Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 42 CFR section 51c 303(f), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay.
Condition Not all patients had valid sliding fee applications on file and not all patients received accurate sliding fee adjustments.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During special test/sliding fee testing, noted 16 patients out of a sample of 60 did not have a valid sliding fee application on file. Of the remaining 44 patients, 17 had an incorrect sliding fee adjustment applied based on family income and size.
Cause and Effect An appropriate review of sliding fee applications and adjustments was not completed to ensure valid applications were maintained and the correct adjustment was applied. As a result, not all patients received the correct adjustment and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including levels of review, to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 42 CFR section 51c 303(f), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay.
Condition Not all patients had valid sliding fee applications on file and not all patients received accurate sliding fee adjustments.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During special test/sliding fee testing, noted 16 patients out of a sample of 60 did not have a valid sliding fee application on file. Of the remaining 44 patients, 17 had an incorrect sliding fee adjustment applied based on family income and size.
Cause and Effect An appropriate review of sliding fee applications and adjustments was not completed to ensure valid applications were maintained and the correct adjustment was applied. As a result, not all patients received the correct adjustment and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including levels of review, to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 42 CFR section 51c 303(f), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay.
Condition Not all patients had valid sliding fee applications on file and not all patients received accurate sliding fee adjustments.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During special test/sliding fee testing, noted 16 patients out of a sample of 60 did not have a valid sliding fee application on file. Of the remaining 44 patients, 17 had an incorrect sliding fee adjustment applied based on family income and size.
Cause and Effect An appropriate review of sliding fee applications and adjustments was not completed to ensure valid applications were maintained and the correct adjustment was applied. As a result, not all patients received the correct adjustment and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including levels of review, to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 42 CFR section 51c 303(f), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay.
Condition Not all patients had valid sliding fee applications on file and not all patients received accurate sliding fee adjustments.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During special test/sliding fee testing, noted 16 patients out of a sample of 60 did not have a valid sliding fee application on file. Of the remaining 44 patients, 17 had an incorrect sliding fee adjustment applied based on family income and size.
Cause and Effect An appropriate review of sliding fee applications and adjustments was not completed to ensure valid applications were maintained and the correct adjustment was applied. As a result, not all patients received the correct adjustment and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including levels of review, to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with the Declaration and Certification made to the U.S. Department of Health and Human Services at the time of drawdown and the Organization's internal policy, the Organization must disburse funds for costs that are reasonable, allowable, and allocable to the award within three business days or immediately return the funds.
Condition The Organization maintains and tracks federal expenditures incurred for the year in totality, however, does not maintain adequate records to track the costs applied to each individual draw down made throughout the year. Without this linkage, the timeliness between draw down and disbursement to ensure the disbursement occurred prior to or within three business days of draw down is unable to be validated.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During cash management testing, supporting documentation to identify the costs applied to each drawndown was not maintained for all 8 samples tested. During allowability testing, none of the 30 samples tested were able to be traced to a specific draw down to validate the cost was paid within three business days. However, in total for the year the Organization was able to support the draws received with a detailed listing of federal expenditures as reported on the SEFA.
Cause and Effect Insufficient controls are in place over cash management. As a result, cash drawdowns were made throughout the year with no linkage to specfic federal expenditures and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls over cash management, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement controls, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with the Declaration and Certification made to the U.S. Department of Health and Human Services at the time of drawdown and the Organization's internal policy, the Organization must disburse funds for costs that are reasonable, allowable, and allocable to the award within three business days or immediately return the funds.
Condition The Organization maintains and tracks federal expenditures incurred for the year in totality, however, does not maintain adequate records to track the costs applied to each individual draw down made throughout the year. Without this linkage, the timeliness between draw down and disbursement to ensure the disbursement occurred prior to or within three business days of draw down is unable to be validated.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During cash management testing, supporting documentation to identify the costs applied to each drawndown was not maintained for all 8 samples tested. During allowability testing, none of the 30 samples tested were able to be traced to a specific draw down to validate the cost was paid within three business days. However, in total for the year the Organization was able to support the draws received with a detailed listing of federal expenditures as reported on the SEFA.
Cause and Effect Insufficient controls are in place over cash management. As a result, cash drawdowns were made throughout the year with no linkage to specfic federal expenditures and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls over cash management, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement controls, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with the Declaration and Certification made to the U.S. Department of Health and Human Services at the time of drawdown and the Organization's internal policy, the Organization must disburse funds for costs that are reasonable, allowable, and allocable to the award within three business days or immediately return the funds.
Condition The Organization maintains and tracks federal expenditures incurred for the year in totality, however, does not maintain adequate records to track the costs applied to each individual draw down made throughout the year. Without this linkage, the timeliness between draw down and disbursement to ensure the disbursement occurred prior to or within three business days of draw down is unable to be validated.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During cash management testing, supporting documentation to identify the costs applied to each drawndown was not maintained for all 8 samples tested. During allowability testing, none of the 30 samples tested were able to be traced to a specific draw down to validate the cost was paid within three business days. However, in total for the year the Organization was able to support the draws received with a detailed listing of federal expenditures as reported on the SEFA.
Cause and Effect Insufficient controls are in place over cash management. As a result, cash drawdowns were made throughout the year with no linkage to specfic federal expenditures and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls over cash management, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement controls, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with the Declaration and Certification made to the U.S. Department of Health and Human Services at the time of drawdown and the Organization's internal policy, the Organization must disburse funds for costs that are reasonable, allowable, and allocable to the award within three business days or immediately return the funds.
