Audit 350343

FY End
2024-06-30
Total Expended
$2.95M
Findings
22
Programs
7
Year: 2024 Accepted: 2025-03-29

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
540578 2024-003 Material Weakness - I
540579 2024-003 Material Weakness - I
540580 2024-003 Material Weakness - I
540581 2024-003 Material Weakness - I
540582 2024-003 Material Weakness - I
540583 2024-004 Material Weakness - L
540584 2024-004 Material Weakness - L
540585 2024-004 Material Weakness - L
540586 2024-004 Material Weakness - L
540587 2024-004 Material Weakness - L
540588 2024-005 Material Weakness - ABH
1117020 2024-003 Material Weakness - I
1117021 2024-003 Material Weakness - I
1117022 2024-003 Material Weakness - I
1117023 2024-003 Material Weakness - I
1117024 2024-003 Material Weakness - I
1117025 2024-004 Material Weakness - L
1117026 2024-004 Material Weakness - L
1117027 2024-004 Material Weakness - L
1117028 2024-004 Material Weakness - L
1117029 2024-004 Material Weakness - L
1117030 2024-005 Material Weakness - ABH

Contacts

Name Title Type
UHH5JSWCGEP5 Danielle Cole Auditee
3363559728 Jansen Otterness Auditor
No contacts on file

Notes to SEFA

Title: Note 1: Basis of Presentation Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Negative amounts shown on the Schedule 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: Triad Adult and Pediatric Medicine, Inc. has elected not to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. The accompanying schedule of expenditures of federal awards (the “Schedule”) includes the federal award activity of Triad Adult and Pediatric Medicine, Inc. under programs of the federal government for the year ended June 30, 2024. The information in this Schedule is presented in accordance with the requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). Because the Schedule presents only a selected portion of the operations of Triad Adult and Pediatric Medicine, Inc., it is not intended to and does not present the financial position, results of operations, changes in net assets or cash flows of Triad Adult and Pediatric Medicine, Inc.
Title: Note 4: Federal Loan Programs Accounting Policies: Expenditures reported on the Schedule are reported on the accrual basis of accounting. Such expenditures are recognized following the cost principles contained in the Uniform Guidance, wherein certain types of expenditures are not allowable or are limited as to reimbursement. Negative amounts shown on the Schedule 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: Triad Adult and Pediatric Medicine, Inc. has elected not to use the 10% de minimis indirect cost rate allowed under the Uniform Guidance. Triad Adult and Pediatric Medicine, Inc. did not have any federal loan programs during the year ended June 30, 2024.

Finding Details

Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Procurement – 45 CFR 75.329 Condition – The Organization did not follow its policy governing procurement requirements for the purchase of goods and services charged to federal awards. Questioned Costs – Unknown Context – A sample of one procurement was tested out of a population of six procurements totaling $605,943. The sample was not, and is not intended to be, statistically valid. The one procurement tested in the amount of $18,277 was not completed in accordance with the Organization’s procurement policy for vendor selection. The Organization’s procurement policy does not specify the micro-purchase limit and ongoing monitoring procedures of suspended and debarred vendors is not defined. Lastly, a sample of one vendor was tested out of a population of four vendors with contracts exceeding $25,000. The Organization did not retain documentation to support initial verification of vendor against the exclusions list. Effect – Purchases were made that did not adhere to the Organization’s procurement policy. Cause – The Organization did not comply with their federal procurement policy. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with Uniform Guidance.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Procurement – 45 CFR 75.329 Condition – The Organization did not follow its policy governing procurement requirements for the purchase of goods and services charged to federal awards. Questioned Costs – Unknown Context – A sample of one procurement was tested out of a population of six procurements totaling $605,943. The sample was not, and is not intended to be, statistically valid. The one procurement tested in the amount of $18,277 was not completed in accordance with the Organization’s procurement policy for vendor selection. The Organization’s procurement policy does not specify the micro-purchase limit and ongoing monitoring procedures of suspended and debarred vendors is not defined. Lastly, a sample of one vendor was tested out of a population of four vendors with contracts exceeding $25,000. The Organization did not retain documentation to support initial verification of vendor against the exclusions list. Effect – Purchases were made that did not adhere to the Organization’s procurement policy. Cause – The Organization did not comply with their federal procurement policy. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with Uniform Guidance.