FAC Explorer

Audit 35416

FY End
2022-08-31
Total Expended
$5.23M
Findings
2
Programs
6
Organization: Rural Health, Inc. (IL)
Year: 2022 Accepted: 2023-01-29
Auditor: Kemper CPA Group LLP

Organization Exclusion Status:

Findings

ID Ref Severity Repeat Requirement
33366 2022-001 Significant Deficiency - N
609808 2022-001 Significant Deficiency - N

Programs

ALN Program Spent Major Findings
93.224 Consolidated Health Centers (community Health Centers, Migrant Health Centers, Health Care for the Homeless, and Public Housing Primary Care) $4.16M Yes 1
93.526 Affordable Care Act (aca) Grants for Capital Development in Health Centers $659,357 - 0
93.912 Rural Health Care Services Outreach, Rural Health Network Development and Small Health Care Provider Quality Improvement $326,437 - 0
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $76,112 - 0
93.268 Immunization Cooperative Agreements $6,875 - 0
93.236 Grants to States to Support Oral Health Workforce Activities $3,150 - 0

Contacts

Name Title Type
KGK1FJ3NHJ64 Robert Odum, CPA Auditee
6188334800 Kimberly Walker, CPA Auditor
No contacts on file

Notes to SEFA

Title: Subrecipients Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards includes the federal grant activity of Rural Health, Inc. and is presented on the accrual basis accounting. The information in this schedule is presented for purposes of additional analysis 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). Therefore, some amounts represented in this schedule may differ from amounts presented in, or used in preparation of, the basic financial statements. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Rural Health, Inc. did not provide any amount of federal awards to subrecipients during the fiscal year ended August 31, 2022.
Title: Non-Cash Assistance or Loans Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards includes the federal grant activity of Rural Health, Inc. and is presented on the accrual basis accounting. The information in this schedule is presented for purposes of additional analysis 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). Therefore, some amounts represented in this schedule may differ from amounts presented in, or used in preparation of, the basic financial statements. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Rural Health, Inc. did not receive any non-cash assistance during the fiscal year ended August 31, 2022.
Title: Amount of Insurance Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards includes the federal grant activity of Rural Health, Inc. and is presented on the accrual basis accounting. The information in this schedule is presented for purposes of additional analysis 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). Therefore, some amounts represented in this schedule may differ from amounts presented in, or used in preparation of, the basic financial statements. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. Significant losses are covered by commercial insurance for all major programs: property, liability, and workers compensation. During the year ended August 31, 2022, there were no significant reductions in coverage. Also, there have been no settlement amounts, which have exceeded insurance coverage in the past three years.
Title: Loans or Loan Guarantees Outstanding Accounting Policies: The accompanying Schedule of Expenditures of Federal Awards includes the federal grant activity of Rural Health, Inc. and is presented on the accrual basis accounting. The information in this schedule is presented for purposes of additional analysis 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). Therefore, some amounts represented in this schedule may differ from amounts presented in, or used in preparation of, the basic financial statements. De Minimis Rate Used: N Rate Explanation: The auditee did not use the de minimis cost rate. At August 31, 2022, Rural Health, Inc. had no loans outstanding.

Finding Details

Finding 2022-001
FINDING NO. 2022-001: Ineffective Internal Controls over Sliding Fee Revenues Federal Program Name Health Center Program Project NO. H80CS00711-20-03, H80CS00711-21-04 CFDA # 93.224 Federal Agency Department of Health and Human Services Criteria/Specific Requirement: The Organization is responsible for establishing and maintaining an internal control system over sliding fee and clinic service eligibility requirements. Specifically, 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 as follows: ? Sliding fee discounts are applied to fees for health center services provided to all individuals and families with annual incomes at or below 200 percent of the Federal Poverty Guidelines (FPG); ? A full discount is applied to fees for health center services provided to individuals and families with annual incomes at or below 100 percent of the FPG, or the health center applies only a nominal charge; ? Fees for health center services are discounted based on graduations in family size and income for individuals and families with incomes above 100 and at or below 200 percent of the FPG; and ? No sliding fee discount is applied to fees for health center services provided to individuals and families within 200 percent or more of the FPG. Condition: During the compliance testing of the Uniform Guidance ?Special Tests and Provisions ? Sliding Fee Applications? requirements, we noted the following exceptions: ? For three (3) out of forty (40) sliding fee applications the annual income calculated was incorrect. Questioned Costs: N/A Context: Exceptions were noted in 3 of the 40 sliding fee patients tested. Effect: Incorrect sliding fee income calculations could result in the incorrect sliding fee being charged to the patient. Cause: Lack of oversight over sliding fee applications and calculations. Recommendation: Management should take steps to ensure procedures over sliding fee applications are properly designed and operating effectively. Management?s Response: Management agrees with the finding.
Finding 2022-001
FINDING NO. 2022-001: Ineffective Internal Controls over Sliding Fee Revenues Federal Program Name Health Center Program Project NO. H80CS00711-20-03, H80CS00711-21-04 CFDA # 93.224 Federal Agency Department of Health and Human Services Criteria/Specific Requirement: The Organization is responsible for establishing and maintaining an internal control system over sliding fee and clinic service eligibility requirements. Specifically, 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 as follows: ? Sliding fee discounts are applied to fees for health center services provided to all individuals and families with annual incomes at or below 200 percent of the Federal Poverty Guidelines (FPG); ? A full discount is applied to fees for health center services provided to individuals and families with annual incomes at or below 100 percent of the FPG, or the health center applies only a nominal charge; ? Fees for health center services are discounted based on graduations in family size and income for individuals and families with incomes above 100 and at or below 200 percent of the FPG; and ? No sliding fee discount is applied to fees for health center services provided to individuals and families within 200 percent or more of the FPG. Condition: During the compliance testing of the Uniform Guidance ?Special Tests and Provisions ? Sliding Fee Applications? requirements, we noted the following exceptions: ? For three (3) out of forty (40) sliding fee applications the annual income calculated was incorrect. Questioned Costs: N/A Context: Exceptions were noted in 3 of the 40 sliding fee patients tested. Effect: Incorrect sliding fee income calculations could result in the incorrect sliding fee being charged to the patient. Cause: Lack of oversight over sliding fee applications and calculations. Recommendation: Management should take steps to ensure procedures over sliding fee applications are properly designed and operating effectively. Management?s Response: Management agrees with the finding.