Condition The Organization maintains and tracks federal expenditures incurred for the year in totality, however, does not maintain adequate records to track the costs applied to each individual draw down made throughout the year. Without this linkage, the timeliness between draw down and disbursement to ensure the disbursement occurred prior to or within three business days of draw down is unable to be validated.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During cash management testing, supporting documentation to identify the costs applied to each drawndown was not maintained for all 8 samples tested. During allowability testing, none of the 30 samples tested were able to be traced to a specific draw down to validate the cost was paid within three business days. However, in total for the year the Organization was able to support the draws received with a detailed listing of federal expenditures as reported on the SEFA.
Cause and Effect Insufficient controls are in place over cash management. As a result, cash drawdowns were made throughout the year with no linkage to specfic federal expenditures and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls over cash management, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement controls, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 2 CFR sections 200.318 200.326, the Organization must maintain and use documented procedures for procurement transactions that are consistent with State, local, and tribal laws and regulations and the standards identified in CFR sections 200.317 through 200.327. The Organization must maintain records sufficient to detail the history of each procurement transaction. These records must include the rationale for the procurement method, contract type selection, contractor selection or rejection, and the basis for the contract price. Additionally, in accorance with 2 CFR sections 200.212 and 200.318(h); 2 CFR section 180.300; 48 CFR section 52.209 6, the Organization must verify that the person with whom you intend to do business is not excluded or disqualified.
Condition Policies and procedures in place over procurement, suspension, and debarment are not in conformance with Uniform Guidance. Additionally, the Organization did not procure in accordance with the regulations, including maintaining records sufficient to detail the history of each procurement transaction nor did they comply with suspension and debarement rules.
Questioned Costs $1,121,985
Identification of How Questioned Costs Were Computed Questioned costs resulted from the Organization not maintaining or using the required procurement procedures over non payroll expenditures. Total non payroll expenditures included on the SEFA total $1,121,985.
Context For all four contracts selected for testing, there were no records manintained to support procurement method, contract selection, or verification the entity was not suspended or disbared. Upon further procedures, we identified that the Organization did not follow any procurement guidelines in procuring all non payroll transactions.
Cause and Effect There are no procurement, suspension, and debarement policies in place. As a result, no procedures are being completed over these compliance categories and thus the Organization did not comply with the related compliance requirements.
Recommendation We recommend the Organization implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance and follow those policies.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 2 CFR sections 200.318 200.326, the Organization must maintain and use documented procedures for procurement transactions that are consistent with State, local, and tribal laws and regulations and the standards identified in CFR sections 200.317 through 200.327. The Organization must maintain records sufficient to detail the history of each procurement transaction. These records must include the rationale for the procurement method, contract type selection, contractor selection or rejection, and the basis for the contract price. Additionally, in accorance with 2 CFR sections 200.212 and 200.318(h); 2 CFR section 180.300; 48 CFR section 52.209 6, the Organization must verify that the person with whom you intend to do business is not excluded or disqualified.
Condition Policies and procedures in place over procurement, suspension, and debarment are not in conformance with Uniform Guidance. Additionally, the Organization did not procure in accordance with the regulations, including maintaining records sufficient to detail the history of each procurement transaction nor did they comply with suspension and debarement rules.
Questioned Costs $1,121,985
Identification of How Questioned Costs Were Computed Questioned costs resulted from the Organization not maintaining or using the required procurement procedures over non payroll expenditures. Total non payroll expenditures included on the SEFA total $1,121,985.
Context For all four contracts selected for testing, there were no records manintained to support procurement method, contract selection, or verification the entity was not suspended or disbared. Upon further procedures, we identified that the Organization did not follow any procurement guidelines in procuring all non payroll transactions.
Cause and Effect There are no procurement, suspension, and debarement policies in place. As a result, no procedures are being completed over these compliance categories and thus the Organization did not comply with the related compliance requirements.
Recommendation We recommend the Organization implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance and follow those policies.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 2 CFR sections 200.318 200.326, the Organization must maintain and use documented procedures for procurement transactions that are consistent with State, local, and tribal laws and regulations and the standards identified in CFR sections 200.317 through 200.327. The Organization must maintain records sufficient to detail the history of each procurement transaction. These records must include the rationale for the procurement method, contract type selection, contractor selection or rejection, and the basis for the contract price. Additionally, in accorance with 2 CFR sections 200.212 and 200.318(h); 2 CFR section 180.300; 48 CFR section 52.209 6, the Organization must verify that the person with whom you intend to do business is not excluded or disqualified.
Condition Policies and procedures in place over procurement, suspension, and debarment are not in conformance with Uniform Guidance. Additionally, the Organization did not procure in accordance with the regulations, including maintaining records sufficient to detail the history of each procurement transaction nor did they comply with suspension and debarement rules.
Questioned Costs $1,121,985
Identification of How Questioned Costs Were Computed Questioned costs resulted from the Organization not maintaining or using the required procurement procedures over non payroll expenditures. Total non payroll expenditures included on the SEFA total $1,121,985.
Context For all four contracts selected for testing, there were no records manintained to support procurement method, contract selection, or verification the entity was not suspended or disbared. Upon further procedures, we identified that the Organization did not follow any procurement guidelines in procuring all non payroll transactions.