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Procurement – 45 CFR 75.329 Condition – The Organization did not follow its policy governing procurement requirements for the purchase of goods and services charged to federal awards. Questioned Costs – Unknown Context – A sample of one procurement was tested out of a population of six procurements totaling $605,943. The sample was not, and is not intended to be, statistically valid. The one procurement tested in the amount of $18,277 was not completed in accordance with the Organization’s procurement policy for vendor selection. The Organization’s procurement policy does not specify the micro-purchase limit and ongoing monitoring procedures of suspended and debarred vendors is not defined. Lastly, a sample of one vendor was tested out of a population of four vendors with contracts exceeding $25,000. The Organization did not retain documentation to support initial verification of vendor against the exclusions list. Effect – Purchases were made that did not adhere to the Organization’s procurement policy. Cause – The Organization did not comply with their federal procurement policy. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with Uniform Guidance.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Procurement – 45 CFR 75.329 Condition – The Organization did not follow its policy governing procurement requirements for the purchase of goods and services charged to federal awards. Questioned Costs – Unknown Context – A sample of one procurement was tested out of a population of six procurements totaling $605,943. The sample was not, and is not intended to be, statistically valid. The one procurement tested in the amount of $18,277 was not completed in accordance with the Organization’s procurement policy for vendor selection. The Organization’s procurement policy does not specify the micro-purchase limit and ongoing monitoring procedures of suspended and debarred vendors is not defined. Lastly, a sample of one vendor was tested out of a population of four vendors with contracts exceeding $25,000. The Organization did not retain documentation to support initial verification of vendor against the exclusions list. Effect – Purchases were made that did not adhere to the Organization’s procurement policy. Cause – The Organization did not comply with their federal procurement policy. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with Uniform Guidance.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Procurement – 45 CFR 75.329 Condition – The Organization did not follow its policy governing procurement requirements for the purchase of goods and services charged to federal awards. Questioned Costs – Unknown Context – A sample of one procurement was tested out of a population of six procurements totaling $605,943. The sample was not, and is not intended to be, statistically valid. The one procurement tested in the amount of $18,277 was not completed in accordance with the Organization’s procurement policy for vendor selection. The Organization’s procurement policy does not specify the micro-purchase limit and ongoing monitoring procedures of suspended and debarred vendors is not defined. Lastly, a sample of one vendor was tested out of a population of four vendors with contracts exceeding $25,000. The Organization did not retain documentation to support initial verification of vendor against the exclusions list. Effect – Purchases were made that did not adhere to the Organization’s procurement policy. Cause – The Organization did not comply with their federal procurement policy. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with Uniform Guidance.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Reporting – 45 CFR 75.342 Condition – The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year and an annual Federal Financial Report (FFR) for each award and each grant year. These reports are to be prepared using accurate financial information. Questioned Costs – None Context – One report for each report type listed above was selected for testing with specific data from each report selected for testing. The sampling methodology used is not and is not intended to be statistically valid. Of the twenty-four inputs tested, sixteen exceptions were noted related to the UDS report and one exception was noted related to the annual FFR. Effect – Potential errors were made on the annual UDS and annual FFR reports. Cause – The Organization’s policies and procedures did not identify certain errors that were noted on required reports. Multiple exceptions noted on the UDS related to the Organization’s use of an estimate calculation to report patient totals in Table 4 and encounter totals in Table 5 for the 15 attributes selected for testing between the two tables. The Organization was unable to provide documentation to explain a $13,000 variance for one of the attributes selected for testing in Table 8A. The final UDS error was related to the overreporting of slide discounts and underreporting of other adjustments associated with nurse only visits coded in the practice management system. Program income was not reported on the annual FFR and therefore did not reflect the Organization’s patient service revenue from activities within scope of the health center program. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should revise policies and procedures over federal reporting to ensure reports are prepared using accurate information and supporting documentation for federal grant reports should be maintained.