: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization did not maintain documentation to show that patients had been evaluated for eligibility under its sliding fee scale policy and did not assign patients a sliding fee category. Questioned costs: None. Context: Twenty-five (25) of forty (40) encounters did not have current documentation of family size and income to assess sliding fee discount eligibility, and twenty-five (25) of twenty-five (25) were not assigned a sliding fee category. Cause: This matter was identified during a prior audit and corrected during the second half of calendar year 2023. As a result of when this matter was first identified, corrective active was not able to occur prior to the year ended June 30, 2023 audit. Corrective action occurring during the second half of calendar year 2023. Effect: Patients may not be assessed a correct sliding fee discount according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: Yes, prior year finding 2022-003. Recommendation: Management should continue to work with its third-party vendors to ensure the accuracy and completeness of the patient information within its billing software in addition to continuing to conduct internal audits of patient visits to determine all required patient information has been obtained in accordance with TCA’s policies. Views of responsible officials: There is no disagreement with this finding.
Finding 2023-002
Federal Agency: U.S. Department of Health and Human Services Federal Program Title: Health Center Program Cluster Assistance Listing Numbers: 93.224 and 93.527 Federal Award Identification Number and Year: H80CS00109-21; H80CS00109-22 Award Period: May 1, 2022 – April 30, 2023; May 1, 2023 – April 30, 2024 Type of Finding: Material Weakness in Internal Control over Compliance and Material Noncompliance Criteria or specific requirement: Health centers must prepare and apply a sliding fee discount schedule so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient’s ability to pay. (42 USC 254(k)(3)(E), (F), and (G); 42 CFR sections 51c.303(e), (f), and (g); and 42 CFR sections 56.303(e), (f), and (g)). Condition: The Organization did not maintain documentation to show that patients had been evaluated for eligibility under its sliding fee scale policy and did not assign patients a sliding fee category. Questioned costs: None. Context: Twenty-five (25) of forty (40) encounters did not have current documentation of family size and income to assess sliding fee discount eligibility, and twenty-five (25) of twenty-five (25) were not assigned a sliding fee category. Cause: This matter was identified during a prior audit and corrected during the second half of calendar year 2023. As a result of when this matter was first identified, corrective active was not able to occur prior to the year ended June 30, 2023 audit. Corrective action occurring during the second half of calendar year 2023. Effect: Patients may not be assessed a correct sliding fee discount according to the Organization's sliding fee scale and their ability to pay. Repeat Finding: Yes, prior year finding 2022-003. Recommendation: Management should continue to work with its third-party vendors to ensure the accuracy and completeness of the patient information within its billing software in addition to continuing to conduct internal audits of patient visits to determine all required patient information has been obtained in accordance with TCA’s policies. Views of responsible officials: There is no disagreement with this finding.