Cause and Effect There are no procurement, suspension, and debarement policies in place. As a result, no procedures are being completed over these compliance categories and thus the Organization did not comply with the related compliance requirements.
Recommendation We recommend the Organization implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance and follow those policies.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 2 CFR sections 200.318 200.326, the Organization must maintain and use documented procedures for procurement transactions that are consistent with State, local, and tribal laws and regulations and the standards identified in CFR sections 200.317 through 200.327. The Organization must maintain records sufficient to detail the history of each procurement transaction. These records must include the rationale for the procurement method, contract type selection, contractor selection or rejection, and the basis for the contract price. Additionally, in accorance with 2 CFR sections 200.212 and 200.318(h); 2 CFR section 180.300; 48 CFR section 52.209 6, the Organization must verify that the person with whom you intend to do business is not excluded or disqualified.
Condition Policies and procedures in place over procurement, suspension, and debarment are not in conformance with Uniform Guidance. Additionally, the Organization did not procure in accordance with the regulations, including maintaining records sufficient to detail the history of each procurement transaction nor did they comply with suspension and debarement rules.
Questioned Costs $1,121,985
Identification of How Questioned Costs Were Computed Questioned costs resulted from the Organization not maintaining or using the required procurement procedures over non payroll expenditures. Total non payroll expenditures included on the SEFA total $1,121,985.
Context For all four contracts selected for testing, there were no records manintained to support procurement method, contract selection, or verification the entity was not suspended or disbared. Upon further procedures, we identified that the Organization did not follow any procurement guidelines in procuring all non payroll transactions.
Cause and Effect There are no procurement, suspension, and debarement policies in place. As a result, no procedures are being completed over these compliance categories and thus the Organization did not comply with the related compliance requirements.
Recommendation We recommend the Organization implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance and follow those policies.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria Federal funds awarded must be expended on allowable costs as defined in 45 CFR Part 75, Subpart E.
Condition Costs with prior written approval to be applied against the C8ECS43729 grant (ALN 93.526) by the federal award agency (HRSA) were coded and applied to the H8FCS40356 grant (ALN 93.224/527).
Questioned Costs $73,464
Identification of How Questioned Costs Were Computed Questioned costs of $73,464 resulted from the entity coding the cost to the wrong grant.
Context During allowability testing over non payroll expenditures, one out of five of the samples was improperly coded to the wrong grant.
Cause and Effect An appropriate review of the Organization's allowable costs was not completed to ensure all costs were coded to the correct grant. The Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including level of review, to ensure all costs are properly coded and applied to the correct grant.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls including level of review, to ensure all costs are properly coded and applied to the correct grant.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria Federal funds awarded must be expended on allowable costs as defined in 45 CFR Part 75, Subpart E.
Condition Costs with prior written approval to be applied against the C8ECS43729 grant (ALN 93.526) by the federal award agency (HRSA) were coded and applied to the H8FCS40356 grant (ALN 93.224/527).
Questioned Costs $73,464
Identification of How Questioned Costs Were Computed Questioned costs of $73,464 resulted from the entity coding the cost to the wrong grant.
Context During allowability testing over non payroll expenditures, one out of five of the samples was improperly coded to the wrong grant.
Cause and Effect An appropriate review of the Organization's allowable costs was not completed to ensure all costs were coded to the correct grant. The Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including level of review, to ensure all costs are properly coded and applied to the correct grant.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls including level of review, to ensure all costs are properly coded and applied to the correct grant.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria Federal funds awarded must be expended on allowable costs as defined in 45 CFR Part 75, Subpart E.
Condition Costs with prior written approval to be applied against the C8ECS43729 grant (ALN 93.526) by the federal award agency (HRSA) were coded and applied to the H8FCS40356 grant (ALN 93.224/527).
Questioned Costs $73,464
Identification of How Questioned Costs Were Computed Questioned costs of $73,464 resulted from the entity coding the cost to the wrong grant.
Context During allowability testing over non payroll expenditures, one out of five of the samples was improperly coded to the wrong grant.
Cause and Effect An appropriate review of the Organization's allowable costs was not completed to ensure all costs were coded to the correct grant. The Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including level of review, to ensure all costs are properly coded and applied to the correct grant.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls including level of review, to ensure all costs are properly coded and applied to the correct grant.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria Federal funds awarded must be expended on allowable costs as defined in 45 CFR Part 75, Subpart E.
Condition Costs with prior written approval to be applied against the C8ECS43729 grant (ALN 93.526) by the federal award agency (HRSA) were coded and applied to the H8FCS40356 grant (ALN 93.224/527).
Questioned Costs $73,464
Identification of How Questioned Costs Were Computed Questioned costs of $73,464 resulted from the entity coding the cost to the wrong grant.
Context During allowability testing over non payroll expenditures, one out of five of the samples was improperly coded to the wrong grant.
Cause and Effect An appropriate review of the Organization's allowable costs was not completed to ensure all costs were coded to the correct grant. The Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including level of review, to ensure all costs are properly coded and applied to the correct grant.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls including level of review, to ensure all costs are properly coded and applied to the correct grant.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with notice of awards and the Uniform Data System Health Center Data Reporting Requirements, the health center is required to submit an annual performance report that includes data that reflects all activities in the HRSA health center project.