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Reporting – 45 CFR 75.342 Condition – The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year and an annual Federal Financial Report (FFR) for each award and each grant year. These reports are to be prepared using accurate financial information. Questioned Costs – None Context – One report for each report type listed above was selected for testing with specific data from each report selected for testing. The sampling methodology used is not and is not intended to be statistically valid. Of the twenty-four inputs tested, sixteen exceptions were noted related to the UDS report and one exception was noted related to the annual FFR. Effect – Potential errors were made on the annual UDS and annual FFR reports. Cause – The Organization’s policies and procedures did not identify certain errors that were noted on required reports. Multiple exceptions noted on the UDS related to the Organization’s use of an estimate calculation to report patient totals in Table 4 and encounter totals in Table 5 for the 15 attributes selected for testing between the two tables. The Organization was unable to provide documentation to explain a $13,000 variance for one of the attributes selected for testing in Table 8A. The final UDS error was related to the overreporting of slide discounts and underreporting of other adjustments associated with nurse only visits coded in the practice management system. Program income was not reported on the annual FFR and therefore did not reflect the Organization’s patient service revenue from activities within scope of the health center program. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should revise policies and procedures over federal reporting to ensure reports are prepared using accurate information and supporting documentation for federal grant reports should be maintained.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Reporting – 45 CFR 75.342 Condition – The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year and an annual Federal Financial Report (FFR) for each award and each grant year. These reports are to be prepared using accurate financial information. Questioned Costs – None Context – One report for each report type listed above was selected for testing with specific data from each report selected for testing. The sampling methodology used is not and is not intended to be statistically valid. Of the twenty-four inputs tested, sixteen exceptions were noted related to the UDS report and one exception was noted related to the annual FFR. Effect – Potential errors were made on the annual UDS and annual FFR reports. Cause – The Organization’s policies and procedures did not identify certain errors that were noted on required reports. Multiple exceptions noted on the UDS related to the Organization’s use of an estimate calculation to report patient totals in Table 4 and encounter totals in Table 5 for the 15 attributes selected for testing between the two tables. The Organization was unable to provide documentation to explain a $13,000 variance for one of the attributes selected for testing in Table 8A. The final UDS error was related to the overreporting of slide discounts and underreporting of other adjustments associated with nurse only visits coded in the practice management system. Program income was not reported on the annual FFR and therefore did not reflect the Organization’s patient service revenue from activities within scope of the health center program. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should revise policies and procedures over federal reporting to ensure reports are prepared using accurate information and supporting documentation for federal grant reports should be maintained.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Reporting – 45 CFR 75.342 Condition – The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year and an annual Federal Financial Report (FFR) for each award and each grant year. These reports are to be prepared using accurate financial information. Questioned Costs – None Context – One report for each report type listed above was selected for testing with specific data from each report selected for testing. The sampling methodology used is not and is not intended to be statistically valid. Of the twenty-four inputs tested, sixteen exceptions were noted related to the UDS report and one exception was noted related to the annual FFR. Effect – Potential errors were made on the annual UDS and annual FFR reports. Cause – The Organization’s policies and procedures did not identify certain errors that were noted on required reports. Multiple exceptions noted on the UDS related to the Organization’s use of an estimate calculation to report patient totals in Table 4 and encounter totals in Table 5 for the 15 attributes selected for testing between the two tables. The Organization was unable to provide documentation to explain a $13,000 variance for one of the attributes selected for testing in Table 8A. The final UDS error was related to the overreporting of slide discounts and underreporting of other adjustments associated with nurse only visits coded in the practice management system. Program income was not reported on the annual FFR and therefore did not reflect the Organization’s patient service revenue from activities within scope of the health center program. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should revise policies and procedures over federal reporting to ensure reports are prepared using accurate information and supporting documentation for federal grant reports should be maintained.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Reporting – 45 CFR 75.342 Condition – The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year and an annual Federal Financial Report (FFR) for each award and each grant year. These reports are to be prepared using accurate financial information. Questioned Costs – None Context – One report for each report type listed above was selected for testing with specific data from each report selected for testing. The sampling methodology used is not and is not intended to be statistically valid. Of the twenty-four inputs tested, sixteen exceptions were noted related to the UDS report and one exception was noted related to the annual FFR. Effect – Potential errors were made on the annual UDS and annual FFR reports. Cause – The Organization’s policies and procedures did not identify certain errors that were noted on required reports. Multiple exceptions noted on the UDS related to the Organization’s use of an estimate calculation to report patient totals in Table 4 and encounter totals in Table 5 for the 15 attributes selected for testing between the two tables. The Organization was unable to provide documentation to explain a $13,000 variance for one of the attributes selected for testing in Table 8A. The final UDS error was related to the overreporting of slide discounts and underreporting of other adjustments associated with nurse only visits coded in the practice management system. Program income was not reported on the annual FFR and therefore did not reflect the Organization’s patient service revenue from activities within scope of the health center program. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should revise policies and procedures over federal reporting to ensure reports are prepared using accurate information and supporting documentation for federal grant reports should be maintained.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award No. 6 H80CS26514-04-00 Criteria or Specific Requirement – Activities Allowed or Unallowed and Allowable Costs/Cost Principles - 45 CFR 75.403(g) and Period of Performance - 45 CFR 75.309. Condition – The Organization is required to maintain a system of internal control over compliance to ensure expenditures applied to federal awards are allowable, meet Federal cost principles, and fall within the period of performance. Context - The Organization was subject to a limited scope review by the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Financial Integrity. This review examined the Organization's compliance with certain requirements related to the Access Increases in Mental Health and Substance Abuse Services Supplemental Funding (AIMS), which covered a period of from September 1, 2017 through February 28, 2019, following an approved carryover request. The review identified certain expenditures that fell outside the period of performance or were not supported by appropriate documentation. Questioned Costs - $55,112 Effect - The Organization was not in compliance with the requirements relating to activities allowed or unallowed, allowable costs/cost principles, and period of performance and were required to repay the questioned costs to the granting agency. Cause - The Organization's policies and procedures did not allow for proper cut-off of expenditures as it applied to the AIMS grant. In addition, the Organization's policies and procedures did not prevent certain costs from being applied to the AIMS grant twice. Identification as a repeat finding, if applicable - Not a repeat finding. Recommendation - The Organization should revise its policies and procedures over related to grant expenditures cut-off and tracking to ensure compliant grants management.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Procurement – 45 CFR 75.329 Condition – The Organization did not follow its policy governing procurement requirements for the purchase of goods and services charged to federal awards. Questioned Costs – Unknown Context – A sample of one procurement was tested out of a population of six procurements totaling $605,943. The sample was not, and is not intended to be, statistically valid. The one procurement tested in the amount of $18,277 was not completed in accordance with the Organization’s procurement policy for vendor selection. The Organization’s procurement policy does not specify the micro-purchase limit and ongoing monitoring procedures of suspended and debarred vendors is not defined. Lastly, a sample of one vendor was tested out of a population of four vendors with contracts exceeding $25,000. The Organization did not retain documentation to support initial verification of vendor against the exclusions list. Effect – Purchases were made that did not adhere to the Organization’s procurement policy. Cause – The Organization did not comply with their federal procurement policy. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with Uniform Guidance.