Condition Due to material entries identified and recorded during the 2022 financial statement audit of the Organization, the data submitted within the annual performance report was not accurate. Additionally, there was no evidence of review over the required reports.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context The lack of timely appropriate reconciliation impacted significant balances recorded on the balance sheet and statement of activities and changes in net assets. For two out of two reports tested, there was no evidience of review.
Cause and Effect The Organization did not have controls in place to ensure that the preparation of account reconciliation occurred appropriately in a timely manner. See finding 2022 001 for entries identified. In addition, subsequently to starting our audit procedures, the Organization provided us with a significant amount of adjusting journal entries. The entries provided by the Organization subsequent to the commencement of the audit impacted several balance sheet accounts, and had and had an overall impact to decrease change in net assets by approximately $2,000,000. As a result, the reports filed with HRSA are materially incorrect. The Organization did not comply with the related compliance requirement.
Recommendation We recommend that controls be put in place to prepare and review accurate reconciliation with supporting information over all accounting cycles in a timely fashion.
Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding and is evaluating options to implement timely reconciliation process.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with notice of awards and the Uniform Data System Health Center Data Reporting Requirements, the health center is required to submit an annual performance report that includes data that reflects all activities in the HRSA health center project.
Condition Due to material entries identified and recorded during the 2022 financial statement audit of the Organization, the data submitted within the annual performance report was not accurate. Additionally, there was no evidence of review over the required reports.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context The lack of timely appropriate reconciliation impacted significant balances recorded on the balance sheet and statement of activities and changes in net assets. For two out of two reports tested, there was no evidience of review.
Cause and Effect The Organization did not have controls in place to ensure that the preparation of account reconciliation occurred appropriately in a timely manner. See finding 2022 001 for entries identified. In addition, subsequently to starting our audit procedures, the Organization provided us with a significant amount of adjusting journal entries. The entries provided by the Organization subsequent to the commencement of the audit impacted several balance sheet accounts, and had and had an overall impact to decrease change in net assets by approximately $2,000,000. As a result, the reports filed with HRSA are materially incorrect. The Organization did not comply with the related compliance requirement.
Recommendation We recommend that controls be put in place to prepare and review accurate reconciliation with supporting information over all accounting cycles in a timely fashion.
Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding and is evaluating options to implement timely reconciliation process.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with notice of awards and the Uniform Data System Health Center Data Reporting Requirements, the health center is required to submit an annual performance report that includes data that reflects all activities in the HRSA health center project.
Condition Due to material entries identified and recorded during the 2022 financial statement audit of the Organization, the data submitted within the annual performance report was not accurate. Additionally, there was no evidence of review over the required reports.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context The lack of timely appropriate reconciliation impacted significant balances recorded on the balance sheet and statement of activities and changes in net assets. For two out of two reports tested, there was no evidience of review.
Cause and Effect The Organization did not have controls in place to ensure that the preparation of account reconciliation occurred appropriately in a timely manner. See finding 2022 001 for entries identified. In addition, subsequently to starting our audit procedures, the Organization provided us with a significant amount of adjusting journal entries. The entries provided by the Organization subsequent to the commencement of the audit impacted several balance sheet accounts, and had and had an overall impact to decrease change in net assets by approximately $2,000,000. As a result, the reports filed with HRSA are materially incorrect. The Organization did not comply with the related compliance requirement.
Recommendation We recommend that controls be put in place to prepare and review accurate reconciliation with supporting information over all accounting cycles in a timely fashion.
Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding and is evaluating options to implement timely reconciliation process.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with notice of awards and the Uniform Data System Health Center Data Reporting Requirements, the health center is required to submit an annual performance report that includes data that reflects all activities in the HRSA health center project.
Condition Due to material entries identified and recorded during the 2022 financial statement audit of the Organization, the data submitted within the annual performance report was not accurate. Additionally, there was no evidence of review over the required reports.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context The lack of timely appropriate reconciliation impacted significant balances recorded on the balance sheet and statement of activities and changes in net assets. For two out of two reports tested, there was no evidience of review.
Cause and Effect The Organization did not have controls in place to ensure that the preparation of account reconciliation occurred appropriately in a timely manner. See finding 2022 001 for entries identified. In addition, subsequently to starting our audit procedures, the Organization provided us with a significant amount of adjusting journal entries. The entries provided by the Organization subsequent to the commencement of the audit impacted several balance sheet accounts, and had and had an overall impact to decrease change in net assets by approximately $2,000,000. As a result, the reports filed with HRSA are materially incorrect. The Organization did not comply with the related compliance requirement.
Recommendation We recommend that controls be put in place to prepare and review accurate reconciliation with supporting information over all accounting cycles in a timely fashion.
Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding and is evaluating options to implement timely reconciliation process.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 42 CFR section 51c 303(f), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay.
Condition Not all patients had valid sliding fee applications on file and not all patients received accurate sliding fee adjustments.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During special test/sliding fee testing, noted 16 patients out of a sample of 60 did not have a valid sliding fee application on file. Of the remaining 44 patients, 17 had an incorrect sliding fee adjustment applied based on family income and size.
Cause and Effect An appropriate review of sliding fee applications and adjustments was not completed to ensure valid applications were maintained and the correct adjustment was applied. As a result, not all patients received the correct adjustment and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including levels of review, to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 42 CFR section 51c 303(f), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay.
Condition Not all patients had valid sliding fee applications on file and not all patients received accurate sliding fee adjustments.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During special test/sliding fee testing, noted 16 patients out of a sample of 60 did not have a valid sliding fee application on file. Of the remaining 44 patients, 17 had an incorrect sliding fee adjustment applied based on family income and size.
Cause and Effect An appropriate review of sliding fee applications and adjustments was not completed to ensure valid applications were maintained and the correct adjustment was applied. As a result, not all patients received the correct adjustment and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including levels of review, to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 42 CFR section 51c 303(f), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay.
Condition Not all patients had valid sliding fee applications on file and not all patients received accurate sliding fee adjustments.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During special test/sliding fee testing, noted 16 patients out of a sample of 60 did not have a valid sliding fee application on file. Of the remaining 44 patients, 17 had an incorrect sliding fee adjustment applied based on family income and size.
Cause and Effect An appropriate review of sliding fee applications and adjustments was not completed to ensure valid applications were maintained and the correct adjustment was applied. As a result, not all patients received the correct adjustment and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including levels of review, to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 42 CFR section 51c 303(f), health centers must prepare and apply a sliding fee discount schedule (SFDS) so that the amounts owed for health center services by eligible patients are adjusted (discounted) based on the patient's ability to pay.
Condition Not all patients had valid sliding fee applications on file and not all patients received accurate sliding fee adjustments.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During special test/sliding fee testing, noted 16 patients out of a sample of 60 did not have a valid sliding fee application on file. Of the remaining 44 patients, 17 had an incorrect sliding fee adjustment applied based on family income and size.
Cause and Effect An appropriate review of sliding fee applications and adjustments was not completed to ensure valid applications were maintained and the correct adjustment was applied. As a result, not all patients received the correct adjustment and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including levels of review, to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls to ensure sliding fee applications are maintained and sliding fee adjustments are accurate based on correct family income and size.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with the Declaration and Certification made to the U.S. Department of Health and Human Services at the time of drawdown and the Organization's internal policy, the Organization must disburse funds for costs that are reasonable, allowable, and allocable to the award within three business days or immediately return the funds.
Condition The Organization maintains and tracks federal expenditures incurred for the year in totality, however, does not maintain adequate records to track the costs applied to each individual draw down made throughout the year. Without this linkage, the timeliness between draw down and disbursement to ensure the disbursement occurred prior to or within three business days of draw down is unable to be validated.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During cash management testing, supporting documentation to identify the costs applied to each drawndown was not maintained for all 8 samples tested. During allowability testing, none of the 30 samples tested were able to be traced to a specific draw down to validate the cost was paid within three business days. However, in total for the year the Organization was able to support the draws received with a detailed listing of federal expenditures as reported on the SEFA.
Cause and Effect Insufficient controls are in place over cash management. As a result, cash drawdowns were made throughout the year with no linkage to specfic federal expenditures and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls over cash management, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement controls, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with the Declaration and Certification made to the U.S. Department of Health and Human Services at the time of drawdown and the Organization's internal policy, the Organization must disburse funds for costs that are reasonable, allowable, and allocable to the award within three business days or immediately return the funds.
Condition The Organization maintains and tracks federal expenditures incurred for the year in totality, however, does not maintain adequate records to track the costs applied to each individual draw down made throughout the year. Without this linkage, the timeliness between draw down and disbursement to ensure the disbursement occurred prior to or within three business days of draw down is unable to be validated.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During cash management testing, supporting documentation to identify the costs applied to each drawndown was not maintained for all 8 samples tested. During allowability testing, none of the 30 samples tested were able to be traced to a specific draw down to validate the cost was paid within three business days. However, in total for the year the Organization was able to support the draws received with a detailed listing of federal expenditures as reported on the SEFA.
Cause and Effect Insufficient controls are in place over cash management. As a result, cash drawdowns were made throughout the year with no linkage to specfic federal expenditures and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls over cash management, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement controls, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with the Declaration and Certification made to the U.S. Department of Health and Human Services at the time of drawdown and the Organization's internal policy, the Organization must disburse funds for costs that are reasonable, allowable, and allocable to the award within three business days or immediately return the funds.
Condition The Organization maintains and tracks federal expenditures incurred for the year in totality, however, does not maintain adequate records to track the costs applied to each individual draw down made throughout the year. Without this linkage, the timeliness between draw down and disbursement to ensure the disbursement occurred prior to or within three business days of draw down is unable to be validated.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During cash management testing, supporting documentation to identify the costs applied to each drawndown was not maintained for all 8 samples tested. During allowability testing, none of the 30 samples tested were able to be traced to a specific draw down to validate the cost was paid within three business days. However, in total for the year the Organization was able to support the draws received with a detailed listing of federal expenditures as reported on the SEFA.
Cause and Effect Insufficient controls are in place over cash management. As a result, cash drawdowns were made throughout the year with no linkage to specfic federal expenditures and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls over cash management, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement controls, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with the Declaration and Certification made to the U.S. Department of Health and Human Services at the time of drawdown and the Organization's internal policy, the Organization must disburse funds for costs that are reasonable, allowable, and allocable to the award within three business days or immediately return the funds.