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Procurement – 45 CFR 75.329 Condition – The Organization did not follow its policy governing procurement requirements for the purchase of goods and services charged to federal awards. Questioned Costs – Unknown Context – A sample of one procurement was tested out of a population of six procurements totaling $605,943. The sample was not, and is not intended to be, statistically valid. The one procurement tested in the amount of $18,277 was not completed in accordance with the Organization’s procurement policy for vendor selection. The Organization’s procurement policy does not specify the micro-purchase limit and ongoing monitoring procedures of suspended and debarred vendors is not defined. Lastly, a sample of one vendor was tested out of a population of four vendors with contracts exceeding $25,000. The Organization did not retain documentation to support initial verification of vendor against the exclusions list. Effect – Purchases were made that did not adhere to the Organization’s procurement policy. Cause – The Organization did not comply with their federal procurement policy. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with Uniform Guidance.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Procurement – 45 CFR 75.329 Condition – The Organization did not follow its policy governing procurement requirements for the purchase of goods and services charged to federal awards. Questioned Costs – Unknown Context – A sample of one procurement was tested out of a population of six procurements totaling $605,943. The sample was not, and is not intended to be, statistically valid. The one procurement tested in the amount of $18,277 was not completed in accordance with the Organization’s procurement policy for vendor selection. The Organization’s procurement policy does not specify the micro-purchase limit and ongoing monitoring procedures of suspended and debarred vendors is not defined. Lastly, a sample of one vendor was tested out of a population of four vendors with contracts exceeding $25,000. The Organization did not retain documentation to support initial verification of vendor against the exclusions list. Effect – Purchases were made that did not adhere to the Organization’s procurement policy. Cause – The Organization did not comply with their federal procurement policy. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with Uniform Guidance.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Procurement – 45 CFR 75.329 Condition – The Organization did not follow its policy governing procurement requirements for the purchase of goods and services charged to federal awards. Questioned Costs – Unknown Context – A sample of one procurement was tested out of a population of six procurements totaling $605,943. The sample was not, and is not intended to be, statistically valid. The one procurement tested in the amount of $18,277 was not completed in accordance with the Organization’s procurement policy for vendor selection. The Organization’s procurement policy does not specify the micro-purchase limit and ongoing monitoring procedures of suspended and debarred vendors is not defined. Lastly, a sample of one vendor was tested out of a population of four vendors with contracts exceeding $25,000. The Organization did not retain documentation to support initial verification of vendor against the exclusions list. Effect – Purchases were made that did not adhere to the Organization’s procurement policy. Cause – The Organization did not comply with their federal procurement policy. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with Uniform Guidance.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Procurement – 45 CFR 75.329 Condition – The Organization did not follow its policy governing procurement requirements for the purchase of goods and services charged to federal awards. Questioned Costs – Unknown Context – A sample of one procurement was tested out of a population of six procurements totaling $605,943. The sample was not, and is not intended to be, statistically valid. The one procurement tested in the amount of $18,277 was not completed in accordance with the Organization’s procurement policy for vendor selection. The Organization’s procurement policy does not specify the micro-purchase limit and ongoing monitoring procedures of suspended and debarred vendors is not defined. Lastly, a sample of one vendor was tested out of a population of four vendors with contracts exceeding $25,000. The Organization did not retain documentation to support initial verification of vendor against the exclusions list. Effect – Purchases were made that did not adhere to the Organization’s procurement policy. Cause – The Organization did not comply with their federal procurement policy. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should review its procurement policy and ensure proper staff education on the policy is established. In addition, the Organization should review the policy on an annual basis to ensure it is consistent with Uniform Guidance.