Condition The Organization maintains and tracks federal expenditures incurred for the year in totality, however, does not maintain adequate records to track the costs applied to each individual draw down made throughout the year. Without this linkage, the timeliness between draw down and disbursement to ensure the disbursement occurred prior to or within three business days of draw down is unable to be validated.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context During cash management testing, supporting documentation to identify the costs applied to each drawndown was not maintained for all 8 samples tested. During allowability testing, none of the 30 samples tested were able to be traced to a specific draw down to validate the cost was paid within three business days. However, in total for the year the Organization was able to support the draws received with a detailed listing of federal expenditures as reported on the SEFA.
Cause and Effect Insufficient controls are in place over cash management. As a result, cash drawdowns were made throughout the year with no linkage to specfic federal expenditures and thus the Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls over cash management, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement controls, including layers of review, to ensure supporting documentation to link federal expenditures to each drawdown is maintained and the timely disbursement of funds received.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 2 CFR sections 200.318 200.326, the Organization must maintain and use documented procedures for procurement transactions that are consistent with State, local, and tribal laws and regulations and the standards identified in CFR sections 200.317 through 200.327. The Organization must maintain records sufficient to detail the history of each procurement transaction. These records must include the rationale for the procurement method, contract type selection, contractor selection or rejection, and the basis for the contract price. Additionally, in accorance with 2 CFR sections 200.212 and 200.318(h); 2 CFR section 180.300; 48 CFR section 52.209 6, the Organization must verify that the person with whom you intend to do business is not excluded or disqualified.
Condition Policies and procedures in place over procurement, suspension, and debarment are not in conformance with Uniform Guidance. Additionally, the Organization did not procure in accordance with the regulations, including maintaining records sufficient to detail the history of each procurement transaction nor did they comply with suspension and debarement rules.
Questioned Costs $1,121,985
Identification of How Questioned Costs Were Computed Questioned costs resulted from the Organization not maintaining or using the required procurement procedures over non payroll expenditures. Total non payroll expenditures included on the SEFA total $1,121,985.
Context For all four contracts selected for testing, there were no records manintained to support procurement method, contract selection, or verification the entity was not suspended or disbared. Upon further procedures, we identified that the Organization did not follow any procurement guidelines in procuring all non payroll transactions.
Cause and Effect There are no procurement, suspension, and debarement policies in place. As a result, no procedures are being completed over these compliance categories and thus the Organization did not comply with the related compliance requirements.
Recommendation We recommend the Organization implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance and follow those policies.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 2 CFR sections 200.318 200.326, the Organization must maintain and use documented procedures for procurement transactions that are consistent with State, local, and tribal laws and regulations and the standards identified in CFR sections 200.317 through 200.327. The Organization must maintain records sufficient to detail the history of each procurement transaction. These records must include the rationale for the procurement method, contract type selection, contractor selection or rejection, and the basis for the contract price. Additionally, in accorance with 2 CFR sections 200.212 and 200.318(h); 2 CFR section 180.300; 48 CFR section 52.209 6, the Organization must verify that the person with whom you intend to do business is not excluded or disqualified.
Condition Policies and procedures in place over procurement, suspension, and debarment are not in conformance with Uniform Guidance. Additionally, the Organization did not procure in accordance with the regulations, including maintaining records sufficient to detail the history of each procurement transaction nor did they comply with suspension and debarement rules.
Questioned Costs $1,121,985
Identification of How Questioned Costs Were Computed Questioned costs resulted from the Organization not maintaining or using the required procurement procedures over non payroll expenditures. Total non payroll expenditures included on the SEFA total $1,121,985.
Context For all four contracts selected for testing, there were no records manintained to support procurement method, contract selection, or verification the entity was not suspended or disbared. Upon further procedures, we identified that the Organization did not follow any procurement guidelines in procuring all non payroll transactions.
Cause and Effect There are no procurement, suspension, and debarement policies in place. As a result, no procedures are being completed over these compliance categories and thus the Organization did not comply with the related compliance requirements.
Recommendation We recommend the Organization implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance and follow those policies.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 2 CFR sections 200.318 200.326, the Organization must maintain and use documented procedures for procurement transactions that are consistent with State, local, and tribal laws and regulations and the standards identified in CFR sections 200.317 through 200.327. The Organization must maintain records sufficient to detail the history of each procurement transaction. These records must include the rationale for the procurement method, contract type selection, contractor selection or rejection, and the basis for the contract price. Additionally, in accorance with 2 CFR sections 200.212 and 200.318(h); 2 CFR section 180.300; 48 CFR section 52.209 6, the Organization must verify that the person with whom you intend to do business is not excluded or disqualified.
Condition Policies and procedures in place over procurement, suspension, and debarment are not in conformance with Uniform Guidance. Additionally, the Organization did not procure in accordance with the regulations, including maintaining records sufficient to detail the history of each procurement transaction nor did they comply with suspension and debarement rules.
Questioned Costs $1,121,985
Identification of How Questioned Costs Were Computed Questioned costs resulted from the Organization not maintaining or using the required procurement procedures over non payroll expenditures. Total non payroll expenditures included on the SEFA total $1,121,985.
Context For all four contracts selected for testing, there were no records manintained to support procurement method, contract selection, or verification the entity was not suspended or disbared. Upon further procedures, we identified that the Organization did not follow any procurement guidelines in procuring all non payroll transactions.
Cause and Effect There are no procurement, suspension, and debarement policies in place. As a result, no procedures are being completed over these compliance categories and thus the Organization did not comply with the related compliance requirements.
Recommendation We recommend the Organization implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance and follow those policies.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with 2 CFR sections 200.318 200.326, the Organization must maintain and use documented procedures for procurement transactions that are consistent with State, local, and tribal laws and regulations and the standards identified in CFR sections 200.317 through 200.327. The Organization must maintain records sufficient to detail the history of each procurement transaction. These records must include the rationale for the procurement method, contract type selection, contractor selection or rejection, and the basis for the contract price. Additionally, in accorance with 2 CFR sections 200.212 and 200.318(h); 2 CFR section 180.300; 48 CFR section 52.209 6, the Organization must verify that the person with whom you intend to do business is not excluded or disqualified.
Condition Policies and procedures in place over procurement, suspension, and debarment are not in conformance with Uniform Guidance. Additionally, the Organization did not procure in accordance with the regulations, including maintaining records sufficient to detail the history of each procurement transaction nor did they comply with suspension and debarement rules.
Questioned Costs $1,121,985
Identification of How Questioned Costs Were Computed Questioned costs resulted from the Organization not maintaining or using the required procurement procedures over non payroll expenditures. Total non payroll expenditures included on the SEFA total $1,121,985.
Context For all four contracts selected for testing, there were no records manintained to support procurement method, contract selection, or verification the entity was not suspended or disbared. Upon further procedures, we identified that the Organization did not follow any procurement guidelines in procuring all non payroll transactions.
Cause and Effect There are no procurement, suspension, and debarement policies in place. As a result, no procedures are being completed over these compliance categories and thus the Organization did not comply with the related compliance requirements.
Recommendation We recommend the Organization implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance and follow those policies.
Views of Responsible Officials and Planned Corrective Actions The Organization will implement written policies and procedures over procurement, suspension, and debarement that conform with Uniform Guidance.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria Federal funds awarded must be expended on allowable costs as defined in 45 CFR Part 75, Subpart E.
Condition Costs with prior written approval to be applied against the C8ECS43729 grant (ALN 93.526) by the federal award agency (HRSA) were coded and applied to the H8FCS40356 grant (ALN 93.224/527).
Questioned Costs $73,464
Identification of How Questioned Costs Were Computed Questioned costs of $73,464 resulted from the entity coding the cost to the wrong grant.
Context During allowability testing over non payroll expenditures, one out of five of the samples was improperly coded to the wrong grant.
Cause and Effect An appropriate review of the Organization's allowable costs was not completed to ensure all costs were coded to the correct grant. The Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including level of review, to ensure all costs are properly coded and applied to the correct grant.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls including level of review, to ensure all costs are properly coded and applied to the correct grant.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria Federal funds awarded must be expended on allowable costs as defined in 45 CFR Part 75, Subpart E.
Condition Costs with prior written approval to be applied against the C8ECS43729 grant (ALN 93.526) by the federal award agency (HRSA) were coded and applied to the H8FCS40356 grant (ALN 93.224/527).
Questioned Costs $73,464
Identification of How Questioned Costs Were Computed Questioned costs of $73,464 resulted from the entity coding the cost to the wrong grant.
Context During allowability testing over non payroll expenditures, one out of five of the samples was improperly coded to the wrong grant.
Cause and Effect An appropriate review of the Organization's allowable costs was not completed to ensure all costs were coded to the correct grant. The Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including level of review, to ensure all costs are properly coded and applied to the correct grant.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls including level of review, to ensure all costs are properly coded and applied to the correct grant.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria Federal funds awarded must be expended on allowable costs as defined in 45 CFR Part 75, Subpart E.
Condition Costs with prior written approval to be applied against the C8ECS43729 grant (ALN 93.526) by the federal award agency (HRSA) were coded and applied to the H8FCS40356 grant (ALN 93.224/527).
Questioned Costs $73,464
Identification of How Questioned Costs Were Computed Questioned costs of $73,464 resulted from the entity coding the cost to the wrong grant.
Context During allowability testing over non payroll expenditures, one out of five of the samples was improperly coded to the wrong grant.
Cause and Effect An appropriate review of the Organization's allowable costs was not completed to ensure all costs were coded to the correct grant. The Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including level of review, to ensure all costs are properly coded and applied to the correct grant.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls including level of review, to ensure all costs are properly coded and applied to the correct grant.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria Federal funds awarded must be expended on allowable costs as defined in 45 CFR Part 75, Subpart E.
Condition Costs with prior written approval to be applied against the C8ECS43729 grant (ALN 93.526) by the federal award agency (HRSA) were coded and applied to the H8FCS40356 grant (ALN 93.224/527).
Questioned Costs $73,464
Identification of How Questioned Costs Were Computed Questioned costs of $73,464 resulted from the entity coding the cost to the wrong grant.
Context During allowability testing over non payroll expenditures, one out of five of the samples was improperly coded to the wrong grant.
Cause and Effect An appropriate review of the Organization's allowable costs was not completed to ensure all costs were coded to the correct grant. The Organization did not comply with the related compliance requirement.
Recommendation We recommend the Organization implement controls, including level of review, to ensure all costs are properly coded and applied to the correct grant.
Views of Responsible Officials and Corrective Action Plan The Organization will implement controls including level of review, to ensure all costs are properly coded and applied to the correct grant.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with notice of awards and the Uniform Data System Health Center Data Reporting Requirements, the health center is required to submit an annual performance report that includes data that reflects all activities in the HRSA health center project.