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Reporting – 45 CFR 75.342 Condition – The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year and an annual Federal Financial Report (FFR) for each award and each grant year. These reports are to be prepared using accurate financial information. Questioned Costs – None Context – One report for each report type listed above was selected for testing with specific data from each report selected for testing. The sampling methodology used is not and is not intended to be statistically valid. Of the twenty-four inputs tested, sixteen exceptions were noted related to the UDS report and one exception was noted related to the annual FFR. Effect – Potential errors were made on the annual UDS and annual FFR reports. Cause – The Organization’s policies and procedures did not identify certain errors that were noted on required reports. Multiple exceptions noted on the UDS related to the Organization’s use of an estimate calculation to report patient totals in Table 4 and encounter totals in Table 5 for the 15 attributes selected for testing between the two tables. The Organization was unable to provide documentation to explain a $13,000 variance for one of the attributes selected for testing in Table 8A. The final UDS error was related to the overreporting of slide discounts and underreporting of other adjustments associated with nurse only visits coded in the practice management system. Program income was not reported on the annual FFR and therefore did not reflect the Organization’s patient service revenue from activities within scope of the health center program. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should revise policies and procedures over federal reporting to ensure reports are prepared using accurate information and supporting documentation for federal grant reports should be maintained.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Reporting – 45 CFR 75.342 Condition – The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year and an annual Federal Financial Report (FFR) for each award and each grant year. These reports are to be prepared using accurate financial information. Questioned Costs – None Context – One report for each report type listed above was selected for testing with specific data from each report selected for testing. The sampling methodology used is not and is not intended to be statistically valid. Of the twenty-four inputs tested, sixteen exceptions were noted related to the UDS report and one exception was noted related to the annual FFR. Effect – Potential errors were made on the annual UDS and annual FFR reports. Cause – The Organization’s policies and procedures did not identify certain errors that were noted on required reports. Multiple exceptions noted on the UDS related to the Organization’s use of an estimate calculation to report patient totals in Table 4 and encounter totals in Table 5 for the 15 attributes selected for testing between the two tables. The Organization was unable to provide documentation to explain a $13,000 variance for one of the attributes selected for testing in Table 8A. The final UDS error was related to the overreporting of slide discounts and underreporting of other adjustments associated with nurse only visits coded in the practice management system. Program income was not reported on the annual FFR and therefore did not reflect the Organization’s patient service revenue from activities within scope of the health center program. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should revise policies and procedures over federal reporting to ensure reports are prepared using accurate information and supporting documentation for federal grant reports should be maintained.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Reporting – 45 CFR 75.342 Condition – The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year and an annual Federal Financial Report (FFR) for each award and each grant year. These reports are to be prepared using accurate financial information. Questioned Costs – None Context – One report for each report type listed above was selected for testing with specific data from each report selected for testing. The sampling methodology used is not and is not intended to be statistically valid. Of the twenty-four inputs tested, sixteen exceptions were noted related to the UDS report and one exception was noted related to the annual FFR. Effect – Potential errors were made on the annual UDS and annual FFR reports. Cause – The Organization’s policies and procedures did not identify certain errors that were noted on required reports. Multiple exceptions noted on the UDS related to the Organization’s use of an estimate calculation to report patient totals in Table 4 and encounter totals in Table 5 for the 15 attributes selected for testing between the two tables. The Organization was unable to provide documentation to explain a $13,000 variance for one of the attributes selected for testing in Table 8A. The final UDS error was related to the overreporting of slide discounts and underreporting of other adjustments associated with nurse only visits coded in the practice management system. Program income was not reported on the annual FFR and therefore did not reflect the Organization’s patient service revenue from activities within scope of the health center program. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should revise policies and procedures over federal reporting to ensure reports are prepared using accurate information and supporting documentation for federal grant reports should be maintained.