Condition Due to material entries identified and recorded during the 2022 financial statement audit of the Organization, the data submitted within the annual performance report was not accurate. Additionally, there was no evidence of review over the required reports.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context The lack of timely appropriate reconciliation impacted significant balances recorded on the balance sheet and statement of activities and changes in net assets. For two out of two reports tested, there was no evidience of review.
Cause and Effect The Organization did not have controls in place to ensure that the preparation of account reconciliation occurred appropriately in a timely manner. See finding 2022 001 for entries identified. In addition, subsequently to starting our audit procedures, the Organization provided us with a significant amount of adjusting journal entries. The entries provided by the Organization subsequent to the commencement of the audit impacted several balance sheet accounts, and had and had an overall impact to decrease change in net assets by approximately $2,000,000. As a result, the reports filed with HRSA are materially incorrect. The Organization did not comply with the related compliance requirement.
Recommendation We recommend that controls be put in place to prepare and review accurate reconciliation with supporting information over all accounting cycles in a timely fashion.
Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding and is evaluating options to implement timely reconciliation process.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with notice of awards and the Uniform Data System Health Center Data Reporting Requirements, the health center is required to submit an annual performance report that includes data that reflects all activities in the HRSA health center project.
Condition Due to material entries identified and recorded during the 2022 financial statement audit of the Organization, the data submitted within the annual performance report was not accurate. Additionally, there was no evidence of review over the required reports.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context The lack of timely appropriate reconciliation impacted significant balances recorded on the balance sheet and statement of activities and changes in net assets. For two out of two reports tested, there was no evidience of review.
Cause and Effect The Organization did not have controls in place to ensure that the preparation of account reconciliation occurred appropriately in a timely manner. See finding 2022 001 for entries identified. In addition, subsequently to starting our audit procedures, the Organization provided us with a significant amount of adjusting journal entries. The entries provided by the Organization subsequent to the commencement of the audit impacted several balance sheet accounts, and had and had an overall impact to decrease change in net assets by approximately $2,000,000. As a result, the reports filed with HRSA are materially incorrect. The Organization did not comply with the related compliance requirement.
Recommendation We recommend that controls be put in place to prepare and review accurate reconciliation with supporting information over all accounting cycles in a timely fashion.
Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding and is evaluating options to implement timely reconciliation process.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with notice of awards and the Uniform Data System Health Center Data Reporting Requirements, the health center is required to submit an annual performance report that includes data that reflects all activities in the HRSA health center project.
Condition Due to material entries identified and recorded during the 2022 financial statement audit of the Organization, the data submitted within the annual performance report was not accurate. Additionally, there was no evidence of review over the required reports.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context The lack of timely appropriate reconciliation impacted significant balances recorded on the balance sheet and statement of activities and changes in net assets. For two out of two reports tested, there was no evidience of review.
Cause and Effect The Organization did not have controls in place to ensure that the preparation of account reconciliation occurred appropriately in a timely manner. See finding 2022 001 for entries identified. In addition, subsequently to starting our audit procedures, the Organization provided us with a significant amount of adjusting journal entries. The entries provided by the Organization subsequent to the commencement of the audit impacted several balance sheet accounts, and had and had an overall impact to decrease change in net assets by approximately $2,000,000. As a result, the reports filed with HRSA are materially incorrect. The Organization did not comply with the related compliance requirement.
Recommendation We recommend that controls be put in place to prepare and review accurate reconciliation with supporting information over all accounting cycles in a timely fashion.
Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding and is evaluating options to implement timely reconciliation process.
Assistance Listing, Federal Agency, and Program Name 93.224, 93.527; COVID 19: Health Center Program Cluster
Federal Award Identification Number and Year H80CS24134, H8ECS37956, H8FCS40356, and H8GCS48255 2022
Pass through Entity N/A
Finding Type Material weakness and material noncompliance with laws and regulations
Repeat Finding No
Criteria In accordance with notice of awards and the Uniform Data System Health Center Data Reporting Requirements, the health center is required to submit an annual performance report that includes data that reflects all activities in the HRSA health center project.
Condition Due to material entries identified and recorded during the 2022 financial statement audit of the Organization, the data submitted within the annual performance report was not accurate. Additionally, there was no evidence of review over the required reports.
Questioned Costs None
Identification of How Questioned Costs Were Computed N/A
Context The lack of timely appropriate reconciliation impacted significant balances recorded on the balance sheet and statement of activities and changes in net assets. For two out of two reports tested, there was no evidience of review.
Cause and Effect The Organization did not have controls in place to ensure that the preparation of account reconciliation occurred appropriately in a timely manner. See finding 2022 001 for entries identified. In addition, subsequently to starting our audit procedures, the Organization provided us with a significant amount of adjusting journal entries. The entries provided by the Organization subsequent to the commencement of the audit impacted several balance sheet accounts, and had and had an overall impact to decrease change in net assets by approximately $2,000,000. As a result, the reports filed with HRSA are materially incorrect. The Organization did not comply with the related compliance requirement.
Recommendation We recommend that controls be put in place to prepare and review accurate reconciliation with supporting information over all accounting cycles in a timely fashion.
Views of Responsible Officials and Planned Corrective Actions Management agrees with the finding and is evaluating options to implement timely reconciliation process.