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Reporting – 45 CFR 75.342 Condition – The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year and an annual Federal Financial Report (FFR) for each award and each grant year. These reports are to be prepared using accurate financial information. Questioned Costs – None Context – One report for each report type listed above was selected for testing with specific data from each report selected for testing. The sampling methodology used is not and is not intended to be statistically valid. Of the twenty-four inputs tested, sixteen exceptions were noted related to the UDS report and one exception was noted related to the annual FFR. Effect – Potential errors were made on the annual UDS and annual FFR reports. Cause – The Organization’s policies and procedures did not identify certain errors that were noted on required reports. Multiple exceptions noted on the UDS related to the Organization’s use of an estimate calculation to report patient totals in Table 4 and encounter totals in Table 5 for the 15 attributes selected for testing between the two tables. The Organization was unable to provide documentation to explain a $13,000 variance for one of the attributes selected for testing in Table 8A. The final UDS error was related to the overreporting of slide discounts and underreporting of other adjustments associated with nurse only visits coded in the practice management system. Program income was not reported on the annual FFR and therefore did not reflect the Organization’s patient service revenue from activities within scope of the health center program. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should revise policies and procedures over federal reporting to ensure reports are prepared using accurate information and supporting documentation for federal grant reports should be maintained.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award Nos. 6 H80CS26514-10-02, 3 H8FCS40655-01-01, 4 H8GCS47538-01-01, 1 H8LCS50783-01-00 Criteria or Specific Requirement – Reporting – 45 CFR 75.342 Condition – The Organization is required to prepare and submit an annual Uniform Data System (UDS) report for each calendar year and an annual Federal Financial Report (FFR) for each award and each grant year. These reports are to be prepared using accurate financial information. Questioned Costs – None Context – One report for each report type listed above was selected for testing with specific data from each report selected for testing. The sampling methodology used is not and is not intended to be statistically valid. Of the twenty-four inputs tested, sixteen exceptions were noted related to the UDS report and one exception was noted related to the annual FFR. Effect – Potential errors were made on the annual UDS and annual FFR reports. Cause – The Organization’s policies and procedures did not identify certain errors that were noted on required reports. Multiple exceptions noted on the UDS related to the Organization’s use of an estimate calculation to report patient totals in Table 4 and encounter totals in Table 5 for the 15 attributes selected for testing between the two tables. The Organization was unable to provide documentation to explain a $13,000 variance for one of the attributes selected for testing in Table 8A. The final UDS error was related to the overreporting of slide discounts and underreporting of other adjustments associated with nurse only visits coded in the practice management system. Program income was not reported on the annual FFR and therefore did not reflect the Organization’s patient service revenue from activities within scope of the health center program. Identification as a repeat finding, if applicable – Not a repeat finding. Recommendation – The Organization should revise policies and procedures over federal reporting to ensure reports are prepared using accurate information and supporting documentation for federal grant reports should be maintained.
Health Center Program Cluster Assistance Listing Nos. 93.224 and 93.527 U.S Department of Health and Human Services Award No. 6 H80CS26514-04-00 Criteria or Specific Requirement – Activities Allowed or Unallowed and Allowable Costs/Cost Principles - 45 CFR 75.403(g) and Period of Performance - 45 CFR 75.309. Condition – The Organization is required to maintain a system of internal control over compliance to ensure expenditures applied to federal awards are allowable, meet Federal cost principles, and fall within the period of performance. Context - The Organization was subject to a limited scope review by the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Financial Integrity. This review examined the Organization's compliance with certain requirements related to the Access Increases in Mental Health and Substance Abuse Services Supplemental Funding (AIMS), which covered a period of from September 1, 2017 through February 28, 2019, following an approved carryover request. The review identified certain expenditures that fell outside the period of performance or were not supported by appropriate documentation. Questioned Costs - $55,112 Effect - The Organization was not in compliance with the requirements relating to activities allowed or unallowed, allowable costs/cost principles, and period of performance and were required to repay the questioned costs to the granting agency. Cause - The Organization's policies and procedures did not allow for proper cut-off of expenditures as it applied to the AIMS grant. In addition, the Organization's policies and procedures did not prevent certain costs from being applied to the AIMS grant twice. Identification as a repeat finding, if applicable - Not a repeat finding. Recommendation - The Organization should revise its policies and procedures over related to grant expenditures cut-off and tracking to ensure compliant grants management.